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Return to Exercise after Pregnancy

Most women look forward to going back to exercise after pregnancy. But when should you return to running and sports after pregnancy?

When Is It Okay to Exercise after Pregnancy?

While you may be mentally ready to get your body back after 9 months of pregnancy, your body may be not quite as ready to return to its previous levels right away. Most postnatal women will get the all-clear from their OBGYN at their 6 week follow up. However, your body may not be ready for running just yet.

The pelvic floor and core muscles are important for supporting your pelvic organs and continence during high impact activities. However, these muscles are usually stretched out, weakened or injured after pregnancy and delivery. Your body is still undergoing a lot of changes, and hormones can also affect ligaments and joints, which can put you at higher risk of injuries. Postnatal women need adequate healing time and training to regain appropriate strength in their abdominals and pelvic floor muscles after pregnancy and delivery. A pelvic floor physical therapist can help you assess your pelvic floor and aid in its recovery.

High impact activities such as running put extra pressure on the pelvic floor, and if these muscles are not ready for full function when starting running, other issues may arise further down the road.

Causes for Concern

Talk to your OB-GYN or doctor about seeing a pelvic floor physical therapist if you notice any of these signs and symptoms that last beyond 6 weeks:

  • Urinary incontinence
  • Urinary urgency
  • Heaviness or pressure in pelvic area
  • Pelvic pain
  • Separated abdominal muscles (diastasis recti)
  • Hip pain

How to Ease Back into Exercise after Pregnancy

If you had an uncomplicated delivery, and do not have any of the symptoms above, you could consider starting a very low intensity physical activity program, including diaphragmatic breathing, pelvic floor and core exercises and walking, while waiting for your 6-week follow-up.

Continue with the low impact exercise routine for at least 12 weeks after delivery. Low impact exercises include:

  • Walking
  • Yoga
  • Pilates
  • Cycling
  • Swimming
  • Gentle abdominal exercises

If you are planning to return to running or high impact activities, it is recommended to wait at least 12 weeks before embarking on a graded running program.

General Guideline for Exercise after Pregnancy

Week 0-2

Focus on your body mechanics during the first two weeks.

  • Use the “abdominal brace technique” during all activities including standing up, picking baby up, carrying baby, pushing stroller, carrying baby carrier, etc.
  • Avoid slouching; keep your back straight.
  • Breathe out and tighten your pelvic floor muscles and deep core muscles (think kegels and flattening your tummy). Use this technique when changing positions and performing strenuous activities.
  • Do not hold your breath when doing strenuous activities.

You may also start pelvic floor exercises, or kegels:

  • Endurance: hold kegel for 5 seconds, relax for 10 seconds. Repeat 10 times, three times a day.
  • Quick contractions: hold kegel for 1 second, relax for 1 second. Repeat 10 times, three times a day.

Week 2-6

You may go for walks and do other low impact activities as you can tolerate them. Continue with kegels and deep breathing exercises. Talk to your doctor about seeing a pelvic floor physical therapist if you want to follow a postnatal exercise program.

Week 6 and Beyond

Always start small and introduce back new exercises slowly. A good starting point would be around 1-2 minutes of running at an easy pace with walk breaks. Set short term goals, and progress the distance and time on a weekly basis. Monitor for response to running (pain levels and pain duration), which can be indications that training needs to be reduced, changed or stopped. Listen to your body, and talk to an OBGYN if you experience any of the above symptoms. A pelvic floor therapist can help assess and evaluate strength, function and coordination of the abdominal and pelvic floor muscles before you embark on your return to running and high impact sports.

As always, reach out to a CHI Health Women's Health Provider or Pelvic Floor Specialist for questions.

Originally Published: March 2022. Revised: January 2023.

Chun Li Kok, PT, DPT
Chun Li Kok, PT, DPT

Chun Li Kok, PT, DPT is a physical therapist with CHI Health.

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