MY ULTIMATE GUIDE TO POSTPARTUM RECOVERY
Hi MUMS, first of all please know there are NO RULES when it comes to YOUR POSTPARTUM RECOVERY. This is intended as a SAFE training guideline - but the most important part of your journey is to do what feels right for you, when you are ready, how YOU want!
Let's take away the common PRESSURE and expectation placed on new mums. There is NO set TIMELINE for when YOU should start doing ANYTHING! This information is with postpartum AFTER-CARE in mind for mums well being.
Lisa
WEEK 1 - 6 POSTPARTUM
Ideally, this is a great time for REST, RECOVERY and SELF-CARE.
NOTE: This is not always on the mind of a new mum and can feel very unrealistic - there may be other children to look after, work/family commitments, lack of sleep (fatigue/exhaustion), hormonal and mood changes, a new lifestyle to navigate, lack of confidence in parenting skills, difficulty with breast feeding, financial/other stress, birth injuries or trauma...
Again, please note this is NOT a set of rules to follow and is ONLY intended as suggestions for WELLBEING and SAFE TRAINING for this timeframe if it is desired. FATIGUE, ENERGY LEVELS, MOOD and STRESS are all so very important to take in to account.
REST -
Sleep is incredibly important for healing and recovery. While it may not always be possible to sleep well every night with a newborn baby, it is important to prioritise REST where you can.
SELF CARE -
Self care is so important for your overall health and well being. It is so often over-looked or with the intent of having more ability to care for others... You are worthy of self-care for no other reason than you deserve it!
Engage in self-care practices that YOU enjoy daily, even if it is for only 5, 10, 15 minutes.
RECOVERY -
Our body has been through some big changes - with pregnancy and birth (vaginal or c-section).
We know our overall recovery is going to be improved by sleep and self care. So what else can we do to help our recovery?
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Consider avoiding daily movements that crunch your tummy, and large rotational movements - For example, roll on to your side and push yourself up when getting in and out of bed. This helps to reduce strain on our healing abdominal muscles.
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Most of us will simply not 'feel right' doing HIGH IMPACT or HIGH INTENSITY movement early postpartum. Even if you can do this without noticeable symptoms such as pelvic floor dysfunction, I recommend avoiding it. This includes running, jumping and fast paced vigorous movements. Our pelvic floor requires time to heal from pregnancy and birth.
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Notice (and avoid where possible) other movements that cause a CONING or DOMING shape along our abdominal midline.
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Notice (and avoid where possible) movements that trigger pelvic floor dysfunction - this could be a heaviness of the pelvic floor, a "dragging" sensation, pelvic floor pain, leaking (wee, poo or wind). For example, down hill walking could trigger incontinence for you.
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Prevent constipation and straining during bowl movements to help our pelvic floor recover. It may be helpful to lean forward slightly and elevate feet on a low stool during bowel movements if that is comfortable for you. Eating plenty of fibrous fruits and veggies and drinking plenty of fluids will also help with this.
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Focus on how you are sitting and standing - often when we are feeding/nursing or carrying baby we tend to spend long periods of time in a slumped position.
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When you are ready, you can start gentle pelvic floor exercises. It is important to do these correctly, so if you are unsure please reach out for support. Regular 'Kegels' may not be suitable if you have a hypertonic pelvic floor. Pelvic floor exercises (so much more than kegels!!) are included in our online CORE RECOVERY 6 week program - these are well explained so that even without a diagnosis you can ensure you are doing beneficial and SAFE movements for YOU - regardless of whether you have prolapse, or a hypertonic pelvic floor.
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When you are ready, you can start gentle mind-body re-connection work with the lower abs and breath connection. This is NOT traditional ab exercises, including sit ups, planks and double leg lowers or ANY movement that puts strain on the abdominals. I DO NOT recommend stomach vacuums. We include these first GENTLE options in our online CORE RECOVERY 6 week program.
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When you are ready, you can start walking. I recommend starting with very short walks, approx 10mins. There should be NO pain, heaviness or exhaustion associated with your walk.
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If you had a vaginal delivery, with no complications, when YOU are ready (usually from at least 3 weeks postpartum) you can start very gentle CORE RECOVERY. I recommend guidance from a CERTIFIED Pre and Postnatal Coach. If you had a C-SECTION, I recommend waiting at least 6 weeks. There should be NO pain, heaviness or exhaustion associated with this exercise.
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I don’t recommend wearing tight compression/waist trainers postpartum - please note, a waist trainer/girdle or corset is quite different to a ‘gentle hug’ support band - if it is tight enough to be uncomfortable I wouldn’t be wearing it postpartum and certainly recommend you do your research on these.
They can increase the pressure in to your pelvic floor, inhibit your breathing and stop your abs from healing correctly.
The stats for pelvic floor dysfunction is already 1 in 3 women - 1 in 2 of those have prolapse.
Prolonged use of a waist trainer/corset can damage your internal organs.
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If you had a C-SECTION, you may like to work on returning sensitivity to areas that feel numb. Very lightly brushing the area with a cotton ball can help to introduce a slightly rough texture to the healing tissues and nerves. I recommend seeking advice from your OB or women's physio.
FROM WEEK 6 POSTPARTUM
The current guidelines recommend that it is safe to return to physical activity, work and intercourse just six weeks after delivering a baby...
This is an UNREALISTIC TIMEFRAME for MOST women.
1. Every women's pregnancy and birth is different, as is their healing process and progress.
2. We know that complete recovery for most other musculoskeletal injuries (bones/joints/ligaments/muscles/nerves) may take between six months to a year - so suggesting it takes 6 weeks to recover from birth does not make sense.
3. This myth of a "6 week clearance" to return to pre-pregnancy exercise is often an unachievable and unrealistic expectation. COMMON postpartum issues can include pelvic floor dysfunction, diastasis recti, back/hip pain, sore wrists/knees.
GOOD TO KNOW ABOUT:
AB SEPARATION - Some ab separation is normal during the third trimester of pregnancy - more than half remain abnormally wide (diastaisis recti) at 8 weeks postpartum, and although some recover by six months (approx 60%), many have not recovered at even 1 year postpartum. **
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What that means is we should take in to account ab separation and abdominal weakness in our training! For most of us, 6 weeks is not long enough for our core to have fully recovered and it is possible to exacerbate or create DIASTASIS RECTI postpartum by over loading the core.
PELVIC FLOOR DYSFUNCTION - 1 in 3 women will have pelvic floor dysfunction after pregnancy/birth, with 1 in 2 of those having prolapse. We can have a prolapse and be asymptomatic (have no symptoms).
It is believed that hormones (high levels of estrogen, and relaxin) can influence the pelvic floor muscles (which may contribute to the feelings of weakness) for some time after birth - and if breastfeeding these hormonal changes can last the entirety of this time and even up to 2-3 months beyond this point.
Pregnancy increases the load on the pelvic floor - having a C-section does not decrease your risk of pelvic floor dysfunction postpartum.
An assisted vaginal birth (forceps etc) does increase your risk.
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What that means is we should take in to account a likely weakened pelvic floor in our training. We need to address this BEFORE increasing the load/pressure through exercise.
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It is also important to note that PELVIC FLOOR DYSFUNCTION can be a result of a hypertonic pelvic floor (too tight/gripping) which is NON FUNCTIONING (does not relax). Doing regular 'kegels' will not be beneficial for this.
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I recommend guidance (from a pelvic floor phsio or CERTIFIED Pre and Postnatal Coach) for pelvic floor exercises so that you are doing them correctly and also practicing suitable exercises for your particular needs. Our online 6 week CORE RECOVERY PROGRAM includes pelvic floor exercises - these are well explained so that even without a diagnosis you can ensure you are doing beneficial and SAFE movements for YOU - regardless of whether you have prolapse, or a hypertonic pelvic floor.
So you've been cleared to exercise?! Now what??!!
As explained above, for MOST mums, this is simply not a realistic timeframe for you to jump straight back in to your pre-pregnancy workouts like CrossFit, running or even mainstream pilates. These are great options to BUILD up your fitness safely:
1. Start or continue LOW IMPACT cardio like walking or swimming.
Note with swimming, you may still want to avoid large rotational movements to help your abs heal - so picking a stroke (or use a kick-board) that works well for you.
Note with walking you still may want to walk on the flat and build up to walking hills (it is the down hill movement that may be too much for your pelvic floor).
2. Start or continue CORE RECOVERY work.
This focuses on pelvic floor STRENGTH AND FUNCTION, lower abs, and butt muscles. It is so important to build a strong foundation - regardless of whether you are looking to get back in to exercise safely or simply want to feel "more zipped up".
I recommend AT LEAST 6 weeks of consistent and focused core recovery work BEFORE adding in other more intense workouts, any high impact, or any traditional ab work. The majority of mums will NOT feel totally healed and recovered after 6 weeks of core recovery work and therefore should continue to strengthen and heal before excessively increasing core load or intensity.
Variables that can determine the length of time needed for CORE RECOVERY include:
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How active you were before and during pregnancy.
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Whether you had pain or incontinence during your pregnancy.
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Whether you have had mutiple births.
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How long your delivery lasted.
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Whether you had any injuries (for example, a fractured tailbone or instrument assisted birth).
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Severity of tearing or an episiotomy.
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Prior low back pain and pelvic girdle pain.
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C-section recovery - pain, numbness, other.
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How consistent CORE RECOVERY work is postpartum (including how much time you can realistically give to this. If you can fit this in once a week it is great, but progress will be slower than three times for example. Keep in mind there is NO RUSH!).
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How effective the core recovery work you are doing is - I recommend guidance from a pelvic floor physio or CERTIFIED Pre and Postnatal Coach to ensure you are using EFFECTIVE exercise - engaging your muscles and doing suitable movements for your particular symptoms and stage of recovery.
5 AB exercises you may want to avoid during postpartum recovery
3. Take your time: A SAFE RETURN TO EXERCISE
This. I understand there is often a strong urge to get back in to your old exercise routine, to feel more "you" or "get your body back". My top tip would be to allow yourself to recover well - do it once, right. When we rush in to exercise that is inappropriate for our stage in recovery, we risk exacerbating or causing postpartum issues. In the rush to return, we can actually end up extending our recovery. Take your time and don't just rely on "listening to your body". Just because you CAN do something, it doesn't mean you should! An example of this is an asymptomatic prolapse (you have no symptoms) and you start straight in to high impact movements like running instead of doing some core recovery first to help heal the pelvic floor. It may feel ok to start with, but then as your prolapse gets worse symptoms start to appear. Allow your body TIME to heal, give it a strong foundation and ENJOY the process!
You should feel BETTER after a workout. If you feel exhausted, really sore, unwell - it is too much too soon. There should be NO pain (this is different to a 'worked' muscular burn), heaviness, or exhaustion associated with your exercise.
4. C-SECTION RECOVERY - including SCAR TISSUE MASSAGE
Assuming you have had no complications and your incision site is healing well AND you have clearance to start gentle movement, GENTLE core recovery is very beneficial - starting whenever YOU feel ready from 6 weeks postpartum. I always recommend a women's physio or Certified Pre and Postnatal Coach guidance.
Note - if you have significant pain at the 6 week point, or if at any time pain increases, return to your medical practitioner.
You may notice numbness or tingling around your scar - SCAR MOBILIZATION can be very beneficial to alleviate these symptoms. From 6 weeks postpartum or once the scar is healed (this can takes 9-12 weeks), scar tissue massage can be used to mobilise the scar, reduce restriction and reduce pain.
We go over this in our 6 WEEK ONLINE CORE RECOVERY PROGRAM.
I recommend assistance from a women's physio to show you and check your technique.
For our AFFORDABLE, SAFE and EFFECTIVE
6 Week CORE RECOVERY PROGRAM, online:
A comprehensive 6 week program designed to assist Mums with postpartum recovery - including healing ab separation and improving pelvic floor dysfunction symptoms.
Designed by a CERTIFIED Pre and Postnatal Coach (GGS), with over 15 years experience as a qualified PT and Group Fitness Instructor and a registered 'Pelvic Floor Safe Fitness Professional' (Incontinence NZ, via Maree Frost).
Now you can gain all the benefits of my postpartum training experience (15+ years of coaching!!) without having to leave home or workout at a certain time to make the class!
"...It may sound ridiculous, but I've seen the light I've had twins just 18 months after my first child was born, which resulted in a hand-width ab separation. For the last 4.5 years I've been to the gym on and off, trying to fix my abs and to get on top of constant lower-back pain. All to no avail. Turns out, all it took was someone who knows what they're doing (AKA Lisa) to show me how to exercise safely. I can hardly believe it myself, but after having followed Lisa's Core Recovery for just 5 weeks, the remaining gap in my abs which I have been trying to fix for literally years, is now down to less than 1 finger!!!
I can't thank Lisa enough and recommend her programme to every woman who's had a baby. I feel Lisa has given me so much more than 6 weeks' online workouts. More importantly, Lisa has given me the confidence and know-how to make ANY gym class my own" Nadine
MEET COACH LISA
"Hi MUMS! I am extremely passionate about raising awareness of common POSTPARTUM ISSUES and EMPOWERING WOMEN to maintain their quality of life postpartum.
The statistics for pelvic floor dysfunction are so poor (1 in 3 women) - and often this can be avoided with appropriate exercise and rehab CORE RECOVERY.
Back and hip pain are also often EXPECTED - and this shouldn't be the case!
I have developed my 6 week online CORE RECOVERY PROGRAM, using all of my 15 years experience coaching and numerous qualifications - that is LOW COST - with the aim to make postpartum after-care accessible to ALL WOMEN.
I'm a solo mum of a now four year old boy, with a full time business, and I understand the challenges that come with fitting in self-care. This program is convenient, you can do the workouts when it suits you, and they are short - just 15-20mins each. There is no mucking around, we get straight in to the exercise - and there are OPTIONS for all stages of recovery to keep the training individual and SAFE.
I also hope to shift the common focus of 'appearance' postpartum to 'FUNCTION'!! Postpartum is forever, how we recover is so important. Rushing this process and risking potential life long damage is simply not worth it! I aim to inspire, postpartum bodies can be so much STRONGER than before!!"
**Statistics from GGS, Pre and Postnatal Coaching Certification Manual, 2018