Ask any postpartum mom whether they’re ready to jump back into their workout routine after their six-week postpartum appointment, and chances are many of them will say no. That’s because in most cases, six weeks is too soon for many women.
While women are usually given the all-clear from their doctors to work out again at six weeks, their bodies are still recovering from the physical toll of pregnancy and delivery, said Sarah Clampett, a physical therapist specializing in postpartum health and clinical director at Origin Physical Therapy.
“The body changes slowly during pregnancy. The body’s center of mass shifts forward, posture changes and even the curvature of the back is affected,” Clampett explained. “It then changes again — and quickly — after delivery.”
Not to mention, at six weeks, you’re still very much in the thick of the newborn stage, which demands all of your energy and time. So it’s not surprising that the thought of lifting a dumbbell or going for a run feels a little out of touch with reality.
“Injuries happen when someone is fatigued and not paying attention to body mechanics and form. At six weeks, the fatigue is real and hormones are still balancing,” Clampett said. “Women should listen to their bodies and start light and then slowly increase the intensity of their exercise.”
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When should I start working out again postpartum?
So how do you know if you’re ready to start working out again? There isn’t a clear-cut answer as every woman is different, but the biggest sign is going to come from listening to your body and respecting the healing process, Clampett said.
While there’s no exercise that’s completely off limits during postpartum (because everyone is different), she recommends starting off with low-intensity versions of the movements you normally do. For example, if you like running, try walking. And if you lift heavy weights, try body-weight exercises to practice movement patterns or go light as you build your way back up.
“It’s also important to remember that exercise doesn’t only mean a 30-minute run or a 45-minute HIIT class. Walking is exercise, so it’s typically safe to start there because we already do it all day long,” Clampett said.
Once you’re comfortable with the exercises and feel like you’re ready for a challenge, you can gradually add higher-intensity moves into your workouts. You just want to make sure that you’re doing the exercises with proper form, engaging the right muscles, managing your breath (read: not holding it), and listening to your body, making sure not to overexert yourself.
Women who weren’t as active before or during their pregnancy should take even more time to ease back into fitness and show themselves some grace.
“Start with walks, stretching and very gentle exercises, like standing up from a chair 10 times,” Clampett said.
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Think of your energy in terms of ‘tokens’
“It’s important for women to listen to their bodies and think of their time and energy like tokens. For example, if someone has 12 energy tokens to spend per day, six might be used for feeding and caring for the baby, three might be used for laundry, which leaves three left for exercise.”
These three tokens, Clampett said, could be used to go on a 30-minute walk or restorative yoga class — basically any type of physical activity. The point is that exercise takes up just a fraction of your energy compared to everything else during the first six weeks of post-pregnancy.
But at 10 weeks postpartum, that could change. “They might have 18 or 20 tokens for the day, yielding more and more tokens for exercise. Every woman is different, every recovery is different, and no one should ever compare their recovery to that of friends, family or someone on social media,” Clampett said.
So before you lace up those running shoes and break out the kettlebells, here are some things to consider as you jump back into exercise.
4 things to consider before you start a postpartum fitness routine
1. The importance of recovery
Whether you had a Cesarean or vaginal birth, re-engaging your core and finding your breath is going to be key for easing back into fitness, Clampett said.
“After a C-section, it is often harder to find your abdominal muscles because the incision remains numb for some period of time,” she explained. So Clampett recommends starting with lower-intensity ab exercises, such as marches, bird dog leg lift progressions and belly lifts, to make sure your brain is connecting with your core. With these ab exercises, you should focus on bracing the transverse abdominis, which is the deep, corseting ab muscle.
How do you know if you’re engaging your core? Clampett said you place your fingers on your abs and feel the muscles contract. While it might be hard to sense the contraction at first, Clampett said that it helps reinforce the muscle and brain connection. As you begin to feel your ab muscles contracting more, you can gradually increase the intensity of the exercises.
From there, you want to make sure you’re working the core in different directions. “Once your incision has healed, it is important to move in all three planes — side to side, front to back and rotation — to bring more mobility and movement to your core,” Clampett said.
And if you delivered vaginally, Clampett said you also want to focus on lower-intensity ab exercises.
“You want to make sure that none of the exercises you’re doing irritates your perineum or scar,” she said. “Pay close attention to the pressure you feel on your pelvic floor as well. Holding your breath can put more pressure on the pelvic floor, which can make it feel heavy or painful.”
2. Diastasis recti
During pregnancy, your abdominal wall stretches and weakens as your baby continues to put pressure on the linea alba — the tissue that connects the two halves of your rectus abdominis, aka the ab muscle in the front of your belly. Because of this, your abs may separate and cause a significant gap known as diastasis recti.
“Having diastasis recti means you need to work harder to manage pressure in your abs,” Clampett said. “Generally this pressure increases when you brace, exert yourself or hold your breath. Similarly, any exercises that cause doming may be too advanced depending on where someone is in their postpartum journey.”
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Ab exercises like planks and crunches, for example, may cause doming of the belly. So if you notice this, it’s best to modify these exercises until you’re ready to progress. You should also ease back into lifting heavy weights, which can make the ab separation worse, especially if you hold your breath. Instead, Clampett recommends working on strengthening the deeper core muscles to help build tension back, so you can manage more challenging exercises.
3. Pelvic floor dysfunction
The muscles in your pelvic floor, which includes your core, are responsible for sexual function and blood flow, as well as preventing incontinence. After pregnancy and delivery, you may experience some pelvic floor dysfunction and certain exercises can make it worse if you’re not careful.
“If you’re experiencing urinary leaking or pressure during exercise, those symptoms indicate that the exercise is more than what your pelvic floor can keep up with right now,” Clampett said. “You may need to start with lower-impact exercises and hold off on higher-impact activities, like jumping, running or powerlifting, and focus on coordinating your breathing, core and pelvic floor muscles.”
Over time, you’ll progress to doing higher-impact exercises.
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4. Muscle imbalances
Because pregnancy shifts your weight forward and changes the curvature of your back, it may cause some muscle imbalances postpartum. For example, many women experience tightness in their hips and back, as well as trouble engaging the glutes and abs, Clampett said.
“Working on getting mobility into their hips and building back ab and glute strength is crucial in protecting the low back, especially because new moms still need to lift and carry their baby all day long,” she said.
And if you’re breastfeeding, your breasts may feel heavier, so when exercising, you should think about strengthening the mid-back and core, Clampett said, to support the additional weight and avoid injury and pain.
Women should focus on healing and feeling strong post-pregnancy — not losing weight and getting back into their pre-pregnancy bodies.
The bottom line
Women should focus on healing and feeling strong post-pregnancy — not losing weight and getting back into their pre-pregnancy bodies. The recovery after childbirth, fatigue from caring for a newborn, and changes to your hormones have a significant impact on your energy levels and ability to exercise.
“[Women] should focus on building functional strength, postural awareness and endurance. The weight loss will come, so shifting emphasis on these things will help set them up for success long term,” Clampett said.
But remember: There is no timeline for exercising postpartum. The changes brought on by new motherhood affect every woman differently, and when to start working out again — and what that looks like — is a personal choice.
“The body changes so much over 40 weeks, and then again in the six weeks after delivery. So at the absolute minimum, women should give themselves at least a year until they feel somewhat like their pre-pregnancy selves,” Clampett said.