Exercise After Childbirth, When is it Safe to Start?
Baby Brooks has just turned 9 months old. I am feeling good about the progress I have made and want to help you too! I have very careful to train correctly and not do too much too soon in an effort to get my body back. I did a lot of research. And what I found, is that in the early stages, what we need more than anything else is REST! Think about what our bodies have just been through. It’s strange to think about childbirth as an injury or trauma. But in many ways that’s what our body has been through. It is an incredible phenomenon isn’t it? There is nothing I am more proud of physically doing more than childbirth. Not the New York City Marathon, Boston Marathon, triathlons, etc. No way. This takes the cake. So hats off to all of you women out there who have been through it or want to go through it!
I am going to spend a lot of time on my blog talking about women’s fitness and how to get where we want to be emotionally and physically post-baby. It is a tough road. But I found ways to make it fun. I want to share them with you.
In the meantime, I want you to take a listen to the interview below about postnatal fitness. When is it time return to which exercises? How can we tell? We don’t want to wheeee ourselves accidentally do we?! We don’t want to make our abs separation and pelvic floor damage worse do we!? Do we need to see a specialist of some sort? So many questions swirling in our minds about getting our body and independence back. But with all the time we need to spend nurturing our bubs, how do we find time to research? How do we find time to put in the effort? I am making this my mission. I am here to help. There is a TON of great content on AnnaKooiman.com in both the fitness and motherhood/baby tabs. Be sure to check them out after you watch the video below! Dr. Jill Gamberg shares her top tips for getting back into fitness after having a baby, the SAFE way.
1. ANNA: When can new mothers return to low impact exercises?
DR. JILL GAMBERG: New mothers can return to low impact exercises at around 6-8 weeks. If the delivery was complicated or there were any birth injuries, recovery time may be longer, and the return to exercise may be delayed.
It is important to check with your GP, midwife, physiotherapist or obstetrician before returning to exercise after childbirth. Mothers who have issues with incontinence, or develop incontinence once re-starting low impact exercises, should seek professional help before continuing.
There are general guidelines from the Australian Continence Foundation to follow to help plan your return to post childbirth fitness:
0-3 weeks after delivery:
abdominal muscle bracing (tightening your abdominal muscles without movement)
pelvic floor exercises
6-8 weeks after delivery (wait until your six-week doctor/midwife check before starting a group exercise program or going back to the gym):
low impact aerobics or post-natal classes
low intensity water aerobics class and swimming (once vaginal bleeding has stopped)
gym program (light weights)
abdominal muscle bracing
pelvic floor exercises
8-12 weeks after delivery:
follow the same guidelines for 6-8 weeks, gradually increasing your intensity and weights
progress your postnatal abdominal muscle bracing
continue pelvic floor exercises
12-16 weeks after delivery:
consider seeing a women’s health physiotherapist for abdominal and pelvic floor muscle testing before returning to high-impact exercise, running, sport or abdominal exercise programs
16 weeks and more after delivery:
you may be able to return to previous activity levels IF your pelvic floor muscles have returned to normal and you are not experiencing any back pain, vaginal heaviness, or urinary incontinence during or after exercise
2. ANNA: When can new mothers return to running, jumping, and jogging?
DR. JILL GAMBERG: The return to running, jumping and jogging will be a lot longer than return to exercise in general. The pelvic floor is very weak after carrying a baby for 9 months, and will need time to recover post childbirth. Returning to impact exercise too early can cause damage to the pelvic floor. It may also cause or worsen incontinence of the bowel or bladder.
The return to impact or intense exercise may be as early as 16 weeks (if there are no medical issues) but may take up to 6 to 12 months to strengthen the pelvic floor and abdominal muscles enough to return to exercises like running, dancing, skipping or jumping.
Intense exercises like sit-ups, planks, hovers, and curl-ups are not recommended exercises for mums after childbirth, as they can place pressure on the recovering lower abdominal muscles and pelvic floor muscles.
A review with a women’s health physiotherapist for abdominal and pelvic floor muscle testing before returning to high-impact exercise, running, sport or abdominal exercise programs, is a great idea.
3. ANNA: When can new mothers start strengthening our pelvic floor and core again? Which abs should we start with?
DR. JILL GAMBERG: Mothers can start strengthening their pelvic floors as early as is comfortable. The best way to start is to have an awareness of the urine stream and when they are starting and stopping the urine flow. Usually by two weeks, most women are feeling more comfortable and confident, and any areas that have been stitched are starting to heal. They can start thinking about contracting and relaxing those pelvic floor muscles at this time.
Women can start strengthening the traverse abdominals in the early days. Then the abdominal obliques can be worked on next. The best abdominal exercise in the early days is “bracing” the muscles without movement of the body. Then finally after at least 6 weeks, women can start easy exercises with rectus abdominals.
Abdominal exercise may be complicated by a separation in the front or rectus abdominals (called Diastasis Recti). This is very common and up to 2/3 of women have this after birth. Abdominal separation may slow down the return to exercise after childbirth. Getting advice from a physiotherapist or doctor may be necessary to aid recovery.
4. ANNA: How can strengthening our pelvic floor and transverse abs help flatten our tummies post childbirth?
DR. JILL GAMBERG: During pregnancy and childbirth our abdominal and pelvic floor muscles become stretched out and weakened. This is completely normal. That is because of the weight and size of the baby growing inside. Once women are able to start retraining their muscles to work appropriately again post childbirth – this can help to flatten their “tummies”. It is best to do this with supervision by a women’s health physio or doctor, and following the recommended guidelines for “exercise after childbirth”.
5. ANNA: It’s a taboo topic... but how can strengthening our transverse abs and pelvic floor keep us from accidentally wee-omg when we sneeze, cough, jump, etc.
DR. JILL GAMBERG: Women need a certain amount of pelvic floor strength to maintain continence. There are two main types of urinary incontinence. When your bladder is full, you feel the urge to go to the toilet, and you do not make it to the toilet. This is urge incontinence. Stress incontinence is when you lose control of your bladder when you sneeze or cough. Women can have one type or both post childbirth.
Strengthening the pelvic floor and transverse abdominals can help prevent incontinence and it can also improve incontinence. If incontinence is an ongoing or worrisome issue, please see your GP or obstetrician.
6. ANNA: Do you recommend patients who are new moms see a women’s physiologist post-childbirth? If so, which types of patients?
DR. JILL GAMBERG: Every woman should see a women’s health physiotherapist post childbirth, if they can. It is important to educate themselves regarding what happened to their bodies during pregnancy and childbirth. It is important for mothers to learn which muscles to strengthen and at an appropriate time in the months following childbirth. Physiotherapy is especially important to help with recovery from any muscle weaknesses, birth injuries, incontinence issues, and/or prolapse problems. You need to rehabilitate your pelvic floor and abdominal muscles after childbirth, just like you need to rehabilitate an ankle after a sprain injury.
7. ANNA: Anything you would like to add?
DR. JILL GAMBERG: Women should not put pressure on themselves to return to their “pre-baby” bodies as soon as possible. They need to rest and recover, and full recovery takes up to a year post childbirth. Every woman is different and depending on their pregnancy, birth experience and the early months post childbirth – the road to recovery will be different.