Postpartum Exercise [When, What, and How from an Expert]

There is no rush to get back into exercising after you’ve had a baby, but eventually, there will come a day where you feel ready and excited to start working out again. Knowing when, what, and how to safely start postpartum exercise can feel a little confusing, though.

If you are feeling as lost as I did when I wanted to get back into exercising, you are going to want to hear from our expert, Samantha Spencer, PT, DPT. She is a physical therapist specializing in pelvic health, with an emphasis on the prenatal and postpartum transitions. She says, “It’s never just about the pelvic floor, though. Prenatal and postpartum changes impact every part of a woman’s body, so there is a whole lot to consider when it comes to function and movement after pregnancy and birth.”

What You Need to Know About Postpartum Exercise

When is it safe to start postpartum exercise? Does the timeline vary for different situations?

Everyone’s pregnancy, birth, and recovery story is different. In general, simple reconnection exercises are encouraged as soon as mom feels ready, which could be hours or days after birth. This might include breathing exercises, gently engaging the core and pelvic floor, and paying attention to body mechanics with all your daily tasks. If you think about it, almost everything we do as moms could qualify as exercise. For example, standing up off the couch while holding a baby, carrying a carseat, picking baby up out of the crib are all moves that require some sort of core strength and control. So essentially, mom is “working out” in some ways right from day one. 

After the first few weeks of recovery, after you’ve stopped bleeding or your incision has healed and have discussed your exercise plan with your healthcare provider, you can gradually build back up to your pre-pregnancy intensity with a more traditional workout program. The key here is “gradual”, with emphasis on basic, body weight movements before progressing to more weights or impact. If you’re noticing increased bleeding (not associated with a menstrual cycle), pelvic pressure, heaviness, incontinence, or pain, those are all signs you could be doing too much, too soon. Slow your pace and reach out to your provider or a physical therapist to help you figure out what’s up and how to adjust.

For women who have had c-sections, when can they start exercising? What kind of postpartum exercise is safe for them?

Women who have had c-sections are in a similar position to women after vaginal birth: they’re immediately in charge of a baby. After a c-section, gentle movement can really support efficient healing and help to reduce pain associated with the incision. Things like walking and the gentle reconnection exercises mentioned above are all great places to start. When it comes to more traditional exercise, keep in mind that the incision may appear healed after 2-3 weeks, but it has not yet regained its strength and could become injured or painful with too much exertion. In fact, abdominal fascia can take up to 6 months to rebuild most of its strength. That means that the first 6-8 week “cleared for exercise” mark is really just the beginning – start slow and gradually progress over the first several months. 

Can breastfeeding moms exercise or will it affect their supply? 

Breastfeeding moms can absolutely exercise. Research shows that as long as mom is hydrated, there should be no negative impact to the quality or quantity of breastmilk she produces. To stay hydrated, start your day with water and keep it handy as much as possible throughout the day. Just drinking to satisfy your thirst is usually sufficient, so you don’t have to pack in a bunch of water if you’re not feeling thirsty. 

Breastfeeding moms will want to schedule workouts after nursing or pumping, mostly so that they stay comfortable and able to move freely. A supportive sports bra is also essential, and most moms find it most comfortable to remove the sports bra as soon as possible after they’re done exercising. 

Can you give us some examples of pelvic floor and core strength exercises that new moms should try to incorporate into their routine? 

Diaphragmatic breathing can coordinate with your core and pelvic floor. This is an easy and gentle way to start reconnecting. Take a big breath in as you relax your belly and your pelvic floor, then exhale and gently draw your pelvic floor and abdominal muscles in and up without moving your spine. A few breaths like this every morning and every evening for the first several weeks postpartum will help prime your system to use those muscles again.

Exhale every time you get up from the couch, and try to keep your spine nice and long. When we exhale, the pelvic floor muscles and core kick on a little which means we can strengthen them just a little every day. 

Bridges are another favorite. Lying on your back, squeeze your glutes and lift your hips up into the air. Your baby might love sitting on your lap for this one!

Should postpartum moms consider seeing a physical therapist? How can a physical therapist help with recovery? 

I firmly believe that physical therapy should be part of every postpartum care plan. A physical therapist can go through movement modifications, how to support your body during daily tasks, and help you start reconnecting to your core muscles. Your PT can make suggestions specific to your needs and concerns during early recovery and get you started with basic exercises and movement patterns to help you heal and recover optimally.

A physical therapist can also guide your return to fitness, help with scar tissue recovery for softness and mobility, address bowel, bladder, and sexual health concerns, and help you resolve other aches and pains that might arise during the postpartum recovery period. If you’re in pain or have an urgent issue, a PT can be an essential part of your early recovery team. Even if you’re not having major concerns, it’s still a good idea to schedule a check-up to make sure you’re ready for exercise and recovering optimally.

Reach out to a PT in your area while you’re still pregnant or during early recovery to set up a time to meet with them once you feel ready. Depending on your state, you may not need a referral. Call around to PT’s in your area to find out. 

Questions from New Mamas Just Like You

I love running, but I feel lost on how to start up again. Do you have any tips?

Consider yourself a beginner again, and walk before you run. It’s generally not recommended to return to running before 12-16 weeks postpartum, even if you feel recovered. Running places a huge amount of demand on the pelvic floor and core, and no matter what kind of a birth you had, your body just needs time to get back to it’s pre-pregnancy level of strength and coordination.

So what can you do while you wait? Get your body ready, of course! Gradually build your walking distance during the first 12-16 weeks postpartum, while at the same focusing on low impact stability and strength cross-training activities. This can look like basic strength exercises, like bridges, leg raises, plank progressions, squats, and lunges, and progressively building aerobic endurance with cycling, walking, and elliptical training. When you do start to run again, consider following a Couch to 5k program to build your mileage without risking injury by doing too much too soon.

What is more important for recovery if I have to pick one during nap time: sleep or exercise?  

This is a great question, and I’m sure it’s one that most moms think about during that first year postpartum! Fortunately, for those of us who aren’t training for a specific event, there IS an answer: for general health and to combat fatigue, aim for 30 minutes of moderate intensity aerobic activity at least 5 days per week. Walking absolutely counts. If you’ve already checked that box and you’re wondering what you “should” do while baby is sleeping…take a nap! Your body can’t recover from higher levels of intensity or strength training without sleep, so you’re more likely to feel better, have more energy, and reduce the risk of injury if you prioritize sleep in those early months.

Of course, everybody is different. But we can’t always muscle our way through like we may have done in the past. The balance with rest and recovery is essential. And, of course, talk to your healthcare provider if you’re feeling more drained than usual or concerned about your fatigue. There might be more to consider.

It’s been 5 months since I gave birth. What should I do to start exercising after such a long break?  

Getting back into exercise can be really difficult both mentally and physically for people who have been active in the past. After pregnancy and birth, our bodies can be quite a bit different and might feel a bit foreign. That can be frustrating for an active mom, or someone who is used to exercising and feeling connected to her body. Additionally, sometimes it can seem impossible to find the time to focus on exercise!

As you get started, prioritize consistency as much as you can. Every day might look a little different, but if you can set aside 15-30 minutes with no distractions to just move your body each day, you’ll be feeling more like yourself in no time. You might need help to make this happen: ask your partner for support, or prioritize it during your baby’s first nap of the day. 

What you do during that daily movement time ultimately depends on what you enjoy and what your goals are, since everything is modifiable to suit your needs. Start with slow, controlled movements using just your body weight, and progress to heavier or faster movements over the weeks and months as movements get easier. The specifics of your body’s needs might vary depending on your story, so this is an excellent time to reach out to a postpartum or pelvic physical therapist to help you ease back into your exercise routine with all the support and focus you’ll need to stay focused, productive, and injury-free. 

How do I keep up with hydration if exercising as a breastfeeding mom? 

This is another great question, and it can be really hard! I always recommend keeping a big glass of water by your bed, and drinking the whole thing right when you get up in the morning. We are generally the most dehydrated in the mornings after sleeping (or not sleeping) all night long, so this can help set your system up for success.

Other strategies that might work for you include keeping a bottle of water with you, and setting a goal to drink several bottles-full each day. Some people fill several bottles first thing in the morning and keep them stationed at their usual nursing spots, so that whenever the baby gets a drink, mom gets a drink too. Drinking to satisfy thirst is usually sufficient, so no need to chug just for the sake of increasing intake. If you’re noticing dark urine or you’re dealing with constipation, you may also need to increase your daily fluid intake as these can be signs of dehydration.

Expert Bio

Samantha Spencer is a physical therapist specializing in pelvic health, with an emphasis on the prenatal and postpartum transitions. She is also a spokesperson at Aeroflow Breastpumps. Connect with her on Instagram or Facebook.

For more expert advice, head to the Rookie Moms Instagram!

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