Benefits of Post-natal Exercise

Once you have given birth, the healing process and adapting to life as a parent can feel just as physically and emotionally demanding as the pregnancy at times… Regular exercise has so many benefits that can help you to cope with this.

Post-natal exercise helps to improve strength and endurance. This will help you to deal with the physical demands of being a mum. Everyday your carrying the car seat, lifting and holding your baby (often while pushing an empty pram if your baby is anything like mine were!), sat with hunched shoulders feeding and much more. This all can lead to bad posture and sore backs. Exercise can help to address muscle imbalances caused by some of this and Improves posture, protecting your back better. It will also make you stronger and more able to deal with the demands of all of this on your body.

There are many other physical benefits of Post-natal Exercise:

• Improved Fitness
• Enhanced Immune function – helping to fight off the bugs so your fit and well to be mum!
• Increases energy – helping to combat the fatigue from sleepless nights
• Improved circulation and healing
• Better sleep
• Improved digestion
• Improved body composition (reducing body fat and increases muscle mass)
• Increased metabolic rate

As well as the physical benefits, there are also so many psychological benefits to post-natal exercise, which I believe are just as important (if not more!). Post-natal depression now affects more than 1 in every 10 women within a year of giving birth (according to the NHS website). Consistent exercise will relieve stress, ease depression and anxiety, clear your head, help you sleep better, and make you feel happy. It enhances relaxation releasing those feel-good endorphins every time you exercise. Joining a post-natal exercise group is a great way to get some exercise as well as to meet up with other mums, share how your feeling, get some fresh air and make you feel good ?.

Now I have talked about why it’s so great to exercise after birth I am going to take you through how and when to start exercising, some guidelines to keep you safe, what you may need to adapt (depending on whether you have any post-natal symptoms conditions such as a prolapse or varicose veins) and some details around Core Training (which I believe to be the most important part of post-natal exercise).

When can you start exercising after Birth?

The First 6-8 weeks

During this time your hormones are normalising, and your tissues are shrinking, while your bones and joints shift back after the birthing process. It’s important to follow the guidelines and not return to formal exercise during this time as your body is recuperating and needs time to do this. However, there are some gentle exercises you can do from 24 hours after birth:

• Gentle walks: Start going for 5/10 minutes a day and increase by 5 minutes each week as long as you feel up to it
• Abdominal hollowing
• Pelvic Tilt
• Pelvic Floor Exercises

You can find details on how to perform Abdominal hollowing, Pelvic Tilts and Pelvic Floor exercises later in this guide under the Core Training section.

If you’ve had a C-section then make sure you rest for the first few weeks and only start the gentle walking after at least 2 weeks and when you feel ready.

After 6-8 weeks

The general rule (if you’ve had no complications during pregnancy or birth) is that you’re safe to exercise once you’ve had your 6-week check with your midwife and they have confirmed you’re ok to start exercise.

Your body has been through a lot over 9 months, adapting to growing and giving birth to a baby. Once you’ve had your 6-week check and have been given the ok this does not then mean you are ready to dive in and do a 10-mile run or a marathon session at the gym…. It’s important you take things at a steady pace. After birth, your body needs to heal and it’s a gradual process, which if you rush, can cause injury and set-backs. It’s not just a case of jumping straight back into your pre-pregnancy routine, make sure you follow guidelines and gradually build the intensity of your workouts back up. And most importantly listen to your body… Only start exercise if you feel ready. It can take 9-12 months before you return to your pre-pregnancy level of strength & Fitness.

Note if you have had multiple gestations or a C-section you will need to take extra care when returning to exercise and may need a longer recovery period, only return to exercise when you feel ready and seek medical advice from your midwife or doctor. Full recovery from a C-section can take up to 6 months.

Guidelines for Post-natal Exercise

Below are some guidelines and considerations when planning your exercise routine:

• Wear appropriate footwear and comfortable clothes
• Invest in a good sports bra (feeding bras won’t give enough support)
• Eat a light snack 1-2 hours before exercising
• Always have water with you and keep well hydrated
• Don’t exercise if you feel tired / unwell
• Really think about good posture (imagine someone pulling a piece of string at the top of your head bringing your back straight, tummy in and shoulders slightly back before you start every exercise)
• Listen to your body and go at your pace. Stop if something doesn’t feel right
• Avoid high impact Cardio training for at least the first 3 months. Once you’re ready to introduce running and aerobic style training start gently and if you feel overly breathless or light headed then stop. Start with 10/15 minutes of gentle cardio and build it up to 20-30 minutes over the weeks / months
• Avoid high impact hiit training until approx. 5 months after (although everyone is different, and it may be longer or shorter for different people – listen to your body and judge how you feel)
• Relaxin is produced during pregnancy to help relax ligaments of the pelvis allowing your pelvic bones to move and separate in preparation for birth. Relaxin stays in your system for up to 5 months after birth (and sometimes longer). It causes joint instability which needs to be considered when exercising. Be careful to make sure you feel stable and secure in positions when exercising and adapt if you don’t. (e.g. Try a seated version or stand against a wall for more stability)
• Stretching – avoid over stretching or holding stretches for too long. Again, this is due to Relaxin being in your system – it can mean you can over stretch and cause injury
• Weight Training – resume at approximately the same weights as you finished at during pregnancy and then build them back up slowly. Focus on keeping good posture. It’s important to build up core first. Start with lower weights and higher reps initially

Breast feeding and exercise

If you are breastfeeding there are some recommendations and guidelines while exercising:

• Try and feed before exercise if you can to stop engorgement or leaking while exercising
• Wear a good supportive bra
• Drink plenty of water. While breastfeeding you need 30% more which will be further increased by the demands of exercise so it’s important to stay hydrated
• Avoid exercises lying on your front if breasts are tender and the range of movement for upper body exercises may need to be reduced. Use alternative positions until prone position (lying on your front) becomes comfortable
• There is some scientific evidence that suggests that the lactic acid built up in higher intensity exercise can affect your milk and make it taste more sour. If you’ve done this style of exercise the lactic acid should clear 30-60 minutes post exercise. Moderate exercise shouldn’t affect the quality or quantity of milk
• If you have mastitis or severely painful engorged breasts do not exercise

Risks

Sometimes there are certain risks when exercising after birth:

• Exhaustion & excessive fatigue
• Injury due to reduced joint laxity
• Injury due to poor core stability
• Injury due to inappropriate exercise or poor technique
• Reduction in milk quality and quantity

This above list is to inform you so that you are aware. A lot of the conditions and situations listed are very unlikely if you follow the guidelines, but it is important to understand so that you are safe when exercising. It’s also important to follow the advice to return to exercise slowly and not to start with vigorous exercise straight away.

It is important if attending exercise classes to make sure that your fitness instructor is qualified to instruct you in post-natal exercise. By instructing appropriate exercises and good technique they will greatly reduce any risks associated with post-natal exercise.

As well as the normal contraindications to exercise, such as medical conditions, there are also some conditions specific to post-natal exercise that may put you at risk. If any of the following apply to you, you should seek medical advice prior to exercising:

• Joint or Pelvic Pain
• Poor healing or discomfort
• Excessive fatigue
• Gross diastasis of rectus abdominis
• Breast abscess

While you are exercising if you experience any pain or discomfort you should stop exercising and seek medical advice prior to carrying out any more exercise.

Adaptions and Considerations

Certain changes in your body, medical conditions and complications can occur once you’ve had your baby. These do not mean you cannot exercise, you may just have to adapt and avoid certain exercises or positions. If you make sure your instructor is qualified in Post-natal exercise, they will be able to adapt your programme and give you safe exercises which will be effective and cause minimal discomfort.

Please note an exercise professional’s role is to safely prescribe exercises based on the information you give them. They are not qualified to diagnose any conditions please make sure you see a suitably qualified medical professional to do this.

Prolapse

If you have had a prolapse during birth, there are some adaptions you need to make while planning exercise:

• Avoid high impact exercises
• Lift only light weights and avoid any straining
• Only perform gentle abdominal exercises
• Gross diastasis of rectus abdominis
• Engage Pelvic Floor during exercise. Pelvic floor exercises can help to address a prolapse and can sometimes avoid the need for surgery

Pelvic Pain

If you are suffering from persistent pelvic pain after birth seek medical advice prior to continuing with exercise. If you have had medical advice and are ok to exercise the following will help to minimise pain and discomfort when exercising:

• Avoid exercising on one leg as it may cause discomfort
• Any exercises that involve hip abduction or adduction (raising your leg sideways and bringing it back) either do gently or avoid
• Avoid high impact activities if they irritate it
• Breaststroke may irritate it so avoid it if it does

Avoid the following:

• Cross-trainers and steppers
• Rocking hips from side to side
• Sitting cross-legged

Damaged Coccyx

The coccyx (bottom of your spine) may be bruised or fractured if forced back during labour which can cause pain. Lying on your back may be uncomfortable. If this is the case, then tilt your pelvis towards yourself (imagine a bucket of water resting on your tummy and tilt it so it pours out onto your chest). This position may be more comfortable. If it isn’t, avoid lying on your back completely. Adapt to seated exercises and avoid any positions that aggravate it. Find positions that are comfortable for you.

Back Pain

Back pain can be common in new mums as a result of the lack of support provided by abdominal muscles. Therefore, it’s really important to focus on correct posture and core strength while exercising. There’s more detail later in this guide around slowly and safely building up your core strength.

Carpal Tunnel Syndrome

If you’re suffering with wrist pain, there are some recommendations to make you more comfortable:

• Keep wrists in neutral while exercising not flexing or extending them
• Avoid tight gripping
• Avoid kneeling on all fours & press-ups

If the pain persists and is affecting your day to day activities seek medical advice.

Varicose Veins

Varicose veins are common and generally you’ll show signs of improvement after delivery. Good leg care should be continued after birth to continue this improvement. If you have varicose veins:

• Avoid standing / sitting for a long time
• Avoid crossed legs or sitting back on your heels
• Sit with legs elevated if you can
• Go for regular walks as walking helps returns blood back to the heart
• Repeat simple motion exercises such as:
  • Lifting and lowering alternative legs
  • Extending your ankles to point your toes, and then flexing your foot back towards your body

Core Training

Training your Core is one of the most important things when planning post-natal exercise. Strengthening your core will help with posture, reduce any lower back pain and improve your performance when training. After birth your abdominal muscles have stretched and sometimes separated so it’s important to realign, strengthen and return them back to the correct length. Your Pelvic floor muscles have also stretched and need tightening and strengthening.

Pelvic Floor Exercises

Pelvic floor muscles are put under a considerable amount of stress and strain during pregnancy and birth. This can lead to stress incontinence as they over stretch. Pelvic floor exercises can help to improve this. Pelvic floor exercises can also help to heal perineum pain from bruising during birth or if an episiotomy had to be done. The increased blood flow to the area from doing pelvic floor exercises can speed up the healing process.

You can start your Pelvic Floor exercise from 24 hours after birth. There are no limits as to how many you can do providing the muscles aren’t fatigued. A programme to start with could be:

3 blocks daily of:

• 10 slow contractions (slowly building up from 6 to 10 seconds)
  • Stand, lie or sit with feet slightly apart. Draw up and tighten the muscles around your back passage and then hold. Do the same for the front as well (as though you are trying to hold from urinating). Hold for a count of 6 and then release slowly.
• 10 quick contractions

While doing Pelvic Floor exercises make sure you DO NOT:

• Tilt your pelvis
• Tense your buttocks
• Hold your breath

For Pelvic Floor exercises to be effective they need to be done regularly for at least 8 weeks as it can take several months before they return to previous strength. In fact, they’re a good habit to get into for life!

If you download the NHS Squeezy App it gives more information and has reminders you can set to do them every day.

If you are struggling to recruit and exercise your pelvic floor muscles, then go to the doctors and ask to see a physiotherapist who specialises in women’s health.

Abdominal Exercises

The first exercise to concentrate on is Abdominal Hollowing as this will work the muscles that will hold the abdominal wall flat, pulling in the bump you may have after birth. The Abdominal hollowing exercise can be started within 24 hours after giving birth. It can be done Standing, sitting, lying on your back, lying on your side or lying on your front so it’s about finding what’s comfortable for you.

Aim to do 10 sets of 10 second holds 3 times a day.

How to do abdominal hollowing: If you’re on your back lie flat, with pelvis in neutral and knees bent. Place your feet hip width apart and flat on the floor. Relax and then breathe in gently and then as you breathe out pull your belly button in as though a string is pulling it towards your back and the floor. Hold that position tightly and continue to breathe normally. Try and hold the contraction for up to 10 seconds with breathing normally and then release.

Another exercise you can do within your first 6 weeks is Pelvic Tilts. This can be done within the first couple of days after birth. They can be done lying on your back, seated on a chair or birthing ball.

How to do Pelvic tilts (lying down): Lie on your back with your spine and hips in neutral, knees bent and feet just less than hip width apart and flat on the floor. Gentle tip your hips towards yourself (imagine a bucket of water resting on your lower abdomen and you are tipping it towards yourself, so it spills onto you), hold this position for a few seconds and then slowly release back to neutral.

Aim to do 3 sets of 10 reps 3 times a day.

After your 6 week check you can start adding to your core routine but it’s important to check the extent of any abdominal muscle separation (this is called a rec check) to determine what you can and can’t do. Before joining any exercise class, or starting an exercise programme, make sure you have had this checked by your midwife or your fitness instructor can check if they are qualified in post-natal exercise.

To do a Rec check yourself lie on your back with your spine and hips in neutral, knees bent and feet hip width apart and flat on the floor. Place two fingers together horizontally just under your belly button. Relax and then push your fingers down. Inhale and slowly lift your head and shoulders off the floor and curl up. If you can feel the two bands of your abdominal muscles pinching on your fingers the gap is 2cm or less. If you have to separate your fingers out to feel the sides, then the gap is 2cm or more. If this is the case, try with 3 fingers starting the process from the beginning again. If you aren’t sure it always best to get a professional to check before you start exercise.

If you have got a gap of 2cm or more don’t panic. It is a lot more common than you think. Over a third of women have this after their first baby and after second babies it’s more like 2 thirds of women. With good abdominal care and doing the appropriate exercises this gap should begin to close.

It’s important to build core exercises up slowly and watch to make sure ‘doming’ doesn’t occur. Doming occurs between your belly button and bottom of your ribs and happens while you are crunching up. If a dome appears you have come up too far and need to reduce how far you come up with your crunches.

If your Rec Check is more than a 2cm gap:

Make sure you AVOID any strong curl up type exercises.

Continue with Pelvic Floor Exercises, Abdominal Hollowing and Pelvic Tilts. Start to advance the abdominal Hollowing by lifting alternate legs while doing the exercise (this can then be advanced by lifting opposite leg and arm at the same time).

You can then start with a gentle curl up where you only lift your head and shoulders gently but its important to make sure no doming occurs.

Keep monitoring the gap and get it checked again to see if any improvement has been made. Once your reach a 2cm or less gap you can start to develop your core exercises further.

If your Rec Check is less than a 2 cm gap:

Still continue with to Pelvic Floor Exercises, Abdominal hollowing and Pelvic Tilts.

You can start to include reverse curls and half roll backs and then onto abdominal curls and eventually oblique curls (once abdominals are stronger and you feel more comfortable and stronger doing abdominal curls).

Don’t do Stability exercises such as Planks until you feel ready and you have built up your abdominal strength.

How to find the time to exercise

Now we have gone through post-natal exercise, and all the adaptions and considerations required, the next question for mums will be ‘how do I find the time to do it?’. As a new mum you’ll be busy looking after your baby and adapting to life as a parent and fitting in exercise can feel like the last priority on the list, especially if you have the added stress of having to arrange childcare while you do it. But if we go back to the beginning of this guide you can see why it’s so important to try and find that time.

Exercise doesn’t have to mean hours in the gym or long sessions. If you can do little and often it’s more manageable. Here’s a few tips of how to fit the exercise in with baby in tow so you don’t have to worry about childcare:

• Walking is such a great way to get cardio exercise and it’s free too! Wrap your baby up in the pram and get out for a walk while they nap. If you arrange to meet some other mums while walking it’s a great way to see friends and catch up at the same time too
• Use baby’s nap times at home to fit in a short home workout
• Find a Mum & Baby exercise class locally where you can take baby along and it’s a social for you and them as well as getting some exercise

Be Kind to yourself ?

For a lot of new mum’s, the motivation to exercise is very much about returning to their pre-pregnancy body. But make sure that your expectations and goals are realistic. It’s too tempting to try and set hard goals to get the weight off, but unrealistic goals can lead to frustration and disappointment. Make sure you are kind to yourself. It took 9 months to grow your baby and it can take 9-12 months to return to your pre-pregnancy body. The best way to do this is through eating a balanced diet and regular exercise and to do it slowly so it’s maintainable and stays off.

Make sure you take each day at a time and don’t beat yourself up when you have a day with no exercise and lots of tea and biscuits… One of my favourite hashtags is #itsallaboutbalance. If you cut absolutely everything out and deprive yourself all of the time it’s not maintainable. Let yourself have some treats and don’t feel guilty about them.

I hope this guide has been useful. If you’d like to come along to my mum and baby classes all details are on my website or you can follow me on Facebook and Instagram for free workouts, meal ideas, and recipes, along with some honest (and balanced) posts about life as a busy mum working to stay fit and healthy.

Useful Websites:

https://www.nhs.uk/Conditions/Post-natal-depression/
https://www.nhs.uk/live-well/exercise/free-fitness-ideas/
https://www.nhs.uk/common-health-questions/womens-health/what-are-pelvic-floor-exercises/
https://www.nhs.uk/conditions/pregnancy-and-baby/your-body-after-childbirth/

I have tried to include as much information as possible in this guide to answer your questions and to help you safely adapt and plan your exercise routines. If there’s anything you’re not sure about, or would like further information / specific advice, please contact me on workoutlikeamum@yahoo.com or 07870589272