I want my body back: Guidelines for postpartum exercise

I want my body back: Guidelines for postpartum exercise

by | November 23rd, 2015
  

a pair of legs on pavement during sunrise or sunsetWithin weeks (or sometimes, days) after experiencing the miracle of childbirth, some women have been heard asking their obstetrician how long will it take them to regain their pre-pregnancy figure. Such questions as, “How soon can I exercise?” or “Is it ok for me to do crunches?” are commonly posed. As a follow up to my previous post on exercise during pregnancy, I thought it would be worthwhile to address the postpartum do’s and don’ts of exercise.

The American Congress of Obstetricians and Gynecologists updated these recommendations this year.

Guidelines for activity: 150 minutes per week of moderate-intensity aerobic activities are recommended during the postpartum period. Moderate intensity exercises are those that raise your heart rate and cause you to break a sweat. These exercises can be broken down into multiple sessions per week for a total of 150 minutes.

Timing: Depending upon your type of delivery and soreness/swelling, you may begin within a few days of delivery. If your pregnancy was uncomplicated and you had a normal vaginal delivery, you can ease into exercise within a few days. If you had a c-section, you should discuss timing with your provider at your two-week visit.

Types of exercise: Aerobic exercises such as brisk walking are a good start. Your joints and ligaments will still be somewhat loose, so starting easy is important. You can gradually increase your intensity and types of aerobic activity as you regain muscle tone and stability.

Muscle strengthening exercises like yoga, pilates and weight lifting are recommended at least twice per week in addition to the aerobic exercises. Kegel muscle exercises are helpful in toning your pelvic floor muscles (the muscles that support the urethra, bladder, uterus, and rectum). To properly perform Kegel exercises, squeeze the muscles that you use to stop the flow of urine and hold the contraction for 10 seconds, then release. You should repeat the process 10-20 times in a row, three times per day.

Core muscle exercises are a subset of the strengthening exercises that are an important component to regaining strength and tone. Five core exercises are listed by ACOG for the postpartum period. They recommend starting with one and once that exercise is “mastered” — defined by the ability to perform 20 repetitions — the next exercise can be attempted.

  1. Four-point kneeling: Kneel on all fours with shoulders over hands and hips over knees. Your back should be straight. Inhale deeply, then exhale. While exhaling, engage your abdominal muscles by trying to pull your belly button inward toward your spine.
  2. Leg slides: Lie flat on your back with knees bent slightly and feet flat on the floor. Engage your abdominal muscles. Inhale and slide one leg to a straight position. Exhale and return leg to bent position while keeping the abdominal muscles engaged. Relax, then repeat with the other leg.
  3. Knee raises: Start in the same position as the leg slide. Engage the abdominal muscles while raising the knee of one leg above the hip. Then slide the other leg straight while keeping abdominal muscles engaged. Return to the starting position and repeat with other leg.
  4. Heel touches: Begin in the same position as the leg slide and knee raise. Bring both knees above the hip so they’re bent 90 degrees and the lower part of the legs are parallel to the floor. Lower one leg while keeping the knee bent at a 90 degrees angle until your heal touches the floor. Keep the abdominal muscles engaged and pull the knee back up to the starting position. Repeat with the other leg.
  5. Leg extensions: Bring both knees up above the hips, bend at a 90 degrees angle with the lower leg parallel to the floor. Engage abdominal muscles and extend/straighten one leg while exhaling. Then inhale, returning to a bent knee position. Repeat with the opposite leg.

Being physically active in the postpartum period can have beneficial effects for both you and your baby. Even if you experience the emotional rollercoaster of hormonal changes or the exhaustion of feeding schedules, finding a few minutes each day to exercise can be beneficial and actually give you more energy. As always, if you have any questions or concerns, please feel free to discuss with your provider.

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