5 Things to Consider Before Returning to Exercise After Pregnancy
The million-dollar question people have when they’re nearing delivery, or after having a child is, “When can (or should) I start exercising again?” The motivation for wanting to initiate exercise may be different from one person to the next, and not everyone has the same amount of time to commit to exercise in their week. So, I don’t want this blog to to focus on a specific way to exercise or type of exercise that you should be doing. I want to discuss one major factor to beware of when returning and 4 ways to identify when your body and pelvic floor are ready to return to exercise.
FIRST thing…beware of the comparison game
Whether is it hearing about how Candace Parker returned to her WNBA season 7 weeks after delivering her daughter, Paula Radcliffe winning the 2007 NYC Marathon less than 10 months after having a child, or seeing your friends’ posts on Instagram; sometimes we let ourselves believe, “If they can do it, so can I!” But you need to remember that everyone’s recovery looks different because all of our bodies are unique!
Comparison to anyone, especially to an elite athlete, is the worst thing you can do when returning to exercise after carrying a child (or multiple children) inside of you for 9 months and then enduring labor and delivery. I remember going into my first pregnancy thinking I was going to be exercising regularly by the 6-8 week mark after delivery. Well, that certainly did not happen. Not only was I not back to exercising 8 weeks post-delivery, but I couldn't even put on a sports-bra because I was having such a hard time with breastfeeding. When my initial expectations did not meet my reality, it made recovery that much harder; especially when I saw the 4th trimester going so differently for friends and people I follow on Instagram.
Lesson Learned: The comparison game is a waste. Avoid at all costs.
How to identify if your body is ready for and responding well to exercise (4 things)
The easy answer to when it is safe to return to exercise after childbirth is: “It depends.” The ACOG (American College of Obstetricians and Gynecologists) states that if you have an uncomplicated pregnancy with a normal vaginal delivery, you can start whenever it feels right; however, if you had a cesarean section or complicated pregnancy/delivery, you should check with your OBGYN prior to initiating exercise.
Remember that exercise can be defined as going for a 10-minute walk, and it does not necessarily mean full participation in a CrossFit class or going out for a 3-mile run. So, you are probably safe to start walking and doing some gentle movement whenever it feels right for you. The tricky part is knowing when to return to more moderate or high intensity exercise. Here are some tips on how to know when your body is ready for more complex movements, strength training, and running.
Assuming vaginal bleeding has ceased or does not increase with or after exercise, continue your progression of exercise if:
Movements are pain-free (specifically in the back, abdomen, hips, and pelvic region). Soreness is to be expected, but sharp pain in any of these areas could mean that your body has not had sufficient healing time or that something else may be going on that is out of your control. If you have successfully initiated exercise and then experience pain as you progress to the next level of difficulty, you can try to back off a little bit and do with something that hadn’t been bothering you in the past for a few days before trying to progress again. Remember, a little bit of movement is better than no movement.
You are not experiencing significant heaviness/pressure in your pelvic region. Prolapse is when the pelvic organs can move out of their normal position (usually to a lower position). This is more common in people who have had 1 or more vaginal delivery. Sometimes a symptom of prolapse is feeling increased heaviness/pressure in your pelvic region. Fear not, the level of symptoms does not always correlate with the degree of prolapse. This is a common diagnosis that pelvic floor therapists have great success treating!
You are not leaking urine, fecal material, or gas. Some degree of leakage is likely to occur in the early stages of recovery. This is not something to be discouraged by, but it can help you know whether the exercise you are trying to participate in is the right level of difficulty. Continual leaking should be a sign that you are hitting a threshold of exercise or movement that is too difficult without specific treatment.
You can breathe through exercises and avoid significant coning/doming in abdomen. Remember when you were pregnant and you tried to sit straight up and your belly looked like it grew forward? That is what “coning or doming” looks like. It is normal during pregnancy as your abdominal muscles drift further apart to make room for your growing belly. Some degree of separation is normal in the early stages of postpartum delivery, and you most certainly don’t need to be afraid of this happening every once in a while. The main things to be aware of in regards to this topic is that you should be able to breathe and carry on a conversation when first starting out with exercise. As you progress into more difficult activity, if you feel any abdominal pain or weakness and see consistent coning/doming, that would be when you should consult a physical therapist.
If you notice any difficulty with the above 4 issues when trying to initiate exercise or progress in exercise after childbirth, call us at Active Alliance Physical Therapy! These issues are common, but you should not have to deal with them forever after having a child. A pelvic floor therapist is specifically trained to address these issues and help guide you in your return to exercise. Stay tuned for more posts regarding exercise and your pregnancy/postpartum journey!
- Jenna Banks, DPT
