Postpartum Exercise: When Should You Start Working Out?
Before You Begin
Do you remember the joy you felt when your pregnancy belly first started to show? Now that your baby is here, you may be feeling more frumpy than fabulous. Are you anxious to shed those extra pounds? Before you don running shoes or head off to the gym, keep in mind that your body has just experienced a tremendous change.
Pregnancy and childbirth put an enormous strain on the body, and the road to recovery is not always as smooth as we’d like it to be. How long it takes to regain that pre-baby figure depends not on how quickly you can start an exercise routine, but on factors such as pre-pregnancy weight, the amount of weight gained during pregnancy, and your level of fitness after your baby is born. Here are some important considerations to look at before beginning your postnatal exercise program.
Evaluate Your Fitness Level
Most new mothers tend to focus more on the weight gained during their pregnancies than their overall fitness levels, and this is hardly surprising. The media portray images of celebrity moms looking svelte and glamorous seemingly moments after having a baby. This phenomenon puts undue pressure on non-celebrity moms, some of whom embark on a rigorous exercise routine too soon after giving birth.
Refreshingly, when Julia Roberts was pregnant with her twins, she reported that she couldn’t care less about getting her movie-star body back once her babies were born. She was content knowing that her body would return naturally over time.
Yet time is what makes many women despair and fear they’ll never get back to normal. According to the Physician and Sportsmedicine Journal, although the average postpartum weight gain for American women is small, 70 percent are unhappy with their appearance at six-months postpartum. Many women fall prey to the myth that because it took nine months to gain the weight, they should expect weight loss to take an equal amount of time. Remember, there is no time frame for postnatal weight loss. Some women bounce back quickly and others take several years.
Get Started Slowly
How soon after delivery can you exercise? The American College of Sports Medicine (ACSM) says that walking, stretching, and floor activities are safe to begin between two to fourteen days after delivery. They reiterate that moderate exercise in the postpartum period will also help facilitate weight loss and increase a mom’s sense of well-being.
If you didn’t work out much before or during your pregnancy, start slowly postpartum. If you did maintain an exercise program before or during pregnancy, the American College of Obstetrics and Gynecologists’ (ACOG) says it’s OK to gradually resume your pre-pregnancy routine (if your physician or midwife gives you the green light).
Don’t Go Overboard
Some experts warn against getting started too quickly. Diane Lee is a physiotherapist who lectures internationally on the topic of pelvic pain. She is also an education and clinical consultant at Ocean Pointe Physiotherapy Consultants in British Columbia, Canada. “After nine months of continuous stretching of the anterior wall followed by stretching, tearing, or cutting of the pelvic floor, one is crazy to start with traditional exercises too soon after delivery,” says Lee. The abdomen, uterus, and bladder need to reestablish their size and position, and the linea alba (a fibrous structure consisting of connective tissue that runs down the midline of the abdomen) needs to contract back to its proper length. “Then one needs to start strengthening and co-activating the transversus abdominus (or TA—the deepest layer of the abdominal muscles which stabilize the trunk and maintain internal abdominal pressure) and pelvic floor muscles,” says Lee.
During pregnancy, the TA stretches considerably, reducing its ability to stabilize the lumbar spine and pelvis. The pelvic floor must support an ever increasing uterine weight and the internal fascial support system for the uterus and bladder become stretched.
During a vaginal delivery, the anterior pelvic floor becomes even more stretched and occasionally torn or cut (such as in the case of an episiotomy). If a Cesarean section is required, the pelvic floor is preserved, but the abdominal wall is further traumatized with the surgery. After pregnancy, the body tends to retain the inefficient stabilization mechanism since the function of the TA and anterior pelvic floor is not immediately restored.
So what can women to do counteract this? Lee recommends that new moms bind their abdomens for 10 days to two weeks after delivery to support the viscera (heart, lungs, gut, liver, and kidneys) and abdominal tissue, and then start isolation exercises for TA and the pelvic floor about three weeks postpartum.
“Exercises done too quickly or too strenuously can lead to poor support for the lower back, pelvic girdle, uterus, and bladder,” Lee adds, explaining that this can ultimately become non-resolving low back and pelvic girdle pain, prolapse of the uterus or bladder, or urinary incontinence.
Take Time to Rest
Most experts recommend walking as a suitable exercise in the days after giving birth, but only if you’re not experiencing discomfort. And don’t discount exhaustion! Your body has just been through major trauma; this coupled with adjusting to your new life with baby can make exercising unusually tiring.
Although exercise aids the release of endorphins (the happy hormone) which in return increases the sense of well-being, the mental and physical trauma associated with vaginal and C-section births can overwhelm you if you take on too much right away.
“If you exercise too soon after a vaginal delivery or operative delivery you can delay the body’s normal healing mechanisms,” says Dr. Karen Nordahl, MD, who practices family medicine and obstetrics in Burnaby, British Columbia. “In other words, the changes that need to occur as a result of the changing hormones, altered sleep patterns, breastfeeding demands, and so on, will be stretched even further if exercise is too vigorous too soon after birth.”
To keep your body in optimum condition, it is imperative that you take care of yourself not only before conception, but also after the birth of your child. No matter how fit you might seem on the outside, heed your doctor’s advice and keep to a moderate exercise regime until cleared to do something more strenuous. Take this time to relax and enjoy your newborn who loves you unconditionally, jiggly tummy and all!
YOU MIGHT BE INTERESTED IN