A Guideline for Postpartum Fitness

KATE-LEMERE

Congratulations, ma! You did it. You birthed, what is no doubt, the most perfect and incredible baby to ever grace God’s green earth.

LUKE-LEMERE

If your experience is anything like mine, you’re most likely sitting on your couch like a deer in headlights. Maybe you’re freaking the fahk out. You’re probably pumping while eating with one hand and holding your baby in the other. You’re questioning whether or not you’re fit to be a mom, crying because you’re happy, crying because you’re scared, wondering if you’ll ever leave the house again!

BUT EVERYTHING IS FINE! 

And it is, truly. It gets so much better. You get better. And you’ve got this.

The itch to move your body happens at different points in the post-partum journey for every woman, but for most I’ve come across, it happens almost right away.

But just because you feel READY for postpartum fitness, doesn’t mean you are – physiologically speaking.

The below is a guideline for the general post-natal population based off of my experience, education, and current research. These guidelines will vary depending on your delivery and progress of recovery.

If you experienced a traumatic birth, your timeline might differ. ALWAYS check with your doctor to make sure your actions align with your current condition.

As ALWAYS, there is fine print! This is by no means the beginning or the end of postpartum fitness – you have to do what you feel comfortable with, and you ALWAYS have to evaluate your current situation. 

KATE-LEMERE

Your Postpartum Re-Entry Fitness Guide

Week 1 Postpartum: Heal

Chill. The. Fahk. Out. When I hear women say they were at the gym four days/one week/two weeks after giving birth I question their level of sanity.

I would apologize for saying that – but I’m not sorry!

Your body has GOT to heal whether you like it or not. If you rush, there is a GOOD chance you will incur consequences, injury, setback, pain, discomfort, etc., and why would you want that when all your energy and focus is going towards the wellbeing of a tiny little one?

Simply put, you can’t afford a setback.

I mean, think about it. Your organs are out of place, tissue is SENSITIVE and tender, and your center of gravity is on the move. Muscles that have laid dormant for MONTHS are being shocked back into use. Do I need to say more?

Rest when you can, sleep, snuggle with your baby. You’ll be off to your grind soon enough, and these are precious hours you can never have back.

Savor them.

Week 2-5 Postpartum: Engage

Connect your breath to your body – literally.

  • Slow, flat walks for approximately, 20-30 minutes
  • Diaphragmatic breathing, 10 minutes a day, twice a day

Your body will tell you if you’re doing too much, too soon right away. Even an aggressive walk can leave you with inflammation, soreness, or tenderness.

Diaphragmatic breath work is the starting point to heal your diastasis and strengthen your abdominals by re-establishing the connection between your diaphragm, abdominal cannister, and pelvic floor.

To be clear, all three need to be functioning correctly, and in good health for any of the following to ring true.

How to do it:

  1. Select a starting position, and I like to lay down with my feet flat, knees up, and a pillow between my knees to engage my adductors/inner thighs. You can also sit up but make sure your posture is upright, your hips are square, and your feet are flat on the floor.
  2. Take a deep inhale, and visualize your lungs expanding to the sides while your belly fills with air and “hangs.”
  3. Lightly purse your lips and exhale sharply and steadily through your mouth. Make an audible “shhhhh” noise. As you exhale, CONTRACT your abs. Here’s the hard part – CONTRACTION is different than SUCKING IN.

Don’t think about this as bringing your “belly button to spine” but rather flattening, tightening, and lifting. If you experience a bulge or ridge in your belly, either down the center of your abs or underneath your belly button, you’re exhaling too hard and sucking in.

Additionally, visualize your pelvic floor zipping upward to mimic the lift you feel throughout the abs. Less lift through the glutes, and more lift through the inner vaginal wall.

Week 6-13: Rehab and Rebuild

In the U.S. it’s the standard of care to receive a 6-week postpartum checkup to make sure your body is healing properly. Your check-up may differ depending on your type of delivery, and level of trauma.

Regardless, your examination will NOT include a pelvic floor or abdominal evaluation, which is unfortunate since that system is mostly what dictates readiness to return to fitness after having a baby. Diastasis Recti, or abdominal separation, is inevitable during pregnancy. I’ve read publications that claim “60% of women’s diastasis will heal on its own,” and I gotta say, I just don’t believe that.

In my opinion, SOME form of abdominal and pelvic floor rehab is absolutely needed in order to set yourself up for the most success as you re-enter the gym as a postpartum woman.

Continue to do your:

  • Diaphragmatic breathing

Introduce:

  • Abdominal rehab
  • Pelvic floor rehab
  • Foundational strength training
  • Walking on an incline to prepare for a return to running

How to do it:

Abdominal Rehab:

Your ab rehab includes your abs (duh), as well as your posterior chain. Drills such as the below are safe for (but not limited to) this stage in your postpartum life:

  • Cat cow
  • Fire hydrants
  • Clam Shells
  • Bird Dogs (no crunch, focus on the opposite arm and leg extension)
  • Glute bridges
  • Alternating tabletop heel drops*

*Lay on your back with your legs in tabletop, a 90-degree bend in your knees. Without altering the position of your knees, slowly lower one heel to the floor (maintain the 90-degree bend) focusing on the movement from the hip. Return to starting position and repeat on the other side. 

Pelvic Floor Rehab

In my opinion, every postpartum woman should have a consultation at the very least. I was in pelvic floor therapy for six months and credit it to my successful re-entry to fitness. Additionally, each session was like receiving an education. Click HERE to find a therapist in your area. 

Foundational Strength Training

It is naive to think you can go back to the gym and do everything you’ve always done. Your body is now forever changed, and that’s not good or bad – it just is. Your first program back to the gym should be thoughtful, strategic, conservative, and progressive.

  • Stay away from traditional ab work/twisting/flexion. You won’t get your abs “back” by doing crunches anyway!
  • Minimize outward pressure on the abdominal wall from drills like push-ups, chins, various presses, etc.
  • Start with stabilizing strength moves – no plyometrics or unilateral drills that require balance. Your body is TOTALLY different, and your center of gravity will continue to shift as your uterus contracts.
  • Focus on progressive overload, start with lighter weights, and work your way back UP. You should leave the gym feeling like you could do MORE. Soreness will NOT be your biggest indicator of progress.
  • Increase your weights SLOWLY, 10-20% at a time

Drills such as the below are safe for (but not limited to) this stage in your postpartum life:

  • Deadlifts
  • Assisted rows
  • Seated overhead presses
  • Squat varieties
  • Curl and triceps varieties
  • Modified push-ups if your diastasis is healed
  • Dead bug varieties if your diastasis is healed
  • Chest press varieties

Check this post for how to build your own strength building workout.

Walking on Incline to Prepare for Running

The incline promotes proper running economy and stimulates glute and hamstring engagement. Include a rotation in your trunk to strengthen your abs and build endurance, as well as prepare for your pelvic floor for high-impact activity.

  • Walk on an incline at 5-8% with a forward lean. Start gradually 10 minutes, and progress to 30 over the course of WEEKS.  – as shown in this EXTREMELY WELL PRODUCED VIDEO.
  • When you feel as though you’re ready to progress gradually build your time of work.
  • Increase pace on incline, then decrease incline ONE AT A TIME. One week focus on speed, the next week focus on dropping incline.
  • Build your pace on a flat road.

How do you know if you’re ready to progress? This is your checklist:

  • NO incontinence
  • Zero pain or prolapse
  • Never feel heaviness/pressure/tightness in the pelvic floor

FOR A FULL GUIDE ON PERINATAL CARDIO MANAGEMENT CLICK HERE.

Week 14-20: Evaluate

By now, you’ve been back in the gym for six weeks, ideally following a progressive strength training plan. If the above checklist is met, you’re most likely ready to kick it up a notch.

Continue to do your:

  • Diaphragmatic breathing (if needed)
  • Abdominal rehab (if needed)
  • Pelvic floor rehab (if needed)

Introduce:

  • Evaluate your foundational strength building program
  • Running re-entry

How to do it:

Evaluate Your Strength Training

  • Incorporate plyometrics, unilateral drills that require balance, traditional core work if your diastasis is healed, metabolic training, circuits, and heavier loads.
  • Continue to focus on progressive overload.
  • Be cautious while increasing load. I like to increase every other week. On the weeks I increase load, that’s my only focus. On the weeks I do not increase load I am HYPER focused on my mind/muscle connection.
  • Soreness will NOT be your biggest indicator of progress.
  • Increase your weights, 10-30% at a time.

Begin Your Re-entry to Running

  • Jog on an incline at 3-5% with a forward lean. Start gradually 5 minutes on, 1-3 minutes off for 10 minutes, and progress to 30 throughout WEEKS.
  • When you feel as though you’re ready to progress gradually build your time of work.
  • Increase pace on incline, then decrease incline ONE AT A TIME. One week focus on speed, the next week focus on dropping incline.
  • Build your pace on a flat road

Week 21 and Beyond: Go Forth

Assuming you’ve executed the above, and you’ve achieved the below:

  • NO incontinence
  • Zero pain or prolapse
  • Never feel heaviness/pressure/tightness in the pelvic floor

You may be ready to return to your fitness routine pre-pregnancy. Keep in mind; it may be MONTHS until you feel like “yourself.” Don’t lose sight of the forest through the trees. One day, when you least expect it, you’ll be back.

I was nine months postpartum when I did, and it was the best. Feeling. Ever. 

Ma – go get it. And please keep in touch.

kate-lemere

Please note – NONE of this undermines, overwrites, or trumps the advice of your practitioner. YA DIG? 

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  1. I love this so much. Babe is 15 months and while I knew I needed to ease back into it, I was not equipped with the full knowledge of HOW to go about it. Luckily, I have just have a one finger gap – so minor and no incontinence or pelvic pressure, etc. However, despite losing the weight, I still have such low confidence. I’m used to having abs and although the top is better, I feel like my lower tummy pooches or just hangs out if I’m not 100% engaged 100% of the time. Do you know why this might be and if there’s any way to address that? I want to get that tight tummy back! but don’t know where to start or if it’s even possible 🙁 would love your thoughts!

    1. That is SO common. It’s most likely from weak abdominal muscles – implement your diaphragmatic breathing in addition to abdominal rehab and I’m confident you’ll see an improvement. Be careful not to “overly engage” or suck in throughout the day as that can bear pressure down on your pelvic floor and contribute to a potential set back. Does that make sense?

  2. This article is so helpful! I’m due with my first baby in March and I can’t wait to get back into a fitness routine. This will help me stay the course and not overdo it. Quick question when it comes to building your pace when returning to running. You say to increase pace on incline one week and to focus on decreasing incline the next, but you also say to build pace on a flat road. Does this mean that our “speed weeks” should be practiced on ZERO incline? Thank you!

    1. Congratulations, our LO’s will have similar birthdays! LL’s is March 8th! Not necessarily! It’s not so much what you do as how you do it. An incline will help rebuild your economy and posture, a flat road may help you build speed. Both will garner glute engagement, but your form is #1. It’ll will be a process of trial and error of how you return to running but guideline or best practice would be to use incline for form and flat road to acclimate to speed. You may feel better running on a small incline though, so you have to feel it out. I hope that’s helpful even though that’s a vague response.