This one is for all the moms out there.
You carried and birthed a child. And whether the birth was natural or a cesarean, your body did something truly amazing – you should be proud of it and of yourself!
But are you allowed to be?
Everyone is asking about the baby. And, once you’re discharged from the hospital, things start to feel off (and not just because of lack of sleep). Your body is physically not your own anymore - you shared it for nine months. Your mental health may take a toll due to new-mom stress and lack of rest. You eat what you can, when you can.
Once you have your postpartum check-up (about 6 weeks after delivery), your doctor tells you that you look healed up and you can go back to exercise and doing physical activity.
BUT WHAT DOES THIS MEAN?
I had no idea that the postpartum journey could be lonely until I started talking to moms who had birth trauma, postpartum anxiety or didn’t know how to ask for help. It’s absurd, right?!, that women go through more changes in nine months than men will go through in their entire life. And we handle it like champs and act like it’s no big deal.
I am here to tell you it is a big deal - actually, its a huge deal.
As a personal trainer, my focus is not only on making sure mom is returning to exercise safely, but also providing resources for both the perinatal and postpartum periods of her life. This blog will focus only on returning to exercise postpartum, but there are many other aspects such as nutritional deficiencies and mental health that you should also familiarize yourself with to make sure you recover properly.
Here are the four things that I believe are most important when it comes to returning to exercise postpartum:
1. Take Your Time and Rest
One of my favorite pieces of advice is from my colleague Dr. Candace Giesecki, who says: “The first six weeks should focus on being in (first two weeks), on (the next two weeks), and around (last two weeks) the bed. Meaning your body performed the most tremendous physical act it ever will, so take your rest. Light walks and stretching appropriately are great.
Most women will have a postpartum checkup around six weeks (maybe eight if they had a cesarean). The doctor might say “all looks good and healed,” but what does this mean in terms of what you can do for exercise?
2. Stabilize & Strengthen your Pelvic Floor
I recommend getting assessed by a pelvic floor physical therapist (this is actually a great thing to do while pregnant as well). Best case, you have little to no issues and can go on your merry way. Worse case, you have a few things you need to work on and then you can progress back to regular exercise with supervision from your physical therapist.
It’s so important to note that “regular” exercise will look different, too!
I always say: “When someone tears their rotator cuff, they go to rehab, right? Then they gradually start working back to where they were prior to the injury – sometimes, this takes up to a year.”
Returning to exercise after pregnancy is also a bit of rehab. We wouldn’t tell someone who hurt their shoulder: “Hey, go back to throwing a ball in eight weeks.” We gradually get them back to where they were with proper movement patterns and rest.
The same expectation should be considered for women who are newly postpartum. Their bodies need to rest and rehab just like any other body that’s experienced an injury or a surgery.
I think it’s great when women can start running and doing more high-intensity workouts again, but going back too fast or too soon can have long-term consequences like incontinence, pelvic organ prolapse or bulging discs.
Slow and steady is definitely key here to be mindful of preventing injuries down the line.
3. What Should I Be Doing For Exercise?
This can vary from person to person, but my postpartum clients typically start out with something similar to what they were doing for their “prehab” to get ready for birth and labor.
For some, this may mean a 20 minute walk.
For others, this may be getting back to your studio or gym and easing back into your routine.
For my clients, this usually includes some kind of squat variation, rows, presses (both shoulder and chest), glute dominant exercises such as bridges or thrusters and – if there is no doming or coning in the abdomen – a core exercise like a half kneeling pallof press.
I tend to stay away from crunch-type movements due to the pressure or discomfort it can cause on the low back (I rarely program them for private clients).
Everyone should make sure their pelvic floor and core are stabile before trying more advanced, weighted moves. This is so important to prevent injuries and long term issues.
Warming up is also important. My warm-ups for my clients include deep diaphragmatic breathing and opening up the back and shoulders with simple exercises since mom is typically in a more forward position initially with carrying baby, breastfeeding, etc. One of my favorites is open book (moms love it)!
I typically ease my moms back in over a nine-month period (just like pregnancy), progressing each performance plan as she is feeling stronger and more capable of heavier lifting and, most importantly, engaging her core properly.
My favorite part of the process is seeing her newly postpartum, not sure what she should be doing exercise-wise while she figures out her life with baby to seeing her confidence grow while she embraces her inner and outer strength.
4. Scar Massage For C-Sections
A topic that is sometimes not brought up around cesarean recovery is that of self-scar massage. Six to 18 percent of the 1.27 million women who have cesareans in the U.S. may have chronic scar pain related to their cesarean surgery, resulting in difficulty and pain with daily activities – including childcare – and can contribute to hip and back pain.*
At about six to eight weeks postpartum, tissue massage can be applied. You can stretch the tissues by sinking the pads of your fingers down into the tissue above, below and adjacent to the healed incision and pulling or pushing in a direction that feels restricted for a brief time. Remember to work in every direction to get the full benefits.
Other helpful techniques can include massaging in a circle and skin rolling, where you take the tissue and roll it in a multi-directional way between your fingers (this may be uncomfortable and feel a bit like a rug burn, so work your way up to it).
There should never be any bleeding, redness lasting more than a few hours or open incision site after self-massage.
Many of these techniques can be applied three to five minutes per day but can be challenging to do on your own since we’re often reluctant to perform activities that we know cause pain. In addition, it may also be difficult to get at some of the angles. If you’re ever worried that you may be doing the wrong thing, most pelvic physical therapists can assess your technique and give you recommendations as well as treatment that can help you with your scar.
I hope that these tips help you or someone you know who is expecting or newly postpartum. It is never too late to begin exercising again! I have had some clients start with me seven to eight months postpartum and they were really happy when they were finished with their program. I always say: “You cannot pour from an empty cup.” Taking time for yourself helps immensely in all areas of motherhood and life.
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About the Author:
Laura Thomas, CPT-ACE, Certified Pre/Postnatal Coach, OTA Grad, is a fitness coach based in Cleveland, Ohio, who specializes in pre- and postnatal as well as pre- and postmenopausal women. She helps them find confidence through exercise while working within their time constraints. Laura also trains clients online throughout the greater U.S. as a 2019 graduate of the Online Training Academy. She is currently working on her 200-hour yoga teacher training.
For more information, check out https://www.thomasfitnessconsulting.com or @thomasfitnessconsulting on IG and FB.