You just had a baby and you just can’t wait to share your love of the outdoors with your new little bundle, but, before you get back on the trail after birth, it’s important to let your body do some healing.
Pregnancy, labor, and delivery are extremely hard on your body. Just like it took nine months to grow your tiny human(s), it will take time for your body to recover.
I was lucky to have two healthy pregnancies and deliveries which brought me my two little girls. Both times I was eager to get back in action, but how I felt after delivery and my return to action was very different between the two.
Spring birthdays make it even more challenging to hold back. Read on for my experience and problems I encountered as well as some tips and exercises for getting back out there.
Big thanks to Sarah Dahl, PT, DPT, CSCS, CMTPT for helping me review this post to make sure I could give you all the best information!
Looking for some more tips about getting back to adventure? Check out Emily’s post about Bouncing Back to Adventure After Baby.
My Personal Journey Back on the Trail after Birth
Six weeks postpartum, it’s (most often) the first time we see our providers since giving birth. We go in for our appointment, they do a quick check of our lady parts and/or incision site, send us on our way and remind us to come back in a year.
At my appointment, everything checked out fine and I got the “ALL CLEAR.” So, off I went.
I returned to running immediately (I actually started some interval jogging a week earlier) and 2 weeks later I was playing soccer at 8 weeks postpartum.
That summer I ran a trail 5K at 12 weeks and a trail 10K at 18 weeks and played soccer all summer. We did a lot of camping and hiking as well. I played soccer throughout the fall and indoor soccer all winter.
I felt like I was doing great and I was happy with my return to exercise, sports, and hiking. The next summer I joined a local moms fitness group, FitMOM, and continued running and playing soccer.
The FitMOM instructors are amazing and I have learned a lot from them about core and pelvic floor function after giving birth. I learned how to check for abdominal wall separation and just because you gave birth, bladder leakage is not normal.
The best thing I learned was that there are Physical Therapists dedicated to helping with women’s health issues.
This was all great information that I just stored away for future use because I was all good, or so I thought.
It wasn’t until my daughter was about 18 months old that I started having some issues. It started when I was playing indoor soccer, anytime I would try and kick a ball or prepare for impact, I would have a little bladder leakage.
I would go to the bathroom right before and often at halftime as well to try and keep my bladder empty.
I did my best to add Kegels and core strength into my routine, but it just wasn’t enough.
Finally, I had enough with the issue and reached out to a local Women’s Health Physical Therapy office and headed in for my first visit. I learned that I was not doing Kegel exercises correctly and my pelvic floor strength had weakened due to lack of regular core work.
I hadn’t got back into a good workout routine since summer FitMOM ended, so there went my core. A handful of visits later and lots of core work, I was back to playing soccer without any issues.
Fast forward a few years after the birth of my second. My older, wiser, self went to my PT right after my 6 week check-up with my OB. We jumped right in to addressing my Diastasis Rectii and strengthening my pelvic floor.
I first returned to interval running around 8 weeks and then back to soccer, both more delayed than with my first. I still had some leakage with soccer and intense running until about 7 months postpartum as I continued to build strength.
Finally, I had restored the strength and endurance I needed to hold it all together, literally.
Six months after starting, I graduated from PT and can do all my favorite activities without any issues, most days. I am still just 9 months postpartum and my body is still changing. I have learned that I need to keep up on my exercises so I don’t have setbacks.
I loved having my PT help me through returning to exercise and sport. She kept on me about taking care of my body and helping me to strengthen my pelvic floor, core, and so much more.
It’s very important to keep on your exercises so you don’t experience any relapse. I (and my bladder) can tell when I have not been doing my pelvic floor exercises regularly. Keep on it to keep it all in!
Why You Need to Take it Slow
Jumping back into exercise too early (especially high impact) can pose some complications down the road. This could include urinary or fecal incontinence, pelvic organ prolapse, pelvic pain, and/or abdominal wall dysfunction.
Although this might sound scary, these things can likely be treated conservatively with the help of a Women’s Health Physical Therapist.
I don’t know about many of you, but I know my OB did not assess my pelvic floor function or check for diastasis recti before giving me the “ALL CLEAR” to return to activity, running and sports.
Unfortunately, this seems to be a norm for a lot of providers. Labor and delivery is very traumatic on your body. You and your pelvic floor and core will need some TLC as it is often weakened or injured after delivery.
It is recommended that all women, regardless of how they deliver, seek out a pelvic health assessment with a specialist physiotherapist to evaluate strength, function and co-ordination of the abdominal and pelvic floor muscles which are often impacted by pregnancy and delivery.Goom et al. 2019
It’s important to listen to your body and your care team so you don’t over-do it. As you’ve probably been told, you also need to pay attention to your lochia and how you are feeling after activity.
If you have increased bleeding or feel worse after activity, then you should wait for another day when you are feeling ready.
Returning to Activity after Birth
It is recommended that only low impact exercise be performed between 0-3 months postpartum with return to running or higher impact exercise between 3-6 months, at the earliest.
A strong and stable core is crucial to have before returning to more intense exercise like running or hiking with a carrier.
Take it slow. Increase your intensity and duration slowly. Start with short, flat hikes and work your way up. Start with low impact exercise and core stabilization exercises.
The following graphic has some great examples of how to progress your exercise from birth to 12 weeks postpartum.
Things to Take into Consideration
Your weight can affect you in a few ways. During pregnancy, most women hit the “overweight” mark when using BMI indicator. Thankfully, we lose a good amount right after delivery and slowly get back to our pre-pregnancy weight over the course of the year.
The more weight you have, the more load is placed on your pelvic floor.
Being overweight increases the load on the pelvic floor. Women are considered at aPomian et al. 2016
higher risk of pelvic floor related symptoms if they have a BMI >30.
As you start to get your body back and lose the pregnancy weight, your center of gravity will continually change.
Start carrying a baby around and it all changes again. It is important to make sure you continue to work on your core strength and balance to make sure you are able to hike and exercise safely, with or without carrying your baby.
The use of hiking poles is also helpful while babywearing.
Diastasis Rectus Abdominis (DRA)
DRA is the separation of the outermost abdominal muscles and all pregnant women have some degree of separation during their third trimester (Mota et al. 2015). DRA leads to decreased strength and stability throughout your core and tends to go along with a weak pelvic floor.
Although awareness for DRA is increasing, there are still many women unaware that they have a separation. When the diastasis is not corrected, it can cause your body to compensate and lead to other challenges with your core functions.
A Women’s Health PT can help diagnose and treat DRA issues. It is important to have a strong core before returning to more intense exercise.
If you are breastfeeding or pumping, then it is likely that your estrogen levels are are lower and you still have slightly raised levels of relaxin (the hormone that relaxes the ligaments in your body to allow you to give birth).
These hormonal changes can stay with you until 3 months AFTER you wean from nursing or pumping (Goom et al. 2019).
This means you may continue to have increased joint laxity well after giving birth. Take caution with quick movements or if you are on uneven surfaces.
Adequate sleep is required for your body to recover from physical and psychological stresses. As new moms, most of us rarely get enough sleep for the first few months to a year or beyond.
Sleep deprivation can lead to injury, health issues, and increased stress.
Focus on getting quality sleep when you can and adding naps when time allows. Limit hard exercise when fatigued so you don’t risk injury.
Your body has changed, a lot, so its time to update a few things. First, take the time to get measured for a new supportive bra. One that adjusts easily and drops down is great for nursing moms and your ever-changing breast size. A favorite of mine for running is the Fits-to-a-T sports bra. We also recommend the 7 Wonders bra.
Check out our post on Best Bras for Active Women to help you find a bra that might work for you and the girls!
Your feet may also change during pregnancy, and sometimes they stay that way permanently. It is important to make sure your footwear is fitting well and is comfortable before heading out. Head to a reputable shoe store near you that will fit you and your new feet.
Not sure what kind of carrier to get for your new adventures? Check out all of our kid-carrier reviews here!
Tips and Simple Exercises
This post is not a substitute for following up with your provider or heading to a Women’s Health PT, but here are some simple tips and exercises to help you get started. These are things you should be able to start very soon after birth (unless your provider has given you strict orders.)
Find a Women’s Health PT
Women’s Health Physical Therapists are a specialized group of PTs that are dedicated to helping women during pregnancy and postpartum.
They also help women who have any type of urinary incontinence, pelvic floor issues, diastasis rectii and so much more. They are a great resource to help get you back on the trail, road or bike.
Blow before you go
Anytime you hold your breath, you are increasing pressure inside your body. That pressure needs to go somewhere, and that might be through your pelvic floor since if it is weakened. Remember to “blow before you go,” exhale prior to starting a movement and then continue to exhale through the movement. This can help your brain and body to retrain the reflexive pelvic floor response before you move.
You pelvic floor should respond to breath by lowering on inhale and recoiling/lifting on exhale. Start small, before you pick up your baby, exhale. Before you pick up the car seat, exhale. Before you pick up your get up from a chair, exhale. Eventually it will become routine and your pelvic floor will respond.
Lower your expectations
Don’t expect to jump right in where you left off before or during pregnancy. It will take time to build your stamina and strength. Start small with a short hike or bike ride. Pay attention to how your body responds to the increased load and build from there.
Kegel: First, you need to find your pelvic floor muscles and learn to contract them. Next, inhale then exhale slowly while contracting your pelvic floor. Hold for 3-6 seconds then fully relax and inhale, repeat.
Pelvic Tilt: Lie on your back with your knees bent. Exhale and flatten your back against the floor by tightening your abdominal muscles and bending your pelvis up slightly. Hold for up to 10 seconds (breathe). Inhale and relax, repeat.
Bird Dog: Begin on all fours in the tabletop position. Maintain a neutral spine by engaging your abdominal muscles. Exhale and raise your right arm and left leg, keeping your shoulders and hips parallel to the floor. Hold for 3 seconds and then inhale and lower. Repeat with your left arm and right leg. Repeat.
Bridge: Lie on your back with your hands at your sides, knees bent, and feet flat on the floor under your knees. Squeeze your glutes and abdominals then raise your hips to create a straight line from your knees to shoulders while exhaling. Engage your core by pulling your belly button back toward your spine and hold. Inhale and relax back to the ground and repeat.
How to Find a Women’s Health PT
One more time ladies, any bladder leakage is NOT normal and most often can be addressed with therapy.
If you are looking to find a Women’s Health PT near you, you can use a few different search tools. You may want to use multiple searches since they may yield different results.
- Pelvicrehab.com is a directory for pelvic rehabilitation practitioners. Herman & Wallace Pelvic Rehabilitation Institute created this site so that patients can easily search the thousands of clinicians they train.
- Women’s Health APTA Directory. This is a special division of the APTA.
- APTA has a “Find a PT” directory. You can try searching by entering “Pelvic Health” in the “Practice Focus box.” Or, select “Women’s Health” from the Specialist drop-down menu. This search provided very limited results for my area.
- Google “Women’s health PT near me” or “Pelvic PT near me”
Now, due your core work, take it slow, and get back out there when you are ready!
Goom T, Donnelly G & Brockwell E. Returning to running postnatal – Guidelines for medical, health, and fitness professionals managing this population. March 2019.
Mota, P. G. F. D., Pascoal, A. G. B. A., Carita, A. I. A. D., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy, 20(1), 200–205. doi: 10.1016/j.math.2014.09.002
Pomian, A., Lisik, W., Kosieradzki, M. and Barcz, E. (2016) Obesity and Pelvic Floor Disorders: A Review of the Literature. Med Sci Monit 22, 1880-1886.
Thanks again to Sarah Dahl, PT, DPT, CSCS, CMTPT of Ortho and Spine Therapy in Appleton, WI for making sure I was giving you the best information possible. Without her, I would probably still be peeing my pants.
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