Postpartum Exercise: Return to Movement
Postpartum recovery is a process. It does not happen overnight, even if we want it to. After labor and delivery our bodies begin healing. After all, labor and delivery is a huge event. One of the best things you can do as a new mama is to rest and give yourself time to fully process your new role, pregnancy, and birth. I remember the day after my son was born - everything hurt. My husband helped me walk to the bathroom, sit, stand, and nurse. I longed for movement, my pre-pregnancy body**, and the assurance that I was doing a good job.
The Healing Timeline
A typical orthopedic surgery recovery timeline is 12-16 weeks. Yet, current guidelines recommend a safe return to physical activity, intercourse, and work six weeks after delivery. Yes, six weeks. On day 42 is your body magically going to change? Probably not. Everyone’s recovery process and progress is different, with a ton of variables to consider:
- Method of delivery
- How active you were prior to pregnancy / during pregnancy
- How long your labor was
- Severity of tearing or an episiotomy
- Sleep deprivation
- Whether you’ve had multiple births
- ...and more
Healing the Body and Early Movement
I love Jessie Mundell’s approach to returning to pre-pregnancy fitness. https://www.instagram.com/p/B2mGb88BTuv/Jessie's 4-R System for returning to pre-pregnancy fitness includes four steps: Rest - We need to respect this phase and give it the time it deserves. Do not feel guilty for taking the time for recovery and sleep. This doesn’t mean no movement whatsoever (unless directed by your doctor), but it does mean limit time on your feet and be mindful of how your body is feeling. Recovery - The body has gone through a lot. The pelvic floor, pelvic organs, abdominal wall, and perineum are all recovering. Your body needs to chill before you can think about rebuilding and retraining. Rehab - This is the period of time where I highly recommend consulting a women’s health physical therapist. Rehab of the core and pelvic floor is such an important step, and it doesn’t matter how long ago you gave birth. It’s never too late to address. Postpartum is forever. 
One of the biggest takeaways for me from pelvic floor PT was learning to take a full body approach. The core is not just the “six pack” muscles across the midline. When we talk about the “core” we’re talking about the deep central stability system, including the diaphragm, pelvic floor, transverse abdominus , and the multifidus. These four muscles, along with the glutes, work to provide a stable foundation for all of our body’s movements. A properly functioning core is key to healthy, pain-free movement. The focus should really be on breathing, alignment, and lifting and carrying techniques. Kegels and crunches are not for everyone, which is why it’s so important to work with someone who can help you in the rehab phase. Retrain - Intention now for intensity later. The goal isn’t simply to make you tired in your workouts, but to make you better, stronger, and able to safely return to movements and complete everyday tasks. In the postpartum period, training programs are progressive and focused on full-body strength training, along with lots of walking and movement. We will work on rebuilding some baseline strength with simple functional movements, increasing aerobic exercise, establishing optimal breathing patterns, and learn how to activate and engage our core. Feel good mama and listen to your body :) I’ve included a sample workout below. As always, consult your doctor and your physical therapist and only progress if it feels good in your body. In 2020 I will continue learning more about the postpartum body and start offering group training for mamas.
Postpartum Sample Workout
Movement patterns to consider: hinge, squat, lunge, carry, push, pull. I recommend 4-6 exercises per workout. Warm Up - Cardiovascular Warm Up - 5-10 minutes incline walkingFoam Rolling (optional)Connection Breath, Hip Stretch, Glute Activation (lateral band walk, bodyweight squats, banded floor bridges)Exercise 1 - Banded Hip Thrust (weight optional) - 3-4 sets of 10-12 reps https://www.youtube.com/watch?v=CaepDtuABlQExercise 2 - Seated Cable Row - 3-4 sets of 10-12**Option for Renegade Row for advanced clientshttps://www.youtube.com/watch?v=kISTb3lZ21AExercise 3 - Dumbbell Romanian Deadlift - 3-4 sets of 10-12https://www.youtube.com/watch?v=ha_Z41uRiew Exercise 4 - Squat to box w/ dumbbell or bodyweight: 3-4 sets of 10-12**Option to superset with bicep curls for advanced clientshttps://www.youtube.com/watch?v=ffK5JnJpOe0**Dumbbells optional. Also option for bulgarian split squat off bench for advanced clients for unilateral work. Exercise 5 - Tricep Extension: 3-4 sets of 10-12 https://www.youtube.com/watch?v=3Ql5clrX-08Exercise 6 - Dead Bug - Arms Only: 3-4 sets of 10-12**Advanced clients progress to arms & legs https://www.youtube.com/watch?v=ROBfwgops5c **Note - I don’t like the term “pre-pregnancy body.” Is there something wrong with a body that has given birth? Why do we strive for the pre-pregnancy body? After pregnancy and delivery our bodies will be slightly different. After all, they created life. So, you may see me refer to this as “pre-pregnancy fitness” instead.