The Do's and Don'ts of Postnatal Exercise
7 min read
Postnatal
exercise
Your questions answered
Postnatal exercise is a very complex territory. We all have different birth experiences and our bodies heal at their own, unique pace. Some of us suffer from birth injuries or dysfunctions such as prolapse which dictate what we can and can’t do exercise wise.
This new article from our contributor and PT Paulina Szymanska will answer some of the most common questions we’ve received from women during their postnatal period, whether they’ve their first, second or third baby.
The key to exercising postpartum is accepting that every person recovers from birth at a different pace, paying attention to your body’s cues and consulting with a medical professional before you begin any exercise regimen.
Be warned, having a GP’s sign-off or even a physio plan doesn’t mean you’re ready to jump straight into a boot camp class. I am all for high intensity, but 30 minutes doing jump lunges and burpees could be better spent regaining control of your core and pelvic floor first.
Q. How long after childbirth can I start exercising?
Q. Can I exercise while breastfeeding?
Q. What exercises are safe to start exercising postpartum?
Q. Are there any exercises I should avoid initially?
Q. What muscles should I start working out first?
Q. When can I start doing Pelvic Floor Exercises (‘Kegels’) and how often?
Q. Is urinary leakage while exercising after pregnancy normal?
Q. What are the best exercises for Diastasis Recti?
Q. I want to lose the baby weight. How quickly can I do this?
Q. How quickly can I get my pre-baby stomach back??
Q. I have back pain, can exercise help me?
Q. What if exercise is painful?
Q. When is it okay to start high-intensity workouts, like CrossFit?
Q. How long after childbirth can I start exercising?
* Regardless of the type of delivery, always check with a medical professional first before you start exercising. *
If you had a straightforward vaginal delivery, you could start gentle activity almost immediately after delivery (think breath work, walking, strengthening pelvic floor and core muscles). With anything more intense you should wait around 6-8 weeks, have your 6-week postpartum check and GP sign off.
If you had a caesarean or any kind of birth trauma, you may need to wait longer before resuming exercise. Existing guidance recommends that women who have had C-sections should wait 10-12 weeks before trying “vigorous exercise.”
The degree of trauma you experienced giving birth will determine the kind and intensity of exercise you can do. Be gentle on your body and always consult with a doctor and (ideally) Women’s Health Physio before you begin.
Q. Can I exercise while breastfeeding?
Yes, you can. It is perfectly safe for you to work out, as long as you’re getting enough water (around 3 L) and food. You might want to avoid exercise which you personally find uncomfortable or painful.
If you are still worried about the effects of exercise on your milk you can exercise after feeding or nurse or pumping. before training.
Q. What exercises are safe to start exercising postpartum?
Start with breath work, pelvic floor exercises, walking and core strengthening (no sit-ups or planks!).
There is no coming back to training without restoring diaphragm breathing and integrating it with every move.
Breathwork is one of the recommended core exercises, along with heel slides, leg extensions and toe taps, if done correctly.
Right after birth, you can start working on your pelvic floor muscles. You should consult with a Women’s Health Physio to create a personal program.
You can also start with short walks until you can easily walk for 30 min without any pain or being out of breath.
Q. Are there any exercises I should avoid initially?
Any high impact activity such as running, jumping, skipping, trampolines, horse riding, should be avoided until you are sure your pelvic floor and core muscles are strong enough.
Lifting heavyweights, including pushing and towing heavy objects should also be avoided. These exercises create too much intra-abdominal pressure and a bearing-down feeling. The pelvic floor and core muscles are not ready straight after birth to withstand this.
Also avoid sit-up movements and isometric exercises (planks, squat hold, wall sit, lunge hold, warding movements, etc.).
Q. What muscles should I start working out first?
Some of the muscles you’ll need to strengthen first are those that will help you realign your postnatal posture and support you in your new activities as a mum such as feeding and carrying your baby. These muscles are the transversus abdominis (lower part of belly), glutes (all three equally important), multifidus (muscles along the spine), rear delts (back of the shoulder), rhomboids and trapezius (think upper back, space between shoulder blades).
Q. When can I start doing Pelvic Floor Exercises (‘Kegels’) and how often?
‘Kegels’ are not a magic fix. A lot of people need to down-train rather than up-train. Sometimes you need to relax the tissue and do some manual work. Sometimes you need to strengthen it. Therefore, it is crucial to consult a specialist who will choose an adequate treatment.
Right after birth, you can assume your pelvic floor is weakened and you can implement the so-called Kegels. You may be able to start within a few days of an uncomplicated vaginal birth — just make sure you feel ready, and it does not aggravate the pain. If you had complications during vaginal birth or had a c-section, wait until the doctor gives you all clear.
Only a specialist can tell you how many ‘Kegels’ to do and how often. Until your visit at Women’s Health Physio, you can start with an everyday routine of single, short engagements in sets of 10 and longer holds, which you want to build up to 10 seconds.
Q. Is urinary leakage while exercising after pregnancy normal?
Yes and no. Postpartum incontinence or trouble holding a full bladder can be normal — but only for a limited time. Right after a birth, especially vaginal muscles, are stretched and traumatized. You might experience small leakage or feeling lack of control when coughing, sneezing or with the full bladder. Nevertheless, that should go away within a few weeks after birth and doing pelvic floor and core restorative exercises. If it has been a few months or years! and you still struggle with bladder control, it needs specialist attention. Because then, it is not normal!
Incontinence only gets worse with age, so it is crucial to act on it as soon as possible.
Q. What are the best exercises for Diastasis Recti?
The key to healing Diastasis Recti is rebuilding your core from the inside out. Focus on movements that pull the abdominals in, like core engagement when you exhale, pelvic tilts, toe taps, heel slides, and single-leg stretches. The key is to keep your belly pulled in and stop any bulging. If you see your belly dooming, stop the movement. It could exacerbate the condition.
Make sure to give yourself adequate time. The body takes time to heal and results are gradual.
Q. I want to lose the baby weight. How quickly can I do this?
‘It depends’ would be the most accurate answer. Any time of healing and recovery is not the best time to cut calories or food groups. Based on information from the CDC, if you are breastfeeding, you need an extra 500 kcal a day. Even if you are not, you still need protein, healthy fats, carbs and all the micronutrients to heal wounds. Also, sleep deprivation is a huge enemy of fat loss and remember you are caring for a new baby who very likely won’t sleep through the night!
You might have heard that on average you should lose 1 pound a week. Well, that is a lie. Weight loss is never linear, and life simply gets in the way. So instead of timing yourself and watching the scale closely, focus on your RECOVERY. Sleep, hydration, breath work, nourishing food, daily walks. Exercise to feel good and strong.
Q. How quickly can I get my pre-baby stomach back??
I get this question very often. And no one ever likes the hard truth: the answer is “probably never.” But the truth is that you can still have a nice flat six-pack stomach if you wish and dedicate yourself to it, it just will not be exactly the same as your pre-baby stomach. Just keep in mind that a six-pack does not equal a healthy or strong core.
Q. I have back pain, can exercise help me?
Back pain can have many, many causes. As long as it isn’t the result of an injury or any degenerative spine condition. Very frequently, pain comes from postural changes during pregnancy and carrying the baby after labour, while the core is not strong enough. That is why a solution is being active and exercising your core muscles properly.
Q. What if exercise is painful?
Pain exists to signal us that something is wrong. There is a fine line between discomfort coming from the exercise and pain. You know your body the best and if you feel that something is wrong, do not power through. You might need more time and rest. If pain occurs when running, come back to walking. With any other activity, decrease the intensity and/or volume. Seek a specialist’s advice if it does not go away.
Q. When is it okay to start high-intensity workouts, like CrossFit?
Unfortunately, there is no one-size-fits-all. If you have been training CrossFit for most of your life, through pregnancy and had a straightforward birth, you might be back to the gym as soon as you have been cleared out by doctor and physio. Just scale your workouts and avoid too many box jumps, burpees or running at first. If you do not experience any incontinence and your pelvic floor is strong, gradually implement running and jumping.
If you are a newbie, I would not recommend joining CrossFit gym (unless it’s a specialised postnatal class) or start running for at least 6 months.
However, keep in mind that each case is different. Someone might not be ready to run or do HIIT workouts 12 months after birth. As well as another person might be up and running without any side effects or prolapse 8 weeks after labour. Listen to your body and be smart about it. You have time, but only one health.