Pinnacle PT Women’s Health | Returning to Exercise Postpartum

We are frequently asked by postpartum women, “when can I start exercising again?” Many women don’t feel confident enough to get back to exercising so they can feel like themselves again. On the other hand, we’ve noticed that some women are trying to jump back into physical activity as soon as possible. Your OB-GYN will usually give you the green light to return to exercise 6-8 weeks postpartum. Some questions to consider are: What constitutes appropriate and safe exercise? What should be your primary focus as you start back into restoring your pre-pregnancy body? What are the risks that come with returning to exercise too quickly?

Pregnancy: Typical Pelvic Posture

No matter the type of birth, pregnancy leads to a specific posture in the female body. Picture a very pregnant woman walking down the street. She is probably walking with her feet a little wider than normal, slightly toed out, and waddling with an increased sway in her back to account for the fact that she is carrying 10+ lbs directly in her abdomen. This posture will inevitably lead to increased pressure in the low back and front of hips, as well as create over lengthened inner thighs and abs.

AdobeStock_139127186.jpeg

During the postpartum period, it is important to get those muscles that were over lengthened and underused during pregnancy back on board. Your body has an increased risk of injury as you have elevated levels of relaxin hormone in your system during pregnancy and while nursing. Therefore, it is essential that you restore all the abdominal oblique and transversus abdominis muscle and and pelvis muscular support you can get! Relaxin is a hormone that helps our ligaments and tissues stretch during pregnancy and delivery. Postpartum, your body is still adapting and may be a little more hyper-flexible and loose than usual. It is important to key in on the all-important internal and external obliques and get the pelvic floor ascension muscles working effectively once again to protect your body from injury.

Beginning with the birth

The birth process is unique to every woman, so it is important to find out what exactly happened during your delivery. Some questions you should ask your doctor, nurse or doula : “Did  I have an episiotomy? C-section? Did I experience tearing? How many stitches do I have?” All of this information is critical to know in order to have a full understanding of the ideal timing to get back into activity.

StefPelvicFloor.jpg

Where did my abs go?

Your oblique and transversus abdominis muscles were just stretched out for multiple months! In addition to that, your skin has been stretching to accommodate the growing baby.  The baby pushes your internal organs back and up, which can create increased connective tissue tension through your back. You may find that re-finding and feeling your abs turn on is harder or than it was before. Yep, that is totally normal! You need to learn to find them again through re-positioning your pelvis through proper breathing and pelvic stabilization exercises. When you do, you’ll experience massive improvement in mobility and enhanced  security for your pelvis, back and trunk.

*If you’re noticing severe difficulty or finding it impossible to feel and find your abs, you may be experiencing diastasis recti. You need your OB or PT team to identify that condition and will need specific help to address it.  

How do I “find” my abdominals?

The easiest and most effective way to start to find your abdominal muscles is to breathe correctly. By that, we mean you need to figure out how to exhale fully, feel your front ribs move down, in and together and feel an abdominal contraction at the very end of the exhale. You will also start to feel your pelvic floor contract and lift with the full exhale. Next, while inhaling, try to maintain a little abdominal contraction allowing you to expand throughout the chest cavity and into the back, not just ballooning out your belly.  A great tool to help achieve this is to use your hands crossed across your abdomen (hands on the opposite ribs), and feel yourself make that closure of your abdominal cavity and secure your back ribs and low back to the floor during the exhale. (we also use balloons to re-train abdominal function and appreciation in our clinic)

_MLP7294-Edit.jpg

Once you’re able to properly use your abs and pelvic floor muscles to effectively stabilize your pelvis and spine,  you next need to make sure you put them to work in everyday activity! Use em’ or lose em’ definitely applies! Whenever you roll over  in bed or stand up from sitting or pick your precious new baby up, remember to exhale first, bring your rib cage down in the front and brace yourself  to protect your recovering body. Your back, hips and SI joints will love the extra support and not feel strained and over-stressed.

Progressing your core stability postpartum:

Other vital muscles that stabilize the pelvis and trunk are your hamstrings, adductors, and gluteal muscles which have become over-lengthened and neuro-muscularly weakened during pregnancy.

It is imperative that you are specifically targeting and getting these muscles active again prior to returning to more aggressive weight bearing exercises like walking, running and plyometrics.  Have realistic timelines and expectations related to your postpartum fitness. Respect that your pelvis, abdomen and body just went through a major musculoskeletal event that did some real damage to your structural integrity and stability.  An upwards of 3 months of focused core strengthening, breathing, abdominal recruitment, and stability and endurance training is needed to restore your body back to the optimal position and strength to resume weight lifting, running and advanced cardio and strengthening activities.

Our doctors can guide you through the process of what the next best steps are for you to get on the road to recovery. Click below to schedule your free discovery consultation.

Stay tuned to a future Blog detailing Stage 2 of your partpartum journey to optimal back, pelvis and hip health!