Return to Fitness: Week 19-42 - Bulletproof Your Body

Congrats mama! By now you’ve been back in the gym, and ideally following a progressive strength training program incorporating core rehab, pelvic floor exercises, and gentle movement. Your Pelvic Floor Physical therapist may have also given you the “green light” for high impact and higher intensity cardio and movement. But, before we get ready to take it up a notch and lift heavier weights, let’s take a quick check in. The four P’s are always relevant and very important. If we experience any of the below, we’ll want to dial back intensity/load, total volume, or one of our other training variables. 

• Peeing: incontinence in any way during the exercise
• Pain: Pain anywhere in the body
• Pressure: Any uncomfortable sensation in the perineum or pelvic floor. Note: some pressure is normal. However, it’s really important to pay attention to feelings of bulging, heaviness, and dragging. 
• Peaking: Doming or coning through the midline. Not all doming through the linea alba/ diastasis is bad and needs to be avoided entirely. We simply need to note the degree/amount and adjust as necessary. 

You may find that training for aerobic and strength improvements around 19 weeks (~5 months) is difficult due to fatigue or time constraints, or your body isn’t quite ready. Respect the process. Timeframes are extremely variable with postpartum recovery, and no two bodies are the same. Be flexible. The gym and weights will be ready for you when you’re ready, so there’s no rush. Here’s what you can do to maintain and improve core function, increase training intensity, and get ready to return to your favorite sport or activity: 

1. Continue maintenance pelvic floor exercises

While working with a Pelvic Floor Physical therapist, I was prescribed a “maintenance” program for my pelvic floor health. It’s important that we keep up with these exercises during this stage to maintain pelvic floor function and stamina. It may be as simple as 3x/week, 10-second holds, just to maintain muscular endurance. During this phase the goal is that the pelvic floor reacts in a more automated way to the load placed upon it. It shouldn’t be something we have to think about anymore. If we didn’t work on core rehab and pelvic floor rehab initially, now is the time to go back to the basics.  

2. Review breathing pattern

Yes, breathing once again! It may seem redundant, but breathing helps regulate pressure through our abdominal region, and impacts us physically and psychologically. If you’ve built up good breathing patterns in more basic exercises and gentle movements, it’s critical to make sure those patterns carry over to more difficult work. The first few times you try something new or lift heavier weight, the natural tendency is to hold your breath. Make sure your breathing patterns gets carried through the most difficult part of the exercise. For example, in a squat you would inhale on the way down and exhale on the way up (the most difficult part of the exercise) to create a bracing effect without too much intra-abdominal pressure). If you’re breathing patterns feels off, or your core doesn’t feel supported, dial back the weight and head back to the basics.  https://www.youtube.com/watch?v=mM0AsGmm_NA 

3. Increase aerobic endurance

If you’ve received the “green light” from your pelvic floor PT or there’s no sign of pelvic floor dysfunction, now is the time to make a gradual re-entry to running or high-impact exercise. Together we’ll create a plan to increase distance or time, then speed, over weeks and months - not days. We will also incorporate exercises throughout programming that will prepare the body for running, such as single-leg squats and movements that strengthen the hips (targeting the glute medius), and re-strengthen the hip flexors. Example: Walk-jog-walk: Jog interval is 30-60 seconds, and is repeated five times. The next session may include a slightly longer jog interval.  https://www.instagram.com/p/B2PeiTgHNbp/

4. Progress Strength Training

Soreness will not be the best indicator of success during this time. As we continue to progress towards heavier weights and compound movements, we want to be mindful of form and not progressing too quickly. I recommend increasing weight every other week, with the in between weeks focused on mastering the movement and mind/muscle connection.  

Phase 3 Sample Program

The questions from Stage 2 still apply as we progress training: 

• How is your breathing and alignment during the exercises?
• Do you have full control of the movement and load?
• Any pain?
• How does the training impact your sleep, appetite, mood, and fatigue?
• Can you comfortably add load or progress the exercise?

This is also a period of experimentation. Test one variation of an exercise before diving into the more difficult version. Example: Bodyweight squats, box squats, goblet squats, and then back squats. Exercise Recommendations: 

• Strength train 2-4x/week as your energy and schedule allow
• Perform HIIT 1-2x/week as energy level and schedule allow
• Perform 1-2 moderate cardio sessions per week (walking outside with stroller is a great option too!)
• Rest is just as important as training. Try to get adequate sleep and rest as much as you can. 

Exercise	Week 1	Week 2	Week 3	Rest
Deadlift	2 x 10-12	3 x 10-12	3 x 8-10*	90sec
Push-Up (incline if needed)	2 x 8-10	3 x 8-10	3 x 10-12	60 sec
Walking dumbbell lunges	2 x 10-12	3 x 10-12	3 x 8-10*	60-90 sec
Lat pulldown (band)	2 x 10-12	3 x 10-12	3 x 8-10	60 sec
Seated Band Hip abduction	2 x 12-15	3 x 12-15	3 x 15-20	60 sec
Side Plank	2 x 2 (10-15 sec)	2 x 3 (10-15 sec)	3 x 3 (10-15 sec)	30-60 sec

*Try increasing weightAfter this phase (around 10-11 months postpartum) I’m confident you’ll be able to make a safe return to the exercises and activities you love and enjoy confidently. I know this seems like a long time, but the body has been through incredible change. Our bodies took 9-10 months to nourish and grow life, and it’s just as important to give them ample time to rest and recover, rehab, and retrain. Feel good mama. And don’t forget to review the Phase 1 and Phase 2 posts for a breakdown of a safe return to postpartum fitness. Return to Fitness: Weeks 0-6: Rehab and RetrainReturn to Fitness: Weeks 7-18Timeline as recommended by Girls Gone Strong.