Postpartum Return to Exercise Guide: Weeks 0-6
- Maja Degen
- Jul 10, 2024
- 4 min read
Updated: Aug 10, 2024
This guide was written by pelvic floor physiotherapist Maja Degen, who practices pelvic floor physiotherapy in Little Italy, Toronto.
Disclaimer
The information provided in this document is intended for general informational purposes only and should not be considered as a substitute for professional medical advice, diagnosis, or treatment. It is important to note that every individual is unique, and the information shared in this document may not apply to everyone. The content provided may not constitute a therapist-patient relationship, and it is recommended that you consult with a qualified healthcare professional or licensed physiotherapist for personalized advice tailored to your specific situation.
Physical Recovery Overview
Vaginal Bleeding: It's normal to experience vaginal bleeding, known as lochia, for several weeks after delivery. Initially, it will be bright red and heavy, gradually tapering off to a lighter flow and changing to pink or brown.
Perineal Care: If you've experienced perineal trauma, such as tears or episiotomy, proper wound care is essential. Follow your healthcare provider's instructions for hygiene, use sitz baths for comfort, and avoid activities that may strain the perineum. More information is below
Pelvic Floor Rehabilitation: Begin gentle pelvic floor postpartum exercises once ready. Focus on both strength and relaxation. Start with deep breathing exercises and progress to pelvic floor contractions (Kegels). Your physiotherapist can provide personalized guidance based on your individual needs, virtual appointments are available whenever you need. You can book a postpartum appointment here.
Posture and Alignment: Pregnancy and childbirth can affect your posture and alignment. Practice good posture techniques while sitting, standing, and breastfeeding to prevent strain on your back and pelvis.
Gradual Return to Activity: While rest is crucial for initial healing, gradually reintroduce light physical activity as tolerated. Begin with gentle walks and pelvic mobility exercises, gradually increasing intensity over time.
Return to exercise postpartum
Right after birth (0-72 hrs):
Rest and recovery focus
Isometric hip exercises: Hip adduction, abduction, flexion isometric: lying on your back with knees up and feet on the ground, fists between knees, and pushing knees together for 3-10 seconds. Then repeat pushing knees out into hands. Then repeat pushing knees up into hands.
Lifting: keep baby close to you as you lift, lift in stages if it is easier (floor to the couch, then couch up), and make sure you are using your legs and breathing out when lifting up. Engage transversus abdominis and pelvic floor while exhaling.
Day 3+ to Week 2
If ready, begin pelvic floor muscle exercises targeting gentle strength and endurance functions (e.g. pelvic floor contractions, diaphragmatic breathing).
Slowly introduce basic core exercises e.g. pelvic tilts, bent knee drop out, side lying abduction.
Walking: Start with short, leisurely walks around your home or neighborhood. Aim for 5-10 minutes at a time and gradually increase the duration as you feel comfortable. Should be symptom-free.
Get guidance from a pelvic floor physiotherapist if you are unsure what to do.
Sample exercise protocol:
Connection breathing: 3 sets of 10 repetitions (with pelvic floor contraction), hold the contraction for ~3-5 seconds
Side lying hip adduction: 3 sets of 12 reps/side
Bridging with adduction: 3 sets of 15 reps
Supine transversus abdominis: 3 sets of 10 reps
Week 2 to 4
Progress walking to longer distances (+5 mins/walk symptom-free up to 30mins)
Pelvic floor muscle/core rehab progression of exercises (more reps/longer holds as able)
Consider the introduction of unweighted squats, lunges, and bridging, in line with symptoms/readiness
Week 4 to 6
Introduce low-impact exercise as desired e.g. static cycling, swimming, or cross-trainer taking into account individual postnatal recovery, mode of delivery, and perineal trauma. Recovery should be such that you are comfortable
Increase the challenge of exercises (more reps/sets), do not add weight until week 6+
Follow-up Physiotherapy Care:
Postpartum Assessment: Schedule a postpartum physiotherapy assessment around 6 weeks post-delivery, once cleared by your provider. Your pelvic floor physiotherapist will evaluate your pelvic floor function, address any musculoskeletal concerns, and provide guidance for ongoing rehabilitation.
Continued Rehabilitation: Commit to your postpartum rehabilitation program, incorporating pelvic floor exercises, core strengthening, and functional movements. Your physiotherapist will tailor the program to address your specific needs and goals.
The early postpartum period is a critical time for physical and emotional healing, as well as bonding with your new baby. By prioritizing pelvic floor physiotherapy-focused recovery strategies, you can optimize your postpartum experience and lay the foundation for long-term well-being. Remember to listen to your body, seek support when needed, and celebrate your progress along the way. Congratulations on your new arrival, and best wishes for a healthy and fulfilling postpartum journey!
Safety Tips:
Listen to Your Body: Pay attention to how your body feels during and after exercise. If you experience pain, dizziness, or excessive fatigue, stop and rest.
Stay Hydrated: Drink plenty of water before, during, and after exercise to stay hydrated, especially if you're breastfeeding.
Gradual Progression: Progress gradually with exercise intensity and duration, allowing your body time to adapt and recover.
Pelvic Floor Awareness: Focus on engaging and relaxing your pelvic floor muscles throughout your workouts to promote optimal function and prevent issues such as urinary incontinence.
Book Your Appointment Today!
As a pelvic floor physiotherapist in Little Italy, Toronto, I offer specialized treatments and exercises for pregnancy. If you’re in the Little Italy/Annex area of Toronto and need professional guidance, don’t hesitate to reach out. Book an appointment today and let’s work together towards your goals!
By Maja Degen, your trusted pelvic floor physiotherapist in Little Italy, Toronto. Schedule an appointment directly.
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