15 Aug Returning to Exercise after Pregnancy
NOTE: if you are interested in diving deep into providing top quality health & fitness care for postpartum women, PLEASE check out Dr Sarah Ellis Duvall's course POST-PARTUM CORRECTIVE EXERCISE SPECIALIST!
When we look at postpartum recovery I see two kinds of women at the one year postpartum mark: one is super fit, athletic and frankly looks like she never had a child (even though she has had three!); and the other is trying to workout hard but has some leaks, her abs never came back together and she keeps getting hurt and stalling her workout progress.
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What is the difference between these two women? You might say genetics. Sure, genetics helps with stretch marks, extra skin and athletic ability, but that’s not all we are talking about here. The fact is, some women are doing the right things to rebuild their inner core and get their pelvic floor back, and others simply are not.
There are common mistakes made everyday in the first 6 months after having a baby that can cause lasting damage on the body. The good news is most of them are preventable.
Let’s take some time to look at the two most common complaints that I see in those trying to Exercise after Pregnancy:
#1. Pelvic floor leaks and prolapse: Leaking when you run, cough or sneeze is not normal and it’s not just part of being a mom now. Having a vaginal delivery can increase your risk of prolapse, yes, but then why do I see women that had a C-section with prolapse? (Pelvic organ prolapse is where your internal pelvic organs are starting to descend down the vagina. This can cause painful sex and difficulty peeing or pooping. It’s often described as feeling heavy or like there is something in your vagina.) Prolapse often occurs long after the 6 week check up but before the body has a chance to fully heal.
#2. Diastasis Recti, or separation of the center abdominal muscle. This can make you look like you have a belly post-baby when you really don’t.
Pregnancy and delivery increase your risk for both of these, but in most cases they are made worse or better by the choices we make in the postpartum period.
Find out below if you are making any of these common mistakes during exercise after pregnancy:
Thinking you can pick back up where you left off is a major mistake that women make. Holding off on the burpees and double unders is a smart choice and here’s why:
- You still have a ton of ligament laxity in your system. It takes months for your ligaments to return to normal. Lax ligaments make your entire system more vulnerable to injury.
- If you are breastfeeding, that ligament laxity will last even longer.
- A common patient story I hear is “My 6 week check up was fine, no sign of prolapse or leaks. They came later, months later.” Getting that all clear does not mean your body is ready for all types of exercise.
Your abs are still healing from all the stretching. They just took on a very distended position for months and now they need to regroup and get back to normal. At first they are going to be a little slow to fire, which will make core stability difficult. This lag means you will be putting increased pressure on your connective tissue systems. One of those major systems is a line that runs down the front of your abdomen where your abs connect in the front.
Some separating or opening of this area in the middle is normal from the stretching of being pregnant, but if you want to increase your chances of it going back to normal, you don’t want to stress the system. I know that’s not what a lot of the baby bootcamps are telling you but it’s the truth.
Until you’re fully healed, the major list of things to avoid include any front loading exercise after pregnancy, such as Push ups, Sit ups, Crunches, V sits, burpees -- basically anything where you are putting strain on the front of your abdominal wall.
There are also exercises that if done with poor form can stress this area as well.
A great example of this is kipping pull ups. You should be able to do a very controlled static pull up with excellent core firing (no bulging out on that midline of your belly) before you attempt a kipping pull up. Adding stress on top of all the laxity can lead to hernias. Being able to do a pull up without any bulging in your belly tells me your deep core system is exactly where it needs to be!
Same goes for perfect form on any other exercise, poor form stresses the system and prevents healing.
Working on the extensibility of your abs from the inside by utilizing your diaphragm for 360 breathing will give you an advantage for healing your diastasis quickly. It’s also a great preventer of abdominal separation if you want to get pregnant again.
How to for deep breathing to fix your diastasis. Exercise after Pregnancy
The great part about getting your diaphragm working to heal your diastasis is it will simultaneously heal your pelvic floor as well. Win - Win! The pelvic floor plays off the diaphragm. As your diaphragm contracts down for an inhale, your pelvic floor should relax, and then on the exhale you get a natural tightening of the pelvic floor. With this system in place your pelvic floor is getting stronger with each and every breath all day long.
Make sure you can feel your pelvic floor coordinating with your diaphragm. This may take some mental focus in a quiet room. It’s also one of those great multitasking things to do while driving. Exercise after Pregnancy
Focus on two things: 1. Expanding both your low back and midback into the seat when you take a deep inhale. 2. Try and direct the pressure from your breath down to your pelvic floor.
Deep squatting is also a great way to feel your pelvic floor. Just be sure you are not bearing down on the inhale but simply letting your pelvic floor relax.
Once you make sure your diaphragm is coordinating with your pelvic floor, then you can work toward lifting heavier.
Start with breathing during all exercises. No breath holding until you are at least 4-6 months postpartum with zero pelvic floor issues. One of the best preventers of pelvic floor issues is not creating too much intra-abdominal pressure, running, or jumping too soon. Focus on building inner strength and save the pounding and PRs for when your pelvic floor has had at least 4-6 months to recover (preferably 6). You have the rest of your life for these activities and they are much more pleasant without having to deal with prolapse!
We might not be able to do much about the stretch marks (thanks, Mom), but by taking these simple steps above and applying them to your postpartum period, you will be on the right track for great results.
Sarah Ellis Duvall
A wife, mom and adventure sports athlete, Sarah is a women's fitness specialist that takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understanding every aspect of the body is a necessity to complete healing. She integrates functional movement with cutting edge exercises to bring you a results driven program for postpartum recovery, with an emphasis on the pelvic floor and abdominals. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at http://www.CoreExerciseSolutions.com and figuring out how her patients can continue to pursue their dreams and lead a strong, adventurous life.
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