Exercising after giving birth is necessary to rehabilitate the postnatal body and strengthen key areas that support the demands of motherhood:
- The upper back must be strengthened to support breastfeeding.
- The chest needs to be stretched.
- The gluteal muscles need to be strengthened to improve and recover pelvic stability control.
- Pelvic stability muscles such as the piriformis and psoas may need to be stretched and released from the stress of pregnancy and delivery.
- The thorax may need to be stretched to open up the ribcage.
- The pelvic floor must be strengthened and the core must be re-patterned.
It is important to know what exercises are the safest and most effective postpartum. Due to the rehabilitative elements of exercise, it is imperative to avoid movements that will worsen (or create other) imbalances.
Months 1-3 Postpartum (General Guidelines)
- Get your doctor’s approval before beginning your recovery program.
- Start slowly and progress slowly. Remember you are building back up.
- Listen to your body.
- Stay well hydrated.
General Notes & Guidelines:
- Use fluid gentle motions. Avoid changing direction suddenly or otherwise quick jerky movements.
- Don’t rush: smooth movements focusing on balance and grace.
- Remember to breathe!
- If the exercise is not difficult enough, increase repetitions until form falters.
- Involve the baby!
Low impact cardio is best suited for the postpartum condition. This is considerate of the pressure put on the pelvic floor as it rehabilitates and strengthens from supporting the weight of a pregnancy, and in many cases a vaginal delivery. It will support the abdominal wall by not stressing the Linea Alba (connective tissue between the recti), which also supports the rehabilitation of diastasis recti.
The best cardio choices for postpartum are:
- Walking- 30 minutes, 4-7 days/week. Build up as you would with a run program. Start with short distances of 2-3K and over time increase both distance and pace. Don’t think that walking doesn’t count as exercise. The pelvis is still unstable and needs to strengthen.
- Swimming- 30-45 minutes 3-4 days/week. Swimming takes weight off of the joints and offers relief to the pelvis.
- Elliptical or Stationary Bike- 30 minutes, 3-4 days/week. This is a great option for higher heart rate
Post birth is the perfect time to focus on form and target key areas to offset imbalances that accompany the postnatal condition. The focus is typically core, gluteal muscles, lower and upper back, in a full-body functional-movement calisthenic based workout. Exercises must be monitored for discomfort through the pelvis, which indicates a lack of pelvic stability control necessary for a movement. In this case certain movements may become contraindicated so as to not exacerbate the symptoms, while the pelvis in strengthened in a targeted way to support these movements.
- Core: Intra-abdominal core work is the single best investment in postnatal recovery. A comprehensive program recruits the core with synergy and includes the diaphragm, pelvic floor, transverse abdominus and multifidus. This workout will strengthen the core including the back, rehabilitate the pelvic floor, and approximate diastasis recti.
- Lower: Compound movements targeting gluteus maximus and medius, improving pelvic stability control. Lateral and unilateral movements are mindful of gentle weight load transfer to reduce the risk of pubic symphysis discomfort. Some examples are: reverse lunge, squat with lateral leg lift, and full range hip circles standing or side lying.
- Upper: Strengthening the upper body is imperative to supporting the nursing mom’s posture and the daily carrying of the baby (and car seat and huge diaper bag). The upper back is a focus to support the weight of enlarged breasts and the nursing position. Upper body exercises can be done seated on a stability ball, standing unilateral or standing bilateral with an offset weight load for increased balance and pelvic stability work. Some examples are: cable lat pull downs, cable rows, bicep curls, and shoulder press.
Stretching daily is a tremendous investment in preventing general aches and pains postpartum. Dynamic stretching targets fascial lines and the range of motion of joints, and is best in the morning or whenever the body is stiff. Static stretching focuses on isometric positions to lengthen muscles, and is best at night or as a general anytime cool down. I recommend a full body program for both types of stretching, with typical key areas of focus being chest, lower back, gluteal muscles and quads.
The secret to a safe effective postnatal program is to follow the guidelines and target imbalances while keeping the movements functional and meaningful. Now is not the time to sit on a machine and push weights! Use a gentle circuit style approach with sensible and effective exercises. Give yourself time and focus on getting strong rather than skinny. Be gentle and consistent. Short functional workouts frequently are a better investment than hour-long sessions once or twice per week. This will fit perfectly with the new mom schedule, and calisthenics can be done in your living room with a mat, ball, cable or body weight. Train smart and train well.