Updated: Sep 24, 2021
First of all, congratulations on your new bundle of joy!!!!
I’m so happy you are considering exercise again, but really...don’t rush! Not because I’m trying to be nice and telling you it’s okay to be a tired mom who doesn’t want to do anything extra, since your plate is more than full (even though this is 150% true), but because you SHOULDN’T RUSH!
Sleep is absolutely the primary focus at this time for your healing and overall well being. Without sleep, you’re going to go nowhere good and feel miserable. I know sleep is hard: you have a newborn. I am a mom of 3 kiddos under 5 years old (including a 4 month old). So really, I get it. But you JUST HAD A BABY. Your body has been on a rollercoaster ride the past 9 months or so, and the ride isn’t over yet! It’s just beginning! So give your mind and body time to heal and adjust.
But now you’re awake. Okay, so now what can you do?
First, consider whether you have had a vaginal delivery or a C-section. If you have had a C-section, the timeline I go through may be a couple of weeks ahead of you. This may especially be true if you had an emergency C-section vs. a planned C-section. Talk to your OBGYN for movement considerations for your particular case. Look out for a future post on healing after a C-Section and C-section considerations!
Secondly, consider if you are breastfeeding or bottle feeding. If you are breastfeeding, keep in mind that your hormones are having an impact on your body. You have an increased hormone called prolactin in your body which causes ligament laxity. You also have decreased estrogen production since you have higher levels of prolactin. Because estrogen aids in increasing blood flow to your soft tissue, breastfeeding mamas have decreased rates of tissue healing and oxygenation of tissues. Lamens terms? Your muscles are not healing as efficiently as they would otherwise. (Fun fact: decreased estrogen is also why you will need to use lube when intimate with your partner once cleared by your OBGYN since decreased estrogen causes your vagina to be dry). So if you are breastfeeding, it’s important to keep in mind you are more prone to injury- which is why it’s even more important to start exercising wisely and correctly!
Okay, I know you’re ready to find out what you can do already.
(Note: I highly suggest you get cleared for exercise before starting any new exercise program, especially in the newly postpartum period).
Overall, your main goals prior to beginning an exercise program or performing your sport again are to establish a great base of strength and to have the pelvic floor and core functioning as perfectly as it can. Then progress your exercises and activities as your body allows with good form in order to prevent injury.
If you are in your first 4 weeks of postpartum-hood, listed below are your pre-return to exercise goals. Keep in mind each of these goals are intertwined and must be performed with one another. One may not be done without the other.
1. Start Moving
I don’t mean start working out! I mean literally- start moving! Walk around the house, do some mobility exercises listed below, don’t lay in bed all day!
2. Build Posture Awareness
Your body has changed a lot from 9 months ago. Your low back wants to extend, your pelvis wants to rotate forwards, your upper back wants to curve, your neck wants to go forward, your hips are stiff.
Now is the time to start noticing these changes and making minor adjustments. You’ll have plenty of time to make larger adjustments as each week passes. Remember. We are only talking about weeks 0-4! Don’t worry, though; I’ll progress you through postpartum exercise in following posts!
For now. Let’s just try to keep that chin back, prevent your upper back from slouching, and your pelvis neutral when able.
3. Start Deep Breathing Exercises
Learn how to do 360 breathing. This is the very foundation of all your future exercise. The importance of 360 breathing exercises requires a post of it’s own. I know you’re a busy and tired mom, so I’ll spare you 2 posts in 1. In summary, it allows good movement of your ribs and back with each breath. It also allows your abdominal, back, and even legs and neck muscles to function the way they should with breathing. Your pelvic floor also benefits from 360 breathing by decreasing force on the pelvic floor and allowing it to expand and relax as needed with each breath. If your ribs and back aren’t expanding while you breath, it’s a sign of poor joint mobility and muscle imbalance.
Believe it or not, most people breathe WRONG! It’s one of the first things I always correct when I am treating someone. You don’t want your primary or secondary breathing muscles to do more (or less) than they are meant to do. This causes…..you guessed it! Pain and dysfunction! I can tell you- most people who have back pain, buttock pain, neck pain, and hip pain breathe incorrectly!! You want to know what another symptom women have who have poor breathing mechanics? Leaking and urinary urgency. YEP! Peeing your pants when you jump, run, laugh, sneeze, cough and feeling like you need to go and can’t hold it in.
I’m not saying breath correctly and all your problems are solved. I’m saying let’s start with fixing the way you breathe and then learning how to move and exercise while maintaining proper breathing with a good pressure system (you don’t want too much pressure on your pelvic floor or else pain, prolapse, and leaking are likely to continue).
***See example at the bottom of this post**
4. Activation and Mobility Exercises (Begin during week 2)
While you are newly postpartum, now is the time to give your body a solid foundation for the future movements and exercise you will be doing. During pregnancy muscles get lengthened and “inactivated” (e.g. decreased use of core muscles since the baby was busy expanding your belly). This caused others to compensate (e.g. increased use of low back muscles. I know you feel what I mean!) . You need to mobilize the stiff areas and re-activate the weak muscles. Sometimes the body just needs a reminder to improve muscle memory and motor control!
***See example exercises at the bottom of this post**
5. Listen to Your Body
Is your body telling you it’s time to relax? Maybe you feel it’s okay to move a little more? Your mind may be ready to get running again, but I promise-your body isn’t ready to handle as much as you want it to. Not quite yet. I don’t care if you’re a tri-athlete. You’re still newly postpartum and need time to heal from having your baby. Maybe you’ll be ahead of the game next month, just not right now.
Say this mantra to yourself: “Just because I can, doesn’t mean I should.”
That’s right--> 9 months in, 9 months out. Recovery takes time.
As mentioned earlier, now is the time for healing. Monitor for signs of overdoing movement and activity:
Mild depression or lack of motivation
Decrease in strength despite training - Above “new” normal soreness or soreness taking more than a few days to resolve.
Changes in appetite
Decreased milk production
Increased bleeding (call your OBGYN if this occurs to make sure everything is okay)
1. Side Lying Rotation
Relax neck. Reach top arm forward. Rotate open. Hold for a few breaths, stretching a little further on each exhale. Do both sides.
I personally like doing it with my top elbow bent (see below). Rotate back the same as above, keeping the elbow bent.
2. Side Lying Breathing
*Do breathing on both sides*
Inhale: Ribs and abdomen expand, pushing up on your hand, pelvic floor fully relaxes down. Feel the pressure go down to your pelvic floor, letting it relax. Exhale: Abdomen sinks down and ribs go down, pelvic floor tightens (Kegel). If you never let your pelvic floor go for a good inhale, you cannot get a tighten for the exhale. (You cannot tighten an already tight muscle.)
Keep a long neck, arch up and down focusing on feeling it in the midback. Get in a few deep breaths while you are in this position. It will be harder than lying on your side.
How does all of this sound to you? Good? Good!
Remember, listen to your body and step back if you need to! Now is your time to HEAL!
I have been to physical therapy myself following all 3 of my babies for pain. The struggle is real.
Don’t hesitate to call me at 802-851-7707 or shoot me an e-mail at firstname.lastname@example.org if you would like to know more of what you can do in order to prepare your body for increasing your activity levels or exercise; or if you are experiencing any joint or muscular pain during this time- I would love to help you! Remember, I COME TO YOU! You just sit there at home and let me come do the work for you!
With love and encouragement,
Dr. Davida Murray, PT, DPT
An updated version of this post can be found at https://vermont.momcollective.com/2021/09/14/exercising-after-having-a-baby-0-4-weeks-postpartum/
Warning: This program is based on my personal experience. Not every program or exercise is right for every person, so you MUST consult with your healthcare provider before doing any exercises listed here. This is not a substitute for any kind of professional advice. You are responsible for yourself. Please stop any exercise immediately if you feel discomfort or dizziness and consult your healthcare provider immediately. Do not do this program if you have any pre-existing health or orthopedic conditions. If you do choose to do this program, you will not hold Danielle (Davida) Murray or New Moon Physical Therapy and Wellness, PLLC responsible for any illness, injury or issue that results from the program. In no case will New Moon Physical Therapy and Wellness, PLLC (including without limitation breach of contract, tort, negligence, gross negligence, or otherwise) be for more than the amount, if any, paid by you under this agreement to access the product and services delivered herein, in the year in which the claim arose.