When to start?
Gentle exercise can be started whenever you feel ready if your delivery was without any complications. This could be walking, pelvic floor muscle exercises, breathing exercises, deep abdominal muscle activation, gentle stretches and exercising extremities to improve circulation. Appropriate exercises can help you regenerate, enhance circulation, prevent postnatal depression and may even boost your energy level.
If you were active before giving birth, or if you would like to get into better shape, you should always wait for the 6 week postnatal check up at the doctor’s office before commencing any exercise more intense than the above mentioned ones.Your body will likely need more time to recuperate. In general, 12 weeks is advised before beginning aerobic exercise, jogging/running or any high impact activities.
It is best to have a functional assessment done by a physiotherapist for the whole body, but especially the abdomen and the pelvic floor. If the pelvic floor, the abdomen and your breathing pattern are not working well, exercise may put pressure on your back, abdomen and pelvic area no matter how much time has passed since birth. You might not feel that the connective tissue is weakened after giving birth.
Doctors check that your body has started healing properly, but if everything is ‘OK’ it does not mean you are back to ‘normal’. If you do exercise too high in intensity too soon, you are likely to create problems by over-exerting the tissues. This will cause symptoms such as feelings of foreign body in the vaginal area, feeling of heaviness and dragging in the pelvis, lower back aches or lower abdomen dragging/ pain.
The safest way to start or restart exercise, is to contact your physiotherapist, who will prescribe exercises and create a safe and graded plan on how you can get back to running, specific sports or start something new. The program will be progressed according to your specific needs and abilities.
What exercise or physical activity is recommended?
Some ideas include walking or pushing the pram with the baby, joining postnatal exercise classes, Pilates classes and if your scar area has recovered (bleeding has stopped and any perineal/cesarean wound has healed) then swimming/water aerobics or bike riding/indoor cycling may also be a good choice.
How much, how often?
150-300 minutes of moderate-vigorous intensity aerobic exercise weekly is recommended. Gradually building up this amount is best if this seems daunting at first. Splitting this time into 10 minute sessions is a good way to get moving if it is hard to leave the baby and household for longer periods. Start as soon as possible, but always listen to what your body is telling you, to prevent overexertion of the regenerating body! For those seeking to do more at once, 5x 30 minutes to 5x 60 minutes can be another way to schedule the exercise.
Ideas on how to progress:
- Start with exercising for 10-20 minutes, including diaphragmatic breathing, spinal mobility exercises/gently stretching, pelvic floor exercises and walking.
- Increase time up to 5x 30 minutes slowly if desired, adding in deep abdominal muscle (transversus abdominis) activation exercises.
- If you feel well rested and have the time and would like to do more, you can increase to 5×60 minutes, adding strengthening exercises such as glute bridges, side lying leg lifts etc.
You can also stick to the 20 minute time frame and slowly add on the exercises as discussed above.
Breastfeeding and exercise
Paying attention to healthy eating and consuming enough fluids is very important for successful breastfeeding. If the above needs are met, it is safe to exercise 150-300 minutes at even vigorous exercise intensities. You may need to alter the time of the feed or express the milk before exercise if your baby seems to be less content or satisfied when feeding straight after your workout. For example, it may be more comfortable to pump the milk before exercising.
What is too much?
Listen to your body. If you feel fatigued after intense workouts, or if your postnatal bleeding increases or the color turns pink/red, it may be too much for you. If you progress exercises too quickly or you start with exercises too high in intensity, you may start feeling heaviness or dragging in the pelvis or vaginal area, lower abdominal discomfort, pain, urinary incontinence (leaking of urine) or other symptoms may arise. Aim to build up strength and endurance gradually, as well as giving yourself time to get toned or lose unwanted weight. Rest is also key, so be kind to yourself. If you are sleep deprived, skip high intensity workouts and do what feels right for your body. The key is consistency over a long period of time, not rushing! You grew a baby inside you for 9 months. Have patience, your body will return to its best shape in around that much time, too! Only women in advertisements ‘bounce back’ in a few weeks.
By Zsofia Agg
