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What I want every mom to know about returning to exercise after baby...


What I want every mom to know about returning to exercise after baby... Here is my advice, for moms returning to their favorite form of exercise after having a baby. This advice comes from both personal experience and professional education, and includes a mix of practical suggestions and specific guidelines.

{image author's own; used with permission}

Before you even set foot in the gym, this is the most important advice I can give you about your postpartum journey:

  • Be kind to yourself

  • Take it slower than you think

  • Rebuild from the ground up

  • Remind yourself that you’re doing a good job

For the purpose of planning, here is a suggested timeline for the returning to exercise--- or for the majority of this audience, returning to CrossFit:

  • 0 - 8 Weeks: Rest & Recover

  • 6 Weeks - 6 Months: Lay the Foundation

  • 6 Months - 12 Months: Build on the Foundation

  • 12 Months + Beyond: Expand on the Foundation

The problem with a timeline is that every body is different and our bodies do not follow rules! You may find that you don't even want to think about exercising until 4-5 months out. That's ok! You may find that your body heals faster or slower... And that's ok! You might not even read this until you're past the 8 week postpartum mark. And that's ok! The strategy and the concept of re-building the foundation layer by layer still apply to you, regardless of the timing. If you scroll down you will find this timeline broken down into more detail.

Our baby gives us a great example of how to process this timeline. The baby starts life from the ground up, literally. At first they can barely even lift their head, but as they rest and nourish themselves (often at your expense!), they build strength and increase their foundation of movements, adding rolling, sitting, crawling, transitions and eventually walking, running, climbing, etc. This growth experience for each baby is different! And from birth to walking it can take 9 to 15 months! Mommas must consider their own body’s recovery, re-building, and returning to exercise in a similar way. Build from the ground up, with rest & nourishment for your body, and kindness, not comparison, for the process.

During ALL of these phases, from pregnancy to postpartum, I teach my momma's to use the “ABC strategy” to strengthen and stabilize their core (which includes the pelvic floor!):

  1. Alignment: ribs over hips, neutral pelvis

  2. Breath: exhale on exertion!

  3. Core Connection: Engage the core (including pelvic floor & transverse abdominous) with the exhale. Think “Engage - exhale - exert.” Always match the “tension to the task” (Antony Lo quote)-- meaning match the level of effort put into the core-connection to the level of effort demanded from the movement.

This “ABC strategy” is a concept from “Piston Science” by Julie Wiebe PT. I recommend you take time to get very familiar with strategy and study Julie’s materials. This breathing pattern is a key component to optimal core strength!

If at any point during (pregnancy or) your postpartum journey, whether it’s day 1, day 365, or 10 years later...whether it’s during daily life or in the gym, you experience symptoms such as:

  • Leaking urine, gas or feces (i.e. during impact or during a sneeze or cough)

  • Pelvic or vaginal pain, pressure or discomfort

  • Hip, tailbone, or low back pain or discomfort

  • Coning of the abdomen (football shaped protrusion down the middle of your belly)

  • Pulling, aching, sharp or dull pain in the abdomen or pelvis

  • Fatigue, dizziness, or increased heart rate (unable to keep a conversation)

  • Hip, back, or foot aches and pains

  • Painful intimacy (after the first 2 times postpartum)

  • Unable to keep in a tampon

  • “Something doesn’t feel right”

These symptoms would be an indicator to pause and adjust. Reconsider your ABC’s, reduce the intensity and simplify the movement. If that doesn’t change the symptom, don’t push through! This is your body’s way of letting you know more healing needs to be done. If you consistently experience symptoms, you need more attention by a professional like a pelvic floor physical therapist (PFPT). There can be serious complications, like diastasis recti (separation of the core), hernia, prolapse, chronic incontinence, or chronic low back pain, etc., if these symptoms are ignored. (PLEASE NOTE: if you already HAVE one of these conditions, you need to know that there are many ways to work on minimizing or healing them!! Start with a PFPT!)

Before we get into the timeline in more detail, I need to tell you one more thing momma: It’s important to me that you know your body has done amazing things to grow, nourish, carry, deliver and sustain that baby. These things might make your body look and feel different. Don’t allow yourself to be pressured and discouraged by idea that you need your body “back.” Your body is going to take all these amazing changes and move FORWARD with newfound experience and power, because of what it has gone through and the life it has brought forth! And if you move forward in a SMART way, you should be able to be STRONGER than before. This is where "SLOW IS FAST." If you push too hard and too fast, you will slow your recovery down and potentially derail yourself completely.

0 - 8 Weeks: REST & RECOVER

Your plan for the first 0 - 6 weeks should be to REST as much as possible! I know this sounds crazy and impossible. But in the middle of adjusting to a newborn and new routine, including constant feeding of this newborn and usually less sleep than normal for yourself, create a system for yourself that allows you to sit or lay down as much as possible during those first 10-12 days. This will probably mean thinking creatively to outsource some of your usual tasks, and involving the help of a community around you. Make sure to feed and nourish your body well during this time, as a lot is being demanded of your body to heal physically, mentally and emotionally, not to mention the work your body is doing to nourish the baby! This is also a good time to care for your body through body work (chiropractic, massages, lymphatic massage, heat therapy, etc.). This resting and recovery phase is also important because your hormones are still all out of whack, which slows soft tissue healing and increases joint laxity. Not getting a regular amount of sleep and high(er) levels of stress also affects your hormones and therefore healing. If you are breastfeeding the hormones will remain high until 4-6 months after breastfeeding is over.

The birth of a baby, the newborn days (weeks...months…), the changes to your body, adjusting to your new lifestyle… This is a lot to take in! For some this part of the journey is long and exhausting, for some it’s not. It’s perfectly ok if you spend more time in this “adjusting” period and take longer to begin “formal exercise.” There is no pressure!! Eventually you and the baby will reach a point in your routine where you feel comfortable adding in some intentional movement or exercise.

Don't underestimate the importance of rest in these early days, it is a huge contributor to strength and healing in the days to come.

Simple places to start, if you feel ready:

  • BREATH WORK: Even if you were already familiar with the “Piston Science” strategy, your core went through a lot with the labor and delivery and now your body is adjusting back to it’s “pre-pregnancy” state, so you have to take time to retrain this breathing and core connection pattern. Start anti-gravity (laying down or sitting). Work first on the diaphragmatic breath, then on the transverse abdominis activation, then on the pelvic floor engagement, and finally putting it all together into one “Piston Breath.” Once this breathing pattern becomes more natural and feels re-connected, begin applying it to the “exertion” of your daily life movements (i.e. picking up the baby, car-seat or laundry basket)

  • ALIGNMENT WORK: This is an opportunity to “reset” your alignment. As you have the energy and capacity to consider your positioning, make sure to adjust your body to have “ribs over hips” and a neutral pelvis during your daily activities, especially feeding the baby (nursing or bottle-feeding), carrying/holding the baby, baby-wearing, car-seat lifting, and stroller pushing. Having bodywork done, such as massage or chiropractic, can help assist in resetting your alignment.

  • LOW IMPACT EXERCISE: After the first 10 days, walking, hill walking or swimming is an excellent place to start testing your body’s recovery and adding in some stimulation and movement. Start slow, going for shorter intervals than you think! Pay attention to your alignment (especially if pushing a stroller!) any symptoms you experience.

  • To prepare ahead of time (before birth) for this 4th Trimester rest phase I recommend attending a “4th Trimester Preparation” workshop or class. We focus so much on preparing for birth that we are not prepared (or informed) for the 4th Trimester! These first 3 months postpartum can actually be more intense (physically, mentally, and emotionally) than the actual birth process. If you are prepared ahead of time with support methods in place to allow for proper rest and recovery, this period will be easier on you and your body will recover to full strength more quickly. If you are local to Phoenix, I highly recommend attending a workshop or class by Matrescence; they will help you understand what you and your baby need during this time to THRIVE not just survive! And then help you make a plan to accomplish it. Another resource is to read “The First 40 Days.

I am not going to go into recovery and exercise after a c-section, but here is an article to get you started on some additional things to consider if that is your recovery situation.

6 Weeks - 6 Months: Lay the Foundation

At 6 - 8 weeks postpartum we have the typical “recheck” with our provider. For most women this appointment is very quick and casual, and doesn’t address potential deeper issues such as what is going on with the pelvic floor and core recovery or the emotional/mental health recovery. Usually the mom is given the “all clear” to return to physical activity and intimacy! And the temptation is celebrate this new freedom by going for a 5k run or jumping into the next CrossFit WOD. I get it! You are craving the intensity, the burn, the sweat and the feeling of being strong and accomplished. But please slow down. This is where FOUNDATION BUILDING begins. Build into your favorite exercises layer by layer, using the ABC strategy and symptom management (as mentioned above.) And before you get too far into exercise, make sure you have an appointment with a pelvic floor physical therapist (PFPT).

Tips about PFPT:

  • PFPT’s often book far in advance, so you want to get on their schedule as soon as you can (once your provider clears you).

  • You need a referral in most cases, so I recommend checking with your provider about the referral prior to the birth or soon after your birth and then get on the PFPT’s schedule for 6-8 weeks after your delivery. PS: If your provider isn’t willing to give you a referral, reach out the the PT for other options or find a new provider. You have the right to see a PFPT!

  • Schedule to see the PFPT even if you aren’t experiencing symptoms! They will be able to guide your return to exercise and core/pelvic floor healing to help prevent any symptoms from turning up, as well as helping to manage and heal any symptoms that already exist.

  • What to expect at a PFPT visit

  • Look for a local PFPT here (AZ) or here. If you are in Phoenix, send me an email for a recommendation.

In my opinion, returning to the gym, CrossFit, or formal exercise should happen only after these suggestions are met:

  • You are 6-8 weeks postpartum

  • You have been “cleared” by your provider

  • You have had a consultation with a PFPT

  • And you are feeling ready to add in a gym routine! It’s totally ok if you reach 6-8 weeks postpartum and you don’t feel ready to add any formal exercise into your life. You will get there, eventually.

Use this time period to build a strong foundation. Don’t jump right back to heavy barbell lifts, kipping pull-ups, double-unders and high rep volume WODs. Build each movement layer by layer, testing the ABC’s and symptoms. Some movements will rebuild faster than others! And some will take a little more intentional work. If you are willing to patiently build the foundation, you will become stronger than you were before. I’m not going to use this space to go into detail about rebuilding each movement, but I hope you understand the concept of building the foundation using the ABC strategy and symptom management. If you are working with a coach they should be able to help with starting movements from the ground up, even if they are not trained specifically in pregnancy/postpartum. And I’m available to give you more guidance if needed as well! Also a course like Brianna Battles' "Pregnancy & Postpartum Athlete" will really help you understand how to apply these concepts.

introduce runningI recommend waiting until at least 12 weeks postpartum to introduce high-risk (traditional ab work, kipping, etc) and high-impact (jump roping, running, box jumps, etc). When you do introduce these movements, you are still thinking “start small” and “build a foundation.” For example if you want to , don’t start with a 3 mile run, even if that was normal and easy for you “before.” Start with run-walk intervals for 1 mile, checking in with your symptoms, alignment and breathing. Increase the distance and time spent running as your body allows! If you want to rebuild (or learn!) double-unders, start with a small volume of singles, making sure to stay in alignment (ribs over hips) and breath consistently (don't hold your breath or over-grip your pelvic floor--more jumping strategy here!) If you experience symptoms, go back and check your strategy, start smaller, or get treatment from a PFPT. If you don't experience symptoms, increase the volume and build up to a double-under with a "single-single-double" pattern, slowly trading the singles for doubles.

I want you to return to high level and high impact exercises as much as you want to! But if we do not build them layer upon layer, we run the risk of derailing ourselves by injury.

{image author's own; used with permission}

6 Months - 12 Months: Build on the Foundation

In this phase you start getting competitive with yourself. You’ve been diligent to lay a foundation, master the ABC’s, and hopefully aren’t experiencing symptoms-- or if you are, you are making proper adjustments and working with a PFPT. You can start increasing the challenge-- adding weight, increasing the intensity (volume, pace), and adding higher level movements. Always testing slowly first and maintaining the ABC’s and lack of symptoms.

If you haven't already worked on introducing high-level and high-impact exercises, this is a good time to start building those back in, if that is something you want to return to.

12 Months + Beyond: Expand on the Foundation

In this phase you might find yourself competitive against others again. You have a large number of movements that feel strong, and you can start to expand your performance to heavier weights and higher skills. Maybe you even hit new lifetime PR’s or accomplish skills you weren’t able to before. Don’t neglect to check in with your body and watch for

symptoms, but they will be minimal at this point.

[Personal Note]

The return to exercise (CrossFit) after a baby is so individual- because every body, every pregnancy, every labor/delivery, and every recovery is different. And all this information is just “tip of the iceberg.” But hopefully it is a starting point for you, and sets you off on a path that leaves you stronger than before, and helps you to avoid nagging injuries and chronic conditions (such as diastasis recti or incontinence) that often get written off as “normal parts of motherhood.” My goal is that moms don’t have to say, “I wish someone would have told me…”

Let me know if you have any questions along the way! I’m also happy to point to you to the resources I have used (many of them are linked right in this post!) or share more about my personal pregnancy and postpartum CrossFit experiences.

Coach Lauren

lauren@chuckwallacrossfit.com

Pregnancy & Postpartum Core Connections

{image author's own; used with permission}

#mom #postpartum #pelvicfloor #diastasisawareness #crossfit #pregnancy #rehabilitation #baby

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