The 4Ws of exercising after delivery

AngelaRD, LDN, CBS

Planning your postpartum exercise routine will depend on your delivery experience. Many women with a normal, uncomplicated vaginal birth are ready to go for short, easy walks within a few days. But if your bleeding increases after activity then the duration or intensity of your activity may be too much. If you had a cesarean section or a complicated delivery (such as heavy bleeding) then you will likely need to wait longer before exercising.

Listen to your body and don’t push yourself too far or too fast. Keep an eye on your vaginal bleeding, and always check with your healthcare provider before starting to exercise.

Once you have your healthcare provider’s OK, it’s important to build up postpartum exercises slowly over time to give your musculoskeletal system time to recover from pregnancy and labor. The lower spine, pelvis, and knees are especially vulnerable after carrying the brunt of your pregnancy weight. Low back pain, sciatica, pubic symphysis discomfort, and tenderness in the knee joint are all common postpartum ailments, so take your time when changing positions between lying, sitting and standing. And avoid rapid twisting movements that could exacerbate any muscle, bone, or joint issues until you are fully recovered.

Taking things slow before engaging in more strenuous exercise will help you return to your pre-pregnancy state.

Stop exercising and call your healthcare provider if you have any of these symptoms:

  • Vaginal bleeding
  • Dizziness or feeling faint
  • Increased shortness of breath
  • Chest pain
  • Headache
  • Muscle weakness
  • Calf pain or swelling

What to Do

Choose activities that are safe and comfortable.

Start with gentle stretching and strengthening exercises such as curl ups and pelvic tilts. Add pillows or blankets while seated or lying down for comfort and support.

And remember that positions requiring you to lie flat on your stomach may be uncomfortable if you are breastfeeding and your breasts are engorged.

Stretch and warm up for at least 5 minutes before exercising

Stretching will warm up the muscles, increase flexibility and prevent muscle aches and joint stress. Try dynamic stretching, or repeating a stretch multiple times for a short period of time, as opposed to one deep stretch. Dynamic stretching pre-workout is less likely to overextend your muscles and joints and cause injury. And to get the most from stretching while avoiding muscle pulls, move around a bit first – try walking around or going up and down the stairs a few times to warm up your muscles.

Here’s a list of stretches to try:

Lower body stretches

  • Runner’s stretch: Place your hands against the wall about shoulder width apart. Keep your elbows straight. Left foot is about 18 inches from the wall with knee bent and the right leg is extended back with the knee straight. Lean forward for a great calf stretch. Hold for 10 seconds. Do the same with the right foot forward and left leg back. Repeat again on each side.
  • Pelvic tilt: From a standing position with feet wider than hips, place your hands on your thighs and curl your pelvis forward and chin down as you exhale. Inhale and tilt your head up and pelvis back while hands remain on thighs. Continue this dynamic exercise for 30 seconds.
  • Lunges: Stand with feet wider than hips. Bend your right knee to lunge right as you exhale. Try to keep your knee behind your toes. Inhale and step back to starting position. Exhale and lunge left. Repeat this dynamic stretch for 30 seconds.
  • Quad stretch: Bend your right knee and grab your right ankle to stretch your right quads. Pull your ankle gently towards your gluteus. Hold for 10 seconds. Repeat with opposite leg.
  • Forward bend: Take a deep breath in a standing position as you reach your arms up above your head, then exhale and bend forward, reaching for your toes. Bend your knees slightly. Inhale and return to standing then exhale back down to a forward bend. Repeat several times.
  • Butterfly stretch: Sit on the floor with heels of your feet together while gently pressing your knees down towards the floor. Hold for 30 seconds.
  • Toe flex and point: Alternate between flexing and pointing your toes on each foot to increase circulation and flexibility in the lower legs and feet.
  • Piriformis stretch: From a standing position, place your right ankle over your bent left knee and lean your torso forward toward your knee while balancing or holding onto a wall for 10 seconds. Do the same with the left ankle over the right knee. You can also do this while lying on your back. Place your feet on the floor, knees bent and hips width apart. Place your right ankle over your bent left knee. Lace your hands around your left thigh and gently pull it towards your chest, hold for 10 seconds. Switch.

Upper body stretches

  • Side stretch: Inhale and bring your right arm up and over to the left as you exhale. Do the same on the left side. Repeat several times.
  • Elbow bends: Extend your right arm straight up above your head and then bend the right elbow so that your bicep is next to your ear and your hand is behind you. With your left hand press down and back on the right elbow to increase the stretch. Hold for 10 seconds and then repeat on other side.
  • Neck rolls: Gently roll the neck in each direction to release tension and maintain range of motion.
  • Shoulder rolls: Roll shoulders forward for 3 rotations and then back for 3 rotations to release muscle tightness.
  • Wrist and ankle rotations: Extend your right arm and left leg and rotate your right wrist and left ankle for 10 seconds to increase circulation. Repeat with left arm and right leg.
  • Chest opener: Clasp your fingers behind you, squeeze your shoulder blades together, and lift your arms up behind you as much as you comfortably can. Hold for 10 seconds.

Drink plenty of fluids

Keep a water bottle with you and drink before, during, and after your exercise session. Providing your body with enough water helps prevent dehydration and the headaches, dizziness, and rapid pulse that come along with it. If you feel lightheaded or dizzy, then rest and make sure you replenish your fluids and electrolytes.

And with all this drinking, remember to go to the bathroom before you exercise as some women experience urinary incontinence after giving birth.

You may need a pre-workout snack, such as a banana, toast with jelly, or granola bar. This will provide a bit of energy as well as help prevent some of the above symptoms like fatigue, headaches, or dizziness.

Call your doctor if symptoms persist.

Breathe at a comfortable rate

While exercising, you should be able to talk at a normal conversational pace rather than taking rapid, short, shallow breaths (hyperventilation), which can cause lightheadedness and may result in fainting.

If this is not possible, you need to slow down the intensity of your exercise. Be cognizant of taking deep breaths with a slower exhale, and rest when you need to. It can take time to work back up to your pre-pregnancy exercise routine. Even though this can be frustrating, cut yourself a little slack as you get back into it, you have earned it!

Look for postpartum group classes

Check your local community centers, yoga studios and neighborhood boards for postpartum fitness classes. You’ll likely find a variety of offerings, from stretching to stroller classes to swimming.

If group classes aren’t your thing, consider hiring a personal fitness trainer who can serve as an expert to guide you back to your pre-pregnancy fitness level.

Get outside

Walk as much as you comfortably can (and bring your baby with you!) or climb some stairs. The fresh air will do wonders for you and your baby.

Heed heat advisory warnings and exercise indoors when recommended

Check the weather and exercise indoors (preferably with air conditioning!) if it’s very hot and humid.