Written By: Dr. Malerie James, PT

What is the norm for postpartum guidance from modern medicine?

It’s highly likely that your practitioner will have you and your baby in for a 6 week check up, say you’re good to go, and send you on your merry way with your tiny (growing) bundle of joy. But what happens now? Do you even want to think about running, hiking, or hopping back on your bike when walking around the block seems like the edge of your current capabilities? Pregnancy, birth, and postpartum are very different stages for your body. You might move differently, have different concerns depending on your journey, or feel like you don’t know who can help.

Who is qualified to tell me I’m ready to return?

Physical therapists are movement specialists. We help you understand your body, how we recover, and what needs to happen before you get back to doing what you love. By listening to your concerns and goals, watching you move, we can design a personalized program to best suit you. Personal training can also be a great option, especially if you are not dealing with pain, significant movement disorders, or just need some guidance on what you can add into your own postpartum fitness program. Outdoor Women’s Wellness has awesome therapists who are here to listen and help you reach your goals!

When can I start doing anything? 

From day 0, you can be doing sitting “hut hut” exercises. At the beginning of your recovery, you’re looking to activate the muscles, not necessarily make them stronger. Sitting on the edge of a bed, on an exercise ball, or in a firm chair, sit up tall with a neutral pelvis (sit bones are on the surface you’re sitting on and your waistband is parallel with the floor) and place your hands on your hips. Start gently saying “hut, hut, hut” at a speed that allows you to feel your belly muscles jump, or tighten around your ribcage. This is a great way to help find your transverse abdominis, which acts like a corset for your spine. Another easily graded exercise is to stand or sit in front of a counter or table, place the palms of your hands on the underside, and brace your belly as you pull up, as though you might try to lift the table… if you tried 90% harder. Start sitting and progress to standing on firm ground or even on one leg! Check out this video to see these exercises in action: https://youtu.be/Qa13HmlkaLw

What should really be happening before I start running, hiking or biking again?

You should be able to contract your pelvic floor 10 times with good ability to relax the muscles when complete. You should be able to squeeze those same pelvic floor muscles for 6-8 seconds with max effort between 8-12 times. Finally, you should be able to contract with 30-50% of max effort for a 60 second hold (Donnelly, Brockwell & Goom, 2020). These things take time and focused effort to achieve! Physical therapists generally will recommend beginning a run/walk program after 12 weeks. Why not make the most of your maternity leave? We’ll call it active recovery.

References

Donnelly, G., Brockwell, E., & Goom, T. (2020). Return to running postnatal - guideline for medical, health and fitness professionals managing this population. Physiotherapy, 107, e188–e189. https://doi.org/10.1016/j.physio.2020.03.276