When it comes to exercise postpartum, it can be challenging to know when it is safe to start again and even harder to know what exercises to start with.
During pregnancy, it’s much easier to know we need to modify movements/ slow down because we have the physical reminder of our baby in our belly. Postpartum it’s so easy to think “My baby is here, I don’t have an excuse to not be back at the gym.”
Part of the challenge comes when our brain feels ready to jump back into exercise even if our body is not quite there yet. This is why having a general timeline to refer back to can be super helpful and grounding. Just like having a training plan for a big race/competition/other fitness goal, a timeline shows us where we are and where we are going.
When can you begin exercise postpartum?
Beginning at two weeks postpartum, I have compiled a general timeline for returning to exercise postpartum. Please keep in mind that there is no one size fits all and everyone has their own unique postpartum experience. This is meant to be a general timeline that leaves room for individualization and nuance.
If you find this after the 3-month mark and are just getting started, I recommend starting at the rehab stage and working on building a solid foundation. This is written progressively and can be applied later postpartum.
Can I versus should I YET? I want you to keep the word YET in your mind throughout your postpartum recovery. It can be so mentally challenging to not be able to do the exercises you previously loved but it can be helpful to keep reminding yourself that you can get back to them and keep looking at how far you have come. A reframe to “I can’t run” is “I am not running YET.”
Exercise in the first 0-3 months postpartum is rehab season
During this period, our bodies are already under a ton of stress and working very hard to heal. This is true regardless if the baby was born via c-section or vaginally. Other possible stressors include; nursing, lack of sleep, and having other children to care for. As if this was not already a lot, we are also learning how to keep a tiny human alive while navigating a huge transition in family dynamics. This is hard work y’all!
If I told you it was important to rehab your knee after surgery, chances are this would make sense to you. You would agree that going to the gym and doing loaded squats would probably not be the best decision until you did the things to build your strength and stability back up in the affected muscles.
So if we can agree that surgery or injury requires rehab, it makes total sense that our core and pelvic floor muscles also need rehab after going through major stress and injury during pregnancy and birth.
Training Themes for this period are:
- Learn pressure management strategies
- General movement patterns- learn/control
- Body weight/light loads
- Do less now to do more later- most of our long-term goals are to still be exercising and moving our bodies in 2-5-10-15 years. When we think of fitness in years, this period is so short, and taking the time to let our bodies heal is going to pay off in the long run.
- Intention now for intensity later- Although it may not feel like it right now, you will get back to the intensity you crave. Being intentional now will allow you to get to that place and feel good in it so much sooner.
What does rehab season look like regarding the postpartum body?
Depending on your birth experience (vaginal or c-section) your core muscles have spent 9-10 months being stretched and/or have to heal from an incision. Similarly, your pelvic floor has taken on a lot of stress and depending on your birth has potentially sustained injury in the form of tearing or episiotomy.
So engaging deep core and pelvic floor muscles early on is important and can be done with intentional breath work. I know, it sounds so basic but if done correctly it is very effective and becomes the foundation for all exercises to come. Breath work can be started immediately (as soon as you feel up to it) in both vaginal and cesarean births.
The connection breath, for example, is an excellent breathing exercise to practice postpartum in your return to exercise.
Here is how to perform a connection breath:
Step 1: Lying on your back with knees bent and hands on the sides of your ribs.
Step 2: On your inhale take a 360-degree breath (ribs expand all around).
Step 3: Relax your belly and fill with air.
Step 4: As you continue to inhale relax your pelvic floor muscles.
Step 5: Exhale as if you are blowing through a straw
Step 6: Gently (2 of 10 effort) engage your pelvic floor.
Step 7: Gently pull the belly button towards your nose as you complete your exhale
Once you have mastered connection breathing in static positions such as on all 4s, laying on your stomach/side/back, begin coordinating it with gentle exercises that you can begin as early as 2 weeks with vaginal birth and once your incision has fully healed with a cesarean.
Early Postpartum Exercise Circuit
Exercise 1: Prone Breathing – 2 minutes
- Lying on stomach
- Inhale – expand the rib cage and belly while relaxing the pelvic floor – using the floor as feedback.
- Exhale – gently engage your pelvic floor and core – as if you were forcefully blowing out of a coffee straw.
Exercise 2: Rocking with Connection Breath x 10
- On hands and knees inhale and completely relax belly.
- As you exhale slowly rock forward over your hands then come back to the starting position and repeat
Exercise 3: Heel Slides x 6/side
- Lying on your back with knees bent and feet on a slider
- Take a big inhale
- As you exhale; slowly extend one leg, once extended slowly bring it back to the starting position
- Repeat on opposite side
Exercise 3.5: Marches x 6/side
Once heel slides become easy exchange with a march
- Lying on your back with knees bent
- Take a big inhale; as you exhale lift your knee until it is over your hip
- Bring your leg back to the starting position
*If you feel unstable, limit range of motion by only lifting your foot an inch off the floor or just your heel
Exercise 4: Glute Bridges x 10
- Start on your back with knees bent
- Inhale and relax your belly and pelvic floor
- On the exhale send your hips up into a bridge
- Make sure you do not over-squeeze glutes at the top
Exercise 5: Clamshells x 10/side
*This one may feel better if you wait closer to 4 weeks but you can test it out
Start without a band. Add a band once it feels easy
- Laying on your side with knees bent at 45 degrees
- Keep feet together and lift the top knee
- As you bring your top knee back down, try to go slow.
*You should feel in your butt if not lean forward more
After you have been cleared for exercise by your doctor (typically around 6 weeks) start with bodyweight movements (remember to use that connection breath to support movement) such as air squats, lunges, hinges, low step-ups, clamshells, bird dogs, etc. The focus during this period should still be rehab, pressure management strategies, and building back single-leg stability. As body weight feels good, slowly make the exercises progressively more challenging by increasing difficulty, adding weights or resistance bands.
I recommend seeing a pelvic floor physical therapist during this time as well as seeking out someone (like me) who specializes in postpartum exercise.
Exercise 3-6 Months Postpartum- General fitness
This period is for general fitness and continuing to progress into the exercises that bring you joy. By this point you have mastered the connection breath, put in the work to engage your core and pelvic floor muscles, possibly mastered bodyweight movements, and increased stability. This means it may be time to establish a routine that feels good for you. Begin to experiment with adding exercises back in and play with your body’s capacity.
Training Themes for this period are:
- Progress/adjust for any symptoms- As you increase the stimulus and work to build back capacity, you may notice symptoms such as leaking, pressure/heaviness in your pelvic floor, pain, coning in your core, etc. If this happens, it may mean that you need to take a step back and continue to work up to that movement/volume or maybe you need to change your pressure management strategy.
- Loads should be light to moderate-building foundation, not PRs
- If you have not, take time to master bodyweight movements
- Build to impact (jumping/running)
- Running without symptoms
- Indirect core strengthening
During this time it is important to understand that progress is not always linear and it might take a little bit of time to build capacity back in certain exercises such as impact movements. You will need to build back up to impact exercises such as running and jumping.
Here is a great progression to follow:
Impact Progression:
Building Jumping Capacity With Various Stimulus
Prerequisites to this program are:
- At least 3 months postpartum
- Mastered connection breathing
- You have spent time on core rehabilitation exercises
- You have spent time working on single-leg strength and stability
Progression 1: Hopping Progression
- Double leg jump in place
- Single-leg jump in place
- Double leg line jump forward/back
- Double leg line jump lateral
- Single leg line jump forward/back
- Single leg line jump lateral
For all variations, your focus should be:
- Keeping your butt behind you
- Trying to keep your belly and butt relaxed
- Breathing in and out constantly
Progression 2: Skips in Place
- Try to keep your belly soft
- Breathe
- Increase height to make it more difficult
Progression 3: Forward Skips
- Try to keep your belly soft
- Breathe
- Increase height to make it more difficult
Progression 4: Jumping Lunges in Place
- Slight hinge forward
- Inhale down exhale up through the landing
Progression 5: Alternating Jumping Lunges
- Slight hinge forward
- Inhale down exhale up through the
Progression 6: Skater Jumps
Start small and slowly work wider
Progression 7: Jumping Jack Progression
- Single leg step-outs
- Single leg with arms
- Increase speed
- Narrow jumping jacks
- Jumping jacks
Tips
- Inhale as you open
- Exhale as you close
- Hinge if you are feeling leaky
Progression 8: Single to Double Leg Jumps
- Inhale as you bring your leg back
- Exhale as you bring your leg through and land
Progression 9: Jumping Rope
- Nose over toes
- Relax butt and belly
- Breath into you lats
*It may take time to build back capacity, start with smaller sets and increase over time. Shake out and reset between sets
Progression 10: Force Absorption Drills
- Double Foot Drop Landing
- Drop landing with jump
- Depth Jump lands-force absorption
- Depth Jumps
- Depth jumps to broad jumps
Tips
- Inhale at the top before going
- exhale through the full movement
- Try to land through the whole foot
Progression 11: Box Jumps
- Start lower and work your way up in height
- Use your arms to help absorb force
- Inhale-arms up, start your exhale before you jump, and breathe out through the whole movement
- Try to land quietly
- Think butt behind you when you stand
Once you feel ready to run again, start small and slowly increase time/distance and decrease rest. If you feel symptoms in your pelvic floor while running, it may be feedback that you are not ready for that volume yet or you may need to make some tweaks to the way you are running.
Your core muscles will likely still feel weak during this period so being intentional with strengthening is important. Focus on indirect core exercises such as rotational (woodchops/pallof press), carries (suitcase/farmers), front squats/goblet squats, and deadlifts (this is not an extensive list). Your core is likely not ready for things like crunches, situps, and hanging knee raises just yet.
Exercise 6-9 Months Postpartum-Fitness and Strength
Once you get into the 6 to 9-month postpartum range it is still not a time for PRs but, you can work towards previous fitness levels. You are going to want to continue building fundamentals while monitoring symptoms such as leaking, urgency, heaviness, or pressure in your pelvic floor.
Training Themes for this period are:
- Building/experimenting with symptom capacity & threshold
- Heavier weight with lower reps
- Low volume direct ab work
- Increasing intensity
At this point, if you have worked back up to it and built a solid foundation, you can start to focus on strength training. While this still is not a time to be pushing towards PRs, you can increase the weights. You can also start to add in lower volume direct ab work so think sit-up negatives, hanging knee raises/toes to bar, v-up variations, etc.
Keep in mind, that as you push the boundaries and start to increase volume/intensity/ weights, you may notice symptoms more than you did over the previous months. This is feedback and can be used to gauge readiness or be a sign that your strategy needs to be adjusted.
Building capacity takes time and sometimes intentionality. If you feel yourself getting discouraged, think back to 4 weeks postpartum, then 8 weeks postpartum, then 12 weeks postpartum, and remember where you started and how far you have come.
Exercise 9-12 months Postpartum-Performance
At this point, if you have followed this timeline, you might be at a place where you can focus on performance within your sport or exercise program of choice.. Continue to push boundaries while monitoring and adjusting for symptoms. You may feel good enough to shoot for PRs again.
It is important to note, that if you find this blog and happen to be 9 or more months postpartum but have not worked on creating a foundation or worked on progressively building back capacity, you should not start here.
Training Themes for this period are:
- Always quality over quantity
- Push boundaries if the foundation feels good
- Experiment and adjust as needed
- Ab-specific exercises with higher volume
- Some movements may feel great while others still need adjusting
Don’t forget, We are all individuals with our own experiences and considerations so for some of us we may need a little less or a little more time in each stage and that is ok. Use this as a general guide while understanding your timeline might not look exactly the same.
If you are struggling with figuring out your timeline or need support navigating your postpartum recovery/return to exercise, contact me directly so we can work 1:1 in building out your postpartum return to exercise plan. I work with folks in the Houston, Texas area, as well as, virtually who are navigating these seasons of their postpartum journey,