When and how to return to exercise postpartum is one of the most common questions I get as a pelvic floor physical therapist. Typically, women are eager to return to what they were doing pre-pregnancy, but it can be confusing and challenging to figure out how to navigate exercise after baby. While everyone is certainly different, and everyone’s birth experience is different, there are general timelines to consider when returning to exercise. This post will serve as a comprehensive postpartum exercise timeline. We’ll break it down by week and give ideas of exercises to focus on.
Why postpartum exercise can be different
What your body just did
- Organs were squished. While you were pregnant, organs were pushed and pressed on by baby. In many cases, organs were moved out of their normal positions
- Diaphragm and ribs were pushed up and out. In order to make room for baby, your diaphragm (the main muscle that helps you breathe!) was pushed up and out of the way. Your ribcage widened to make more room for baby
- Abs were stretched. Your abdominal muscles were stretched. While this is totally normal, it affects how well your abdominal muscles can work. By 21 weeks of pregnancy, 32% of women already experience diastasis recti. Diastasis recti is when the abdominal muscles (think your “6 pack ab muscles”) separate.
- Back muscles worked harder. In order to counter-act the increased weight of belly and baby, your back muscles had to work a lot harder to keep you from toppling over (thanks center of gravity!).
- Posture changed. Due to all the changes mentioned above as well as the rapid growth of baby, your posture changes dramatically. Typically, our shoulders round forward more. Our upper back rounds forward more, our lower back curve increases as our pelvis tilts forward. Our base of support, how wide our feet are, gets bigger.
- Pelvic floor is under a lot of stress. Your pelvic floor is under a lot more stress than it’s typically used to. The weight of baby and extra fluid weight that’s gained during pregnancy makes the pelvic floor have to also work harder than it usually does.
Why is safe postpartum exercise important?
- Prevent injury
- Lessen symptoms related to pelvic floor issues like urinary leakage or prolapse
- Improve muscular imbalances caused by pregnancy
- Improve mental and emotional well-being
- Restore strength and mobility
Goals of Postpartum Exercise
- Get diaphragm working correctly and back into place
- Get abs contracting
- Strengthen core, hips
- Decrease back tension
- Decrease rib flare
- Strengthen hips
- Return pelvic floor to normal
- Work on posture
Your Postpartum Exercise Timeline
Full postpartum recovery can take up to a year. However, a lot of progress is typically seen in the first 3 months postpartum. The goal of the first 3 months of postpartum recovery is to establish a base of strength and the the pelvic floor and core working together. With that being said, one good thing to keep in mind is, “Just because I can do something, doesn’t mean I should.” It’s important, now more than ever, to really listen to your body. I liked how Laura Jawad described listening to your body, “No peeing, no pain, no pressure, no peaking (doming).” There is a lot to consider when starting a postpartum exercise program, so read on for more guidance.
Avoid these during Initial Postpartum Exercise
- Hard, plyometric exercise
- burpees, jumping jacks, running up stairs
- Running, hard biking, hard swimming
- Front ab exercises
- sit-ups, v-sits, roll downs, leg lifts
- Anything that makes the abs bulge
Safe Cardio Postpartum
- Intensity 25-50% of what you feel is really intense or hard
- Elliptical, biking, swimming
- 10-30 minutes per session
- Start with 5-10 minutes
Signs of Over-Doing it
- Heaviness or pressure in the pelvis or lower abdomen
- Worsening diastasis during or after exercise (peaking or doming)
- Increased cramping, vaginal bleeding in the very immediate postpartum period
- Pain (in any location)
- Peeing or leaking urine (or stool)
- Soreness that lasts more than 24 hours
Postpartum Exercise Timeline Phase 1: Weeks 1-3
Hip Flexor Stretch
Hands and Knees Cat/ Cow
Transverse Abdominis Activation
Postpartum Exercise Timeline Phase 2: Weeks 4-8
|Child’s Pose Back body breathing|
|Side-lying Mid back rotation|
|Stationary ½ lunge|
|Rows in half kneeling|
|Angel Wings in sitting|
|Serratus Towel Wall Slide|
Postpartum Exercise Timeline Phase 3: Weeks 6-10
|Hands/ knees breathing|
|Opposite arm/ leg lift|
|Facedown glut squeeze|
|Foam roller up wall|
Phase 4 Postpartum Exercise Timeline: Weeks 8-12
|Hands/ Knees breathing|
|Hands/ knees mid back rotation|
|Foam roller up wall|
How to Implement
Now that you have the plan, it’s time to get started. The benefits of exercise postpartum are numerous, but finding time for it can be hard. Be gentle with yourself when setting expectations. As you adjust to life with a new baby and body, jumping right back into an old program likely won’t be realistic. Start with a goal of 5-10 minutes of just walking. Second, focus on returning to your breath and overall awareness of your body. This will help you immensely as you start to build your foundation postpartum.
If you need help getting started or are having trouble navigating postpartum exercise, you are not alone. Please reach out to a pelvic floor therapist or make an appointment with Simpli Whole to get professional guidance on your postpartum journey.
Coming soon- a YouTube Channel where you can find all these exercises!