Safe return to exercise after pregnancy and during lactation
By Tanya Kestenberg, PT
- Gentle exercise, such as walking, stretching and pelvic floor exercises can be started as soon as comfortable after uncomplicated delivery
- If your baby was delivered by C-Section, wait 6-8 weeks to resume exercises, and do so only after your post-partum check-up by a physician
- Practically speaking, walking is a great exercise to do with your baby, even a few weeks after C-Section since the baby is easily transportable in a stroller and will most likely enjoy being gently rocked as you push the stroller during your walk
What about more complicated exercises, such as weight lifting, Pilates and Yoga?
Do a simple self-assessment to see if you’re ready:
- Curl up test: lie on your back with your knees bent and feet planted. Slowly try to do a crunch up (lift your head and shoulders, as you keep your chin tucked in).
- Leg lift test: lie on your back with both legs straight, then lift one leg slowly about 2 inches off the ground
During either of the tests, you must assess for the following:
- Do you have back pain or pubic area pain?
- Do you feel a “soft” gap in your stomach (rectus abdominus) muscles?
- Do you see any bulging (like a hernia) in the centre of your stomach?
- Feel your pelvic floor (a space between your legs), do you have a bulging out at your vaginal opening?
If any of the above mentioned 4 symptoms occur, then see your family doctor, obstetrician and/or a physiotherapist for a complete assessment prior to beginning the exercises.
WHAT ARE NORMAL SYMPTOMS DURING DIFFERENT STAGES OF RECOVERY AFTER DELIVERY?
0-8 weeks postpartum:
- You may experience pain in the back, hips or pelvis
- You may have difficulty controlling urine, gas or stool
- Your neck, arms, backs and hips may be sore, as you’re recovering and getting used to new positions and demands as you’re caring for your baby
During this stage of healing allow yourself the time to heal, relax and rest
8+ weeks postpartum:
- Your bleeding should have stopped, and incisions or tears should have healed
- You should no longer feel pain in any of the above mentioned areas
- You should have control over your bowel and bladder
- You may be considering returning to your pre-baby activity level
What can I do to ensure healing goes as expected?
- Use good posture as you care for your baby. Don’t slouch when you nurse your baby, but use pillows to lift the baby up to your breast instead of slouching yourself over towards the baby. When carrying your baby, engage stomach muscles and don’t lean back or arch your back.
- Begin training your pelvic floor and deep abdominal muscles. You should not feel pain as you do these exercises. See a physiotherapist to make sure you’re doing them correctly or if you have any concerns.
- Stretch or massage (with a tennis ball or Pilates roller) your neck, back, shoulders and legs to help relieve soreness.
- Remember to rest and look after yourself, as you’re doing the most important job of caring for your baby.
How would I know if healing is not progressing as it should?
Here is a list of symptoms you should NOT feel:
- Ongoing back, pelvis, groin or abdominal pain
- Leaking urine, gas or stool with laughing, jumping, coughing, sneezing, walking, running and/or lifting
- Being unable to control stool or urine when you feel an urge to go to the washroom
- Pressure or bulging in your vagina or rectum
- Bulging in your abdomen after 8 weeks postpartum during any exercise
- Difficulty doing any of your daily activities due to pain or other symptoms 8 weeks post partum
A few final notes on Returning to Exercise after Pregnancy
- Avoid stretching exercises to the area that has stitches, until the incision/tear has healed (6-10 weeks)
- Start exercising gently and be patient. Remember, everyone is different and will recovery differently, so don’t compare and rush yourself. Exercising should feel good, listen to your body
- Remember to maintain proper rest, nutrition and hydration
- If you’re breastfeeding, you most likely would require extra fluid during the exercise and throughout your day
- If breastfeeding, try to exercise after baby is fed and breasts are empty. At least wear a good supportive bra and not a sport bra (as it would compress the breasts too much, which is undesirable)
Your ligaments are going to be lax for some time after delivery, and even longer if you’re breastfeeding (for the entire duration of lactation and even sometime after). This means you may be more prone to injury caused by ligamentous laxity (i.e. twisting your ankle, seemingly unexplained joint sprains, back, pelvic and hips pain).
Not sure where to start?
If you are having trouble returning back to your activities post partum, our team of physiotherapists, massage therapists and naturopathic doctors would be happy to consult with you. An individualized plan addressing some of the pre pregnancy compensations can get you back to feeling your best and achieving your fitness goals. Contact us for a consultation today!