Part 1: So, you are “cleared” for exercise after baby. Now what?

5 Signs You’re Postpartum Body Isn’t Ready For Your Exercise Program

My best friend just had a baby. She had a pretty tough labor and ended up having a c-section. Her doctor “checked” her at 6 weeks and said “things look fine” and then at 8 weeks she got the go ahead to exercise again. With nothing more than that. No check for Diastasis Recti. No review of pelvic floor dysfunction or prolapse. No guidance on what to begin with. What NOT to do. No details on parts of the body to focus on first and areas to go slower on. Literally nothing! Sound familiar?

Why is it that postpartum exercise isn’t given more attention from our doctors. It can help so much but it can hurt even more in the long run if you choose the wrong path. And it doesn’t help that there is a societal expectation that you look like you didn’t have a baby the day you have a baby. Like seriously so unrealistic! You are bombarded with all of these messages and offers of what to do to get the baby weight off FAST! 

I spoke to Dr. Jenn Parker, PT, DPT, a pelvic health physical therapist and owner of Embody Wellness Physical Therapy here in Livermore, CA and asked her more about postpartum healing and the timeline for returning to exercise after childbirth. She says, “Traditionally, we know that it takes about 6-8 weeks for normal tissue healing to occur when there has been a trauma or injury. So it was believed that this healing process was the same during childbirth either vaginally or with cesarean. However, the pelvic and abdominal anatomy DOES NOT heal at a similar timeline. After a vaginal delivery, the pelvic floor muscles, connective tissue, and nerves take 4-6 months to heal. Healing continues after that taking 12-months for the pelvic opening to return back to baseline, although it does not return back to prenatal size. For cesarean sections, abdominal fascia has regained approximately 75% of it’s original tensile strength at 6-7 months postnatal. This is not to scare anyone away from exercise, this is to inform new moms that their body will continue to heal after they have been cleared to exercise and this is NORMAL.”

I know it’s hard to fight the temptation to jump (literally) back into your old fitness routines or a new fitness routine that promises sweat and soreness and dropping the pounds, but doing so could actually do more harm than good. Your body has been through a lot with pregnancy and childbirth. Like A LOT!! I know modern society likes to downplay or ignore the magnificent feat that moms go through to GROW and bring life into this world but ladies - this is a HUGE thing!! 

“We need time to heal and regain strength— rushing back into activity, especially high-intensity exercise can lead to permanent body changes including pain and dysfunction. As a pelvic health physical therapist, when I ask female clients when their symptoms of their pelvic floor dysfunction started, the majority of the time the answer is during the prenatal/postpartum period” says Jenn. 

You may not get the information or support from your doctors or your mom or grandma or even your friends but I’m here to tell you start small, build the foundations. Doing so will make your future exercise that much more effective. Because if you go too far too fast you risk serious and possibly lasting injury like Diastasis Recti, hernias, pelvic organ prolapse, SI Joint injury, etc. And then you have to take many, many steps backward or even have your future exercise options changed forever. Why not start at the start and care for your body like you would if you had an injury (pregnancy and childbirth is equivalent!). 

Jenn’s advice? “When you are returning back to exercise, it is important to do so mindfully. In fact, waiting until your 6-week postnatal check-up is too long to wait to start gentle pelvic floor, abdominal muscle exercises and a walking program. Pilates-based exercises are a safe and functional program to begin with, even if your goal is to return to high-intensity exercise like running and jumping.” 

Here are 5 red flags to look out for as you get back into exercise that suggest you are pushing yourself too far too fast. 

1. Incontinence or leaking is a sign that your pelvic floor muscles and deep abdominals are not yet strong enough to handle the exercises you are doing.

2. Pelvic pain, pressure or a feeling of heaviness or dragging in the pelvic area is a sign of pelvic floor dysfunction or prolapse. If you have these symptoms, it is important that you visit a pelvic health physical therapist to assess what is going on and work with you to remedy the situation.

3. Doming or coning through the mid-line of your abdomen is a sign of a diastasis recti or separation of the linea alba between the two sides of the rectus abdominus (6-pack abs), which is normal for all women after pregnancy but doing the wrong exercises that create this doming effect can result in a prolonged or permanent diastasis that can lead to the low belly mommy pooch, back pain, and pelvic floor dysfunction.

4. Pelvic, low back or hip pain is pretty common as a new mom but if exercise causes you more discomfort in these areas then take that as a sign that you need to slow down or modify your workout routine.

5. Exhaustion, out of breath, overly sore muscles is a pretty obvious sign that you’ve pushed it too far. Remember you are recovering from a major physical change and possibly major abdominal surgery as well if you had a c-section. Give yourself some grace and slow down so you can properly recovery.

If you have any of these symptoms you may not be ready for the exercise program you have started and it may be beneficial to see a pelvic health specialist like Dr. Parker to address any issues. 

Getting back into exercise doesn’t have to be scary or cause injury. Contact me to help guide you back into exercise and safely rebuild your strength after having a baby. 

XO-

C