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January 7, 2020
By Carolyn Yates, PT, DPT
All right, you’ve made it to the 6-week check-up and your OB/GYN has cleared you for sex, exercise, jumping on trampolines...whatever your heart desires. Great! That means from the OB/GYN perspective you are healthy and ready to move on to the next thing. The OB/GYN “sign-off” is very important but should be viewed as a “yellow light” as opposed to a “green light” for all things exercise. Let’s pump the brakes on the clearance to do any form of exercise as soon as you get that 6-week sign-off and think critically about what your body went through and what has been happening for the past 6 weeks.
At 6 weeks postpartum your uterus and other pelvic organs will finish returning to their pre-pregnancy states, bleeding will typically resolve within 6 to 8 weeks, and urinary incontinence that is going to resolve on its own will typically subside by 6 weeks to 3 months.
At 6 weeks postpartum your body is now ready to start preparing to return to all the beloved exercises you used to do. Think of it this way, you wouldn’t jump into a marathon the day after you decided you wanted to run one right? Well, the 6-week “sign-off” is like the day you decide to sign up for a marathon and not the day of the marathon. So, treat the 6-week “sign-off” as the day you start making your training plan. You need to prepare your body for the road ahead by ensuring that your core is strong and that all of your muscles that were stretched out and pushed through by that little bundle of joy of yours, are back to working properly before you start pounding the pavement!
It is well known that exercise has many more benefits than just weight loss. It combats health conditions and diseases such as depression, anxiety and metabolic syndromes. It improves mood, and sleep, and increases energy. It also can have a positive impact on your social life by going to group exercise classes and getting you out of the house.
Exercise is fabulous and should be in every postpartum mama’s routine. However, the type of exercise you are doing at 6 weeks postpartum is crucial. Ideally for the past 6 weeks you have been doing some simple and gentle rehabilitative exercises (If not, no worries! Check out this article, How to start rehabilitating and strengthening immediately postpartum for some tips on a couple of easy exercises to do for mobility and initial reactivation of your core and pelvic floor). These exercises will have reestablished your core’s foundation to start building upon. Remember, it is the day you DECIDED to sign up for the marathon. So, what’s the next step? Upping your exercise game but not too aggressively. Yoga, pilates, biking, swimming, hiking. Anything that is low-impact is fair game now as long as you are not experiencing symptoms such as pelvic heaviness or have diastasis recti that has not been evaluated. In addition to low-impact exercise, add to your routine these 4 simple exercises described below to ensure that your core, pelvic floor, and hips are reestablishing strength appropriately.
Start sitting on the ground with your feet in front of you and your hands flat on the ground behind you.
Engage your lower abdominals by pulling your pubic bone towards your belly button and contract your pelvic floor muscles.
Lift your hips up off the ground by pushing through your hands and feet so that you are in a table-top position. Hold her for 20 seconds.
Make sure to but pushing up through your hips and engaging your pelvic floor the entire time you are holding.
If you can confidently pass all 6 of the criteria below then you are cleared to return to running and other high-impact, high-load exercise.
When you are:
1) 12-weeks postpartum,
2) have implemented the rehabilitative exercises outlined in this article as well as the How to start rehabilitating and strengthening immediately postpartum article,
3) you are not experiencing any heaviness or pressure at your pelvic floor,
4) you are no longer experiencing incontinence,
5) bleeding has resolved, and
6) you are not having any pelvic, low back, hip or any other unusual pains.
Carolyn Yates, PT, DPT is a Colorado State licensed Physical Therapist with a pelvic floor rehabilitation specialty. She received a Doctorate of Physical Therapy (DPT) from Belmont University School of Physical Therapy and is the owner and head physical therapist of Verity Physical Therapy & Wellness in Boulder, CO.
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