Returning to exercise can be a daunting prospect, but knowing if you’re ready or not to start again, can be even harder. I will run through my top tips before starting exercise again and spoiler alert…. It’s not about starting exercise immediately after the 6 week check! I also have some recommendations of what you can do in the early stages post birth and some things to look out for before starting exercise again.
Back in February 2019, before I was a personal trainer and know what I know now, I left the hospital with my brand new daughter Rosie and a basic pamphlet on 'how to exercise after birth' . This told me very little about what to expect, what to look for/feel for, when I may need to further help for symptoms. Fast forward a few months and I had returned to exercise my own way and my undiagnosed prolapse got worse (because I hadn't been to a physio to tell me I had one - error number 1), postpartum bleeding got worse and ended up having it for 3 months, scarring got infected not only once but twice and mentally I struggled even more as my body felt it had been 'set back' further. I was simply not ready. Tissues and muscles were still healing and I ended up setting myself back more than I could have imagined and my rehab process was longer. Fast forward to now, two babies later and a many qualifications under my belt in this space, I wanted to tell you about the importance of taking the time to rehab and respect the healing process and knowing when you might/might not be ready to exercise after birth
When I put the question out on an instagram, poll, a staggering 400 mums replied when I asked "Did you find it easy to access materials from your GP/doctor about returning to exercise?" here was the result:
This didn't surprise me, so hopefully this blog will help you with your own research and well done for being so proactive with your return to exercise:
So… “How long should I wait before I start”?
The simple answer is "it depends"... it depends on the person, the birth, the number of babies you've had, the pregnancy, the type of birth, any complications etc. During pregnancy your body goes through immense changes and regardless of birth method, healing and recovery is necessary for muscular and tissue repair. The length of this healing process isn’t a matter of days, it can be weeks and months (sometimes much longer than expected or you’re told), and therefore starting back with exercise should be done slowly and gradually.
The phase before returning to exercise should be treated like a process of rebuilding and rehabilitation.
The phase before returning to exercise should be treated like a process of rebuilding and rehabilitation. No matter how much you trained or didn't train in pregnancy, everyone should go through a phase of rehabilitation. Your body has been through a trauma of birth, so like anything, it takes time to recover - regardless of if it is your first or 4th. It is also not the time to put pressure on yourself, be it from other people or yourself. Returning to exercise is highly individual and there is no magical date when you will be ready, it’s about knowing the signs you might not be ready yet and how to set yourself up in the best way before you start.
What are the signs I might not be ready?
This is not an exhaustive list, but here are a few signs that suggest you aren't ready just yet and more rest & recovery might be needed first, or referral to a physio:
Do I have any heaviness or soreness in the pelvis?
Any vaginal heaviness/bulging or leaking
Any stitches still in place or bleeding/healing
Any lochia (postnatal bleeding)
Scarring is still healing
High levels of fatigue & burn out
Post baby hormone peaks & troughs
Also consider delaying if you have any of the following and focusing more on rehab and rest and maybe asking for a physio referral:
Do I have any incontinence when doing everyday movement like lifting baby or walking up the stairs?
Have I got any aches & pains that have occurred since birth and have not gone away after initial recovery?
Am I ready mentally? Do I have the headspace to start something new right now?
Do I have the support of a professional in this field to know I am doing the right exercises and correctly?
Do I have the energy to take something on?
Do I feel ready in myself?
Here are a few top tips to bear in mind before starting...
Top Tip: You many have heard of “the 6 week check" and the "exercise sign off"... this can mean absolutely nothing. Very often the check is a basic assessment using a series of questions, not a physical, internal or mental examination. If no physical examination of our pelvic floor, scarring, pelvic stability, abdominal separation etc. occurs, how can we presume our body is ready? Subsequently many of us put pressure on ourselves to get back to exercise once this check has passed, when realistically many of us are not ready in the slightest. Instead, see the sign off as an indicator of being able to start the initial stages (which I talk about later).
Top tip: Book yourself in for a more through assessment with a women's health physio or pelvic health physio. They are worth their weight in gold! Pelvic health physios are able to do a more thorough internal and/or external (your choice) assessment of your readiness to exercise. They can recognise areas that perhaps need strengthening or more rehab before returning to exercise for the first time since birth. They can also assist with helping you manage symptoms when you return to exercise too, such as diastatis recti (abdominal separation) and prolapse. If this is not available to you, you can also speak with you hospital who often have physios on site and if not again, you can ask for a GP referral if you have any concerns that they can’t help you with.
Top Tip: Dont compare yourself to anyone, including your own body and any previous births. All births are different, even in the same body.
Top Tip: No matter if you exercised regularly or not in pregnancy, no one is exempt from the initial healing and rehab process. You should still always go through it and not ignore it, nor rush it.
6 week check aside… what should I be doing?
Think about it like this, if you had knee surgery and you were told to wait 6-8 weeks and stick with gentle rehab exercises until you’re ready to move to the next step, you would take that advice and hopefully not ignore it! Birth is like this, especially if you had a cesarean section which is major abdominal surgery. But any type of birth is a trauma in itself to the body and a recovery process or ‘4th trimester’ is very much needed. Yet so few of us think of it this way and we put huge amounts of pressure on ourselves to exercise too soon. It can be frustrating to not have control over this period, I can completely sympathise here, you’re coming to terms with a new baby, lack of sleep, a whole new lifestyle and a new way in which your body moves and responds to daily tasks.
First few weeks
In the first few weeks your body is still very vulnerable, regardless of birth method, so even if you feel you can walk or move further, dont push yourself too soon and focus on the following:
Rest and recovery, scar and tissue healing
Pelvic floor squeezes, gentle mobility and optimal Breathing (see videos below) - the squeeze and release as as important as each other and even if you dont feel much 'down there' know that with every squeeze and release brings blood flow to the area which promotes healing and soon you will regain feeling.
Later on in the first few weeks, short walks (few hundred metres at most) if you feel like it
You can watch 3 videos here from my Early Postnatal Program, New Beginnings, which will guide you through optimal breathing postnatally, as well as pelvic floor & core pressure management:
Optimal Breathing Post Birth
Pelvic Floor & Core Connection Post Birth
Gentle Mobility
Using these videos will help you tap into the body and get more of an understanding of how it all works internally with you healing process and what to feel for.
Subsequent weeks following this (vaginal or c-section dependent):
Focus first on connecting with the breath, body and core - monitor for weaknesses, doming, pressure where it shouldn't be or urgency - just get the body functioning correctly first!
Gently increase movement and expand on exercise choice - activating muscles that might have fallen asleep like the glutes, core and pelvic floor - introduce gentle bodyweight exercises like glute bridges, knee folds, leg raises etc. exercises like and more this can also all be found in New Beginnings
C-Section mummas this process takes longer - think 6 weeks to heal inside, and another 6 weeks to heal on the outside. But even then, it might be much longer, especially if you have other children at home and rest isn't an option all the time. These processes of healing really take time.
Ok, so I’ve done some resting, recovery and rehab, how do I know when I'm ready to start harder exercises after birth?
There is no magical time frame or date I can give you, more to just be aware of how you feel and think about all of the above questions I mentioned, but also the following?
Have I had some support from a professional in this field (physio/consultant)?
Have I got an exercise plan in place to follow now that I feel I am ready?
Do I have any pelvic heaviness?
Have I got any aches & pains that have occurred since birth and have not gone away after initial recovery?
Am I ready mentally? Do I have the headspace to start something new right now?
Do I have the energy to take something on?
Do I feel ready?
The first three months post birth are critical for recovery, healing and rehabilitation, so dont ignore any symptoms!
Weeks proceeding rehab phase (minimum 6-12 weeks later) to 6 months+ (vaginal or c-section dependent)
Begin to introduce exercises such as squats, lunges using bodyweight and get used to the movements - how are you feeling after? Immediately and the next day/week?
Any heaviness
Bleeding
Discomfort
Pain
Soreness that doesn't resemble muscular soreness
Keep sessions between 25-50% intensity of what you would find really intense and at this stage - hence bodyweight is a good place to start
Make sure your mobilising any scars once healed. This can be perineal or abdominal, scar mobilisation is key for recovery, especially in the core and pelvic floor and the ability to engage and use these muscles effectively
Slowly, over the course of weeks and months, increase volume by adding resistance to your training if you are not feeling any new symptmos
Increase small bits of impact, a few hops, step up hops, or even tip toe - try more aggressive 'heel to floor' slam down and tip toe takes a new edge! Shying away from impact isn’t real life to come, so gradually increase once you start to exercise again - but again, if you are feeling heaviness it may not be the time to start this yet, but focus more on being less symptomatic first (hence I keep saying it depends on the person!)
Weeks proceeding this, roughly 6-12 months+
Gradually resume training you did previously or if you’re new to it, focusing on increasing your resistance and impact gradually
Working alongside a physio or professional in this field can help so you can ensure you’re doing it right and also managing any symptoms correctly
Final thoughts, remember a fast recovery is not necessarily a safe recovery! you cannot compare your recovery and return to exercise with others. Your pregnancy, your birth and your body and therefore your recovery are totally different. Pushing yourself too soon can result in complications further down the line and even if you didn't have any symptoms immediately post birth, you can still get them later if you rush this process.
You are still weight lifting all day everyday as baby grows, so dont fear resistance and exercise, but focus on supporting your body the best way post birth, as those first few months proceeding it are so key. This will help to limit injury and set backs in the early and latter months.
Finally, when you give birth, you give birth to a new baby and a new mum. Yes you are working in the same body, BUT in a completely new way and it can take time to adjust, so be patient and you will get there - you got this!
If you want to read more about returning to exercise after birth, you can download my free eGuide here 'How to Return to Exercise After Birth' or you can learn more about my Postnatal Programs here:
or book a free discovery call here:
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