Exercise Postpartum (Weeks 13-25): What to expect and beyond

At this point (weeks 13-25 pp) you may have returned to work, or you are making the shift from working to staying at home. After my first, I returned to work at 8 weeks and it was so hard. Then after my second, I did the same thing and left them with a nanny, which only lasted a few months before I decided to transition to being a stay at home working mom. It is crazy that we go back this early because our bodies are barely healed.

While we all have one thing in common, we are mom’s, we may all be in different places at this point— some questioning if they should return to work— hire a nanny or daycare? or maybe some are eager to go back to work and that is good too! While there is so much out of our control, one thing that we can all control, is finding our groove back into our exercise routine! This can help us to feel more like ourselves again—helping us deal with things like postpartum depression and the unwanted physiological changes that came along with pregnancy and delivery . So here is everything you need to know from weeks 13-25 postpartum.  

Reasons to Workout This Trimester

1. Manage any of your “new mom” conditions (back pain, incontinence, and compromised abdominals)

2. Start a gradual return to your pre-pregnancy shape so you can feel your best!

3. Begin to find a routine that works for you to keep you feeling mentally and physically strong.

Physiological Changes (13-25 Weeks)

Backaches

Nothing like a backache to damper your mood…This is something I suffered with a lot after my first and particularly from breastfeeding. Most people notice pain around the lumbar (lower) section of the spine.

Many factors contribute to this common postpartum ailment:

1. Lingering effects of relaxin on the body

2. Increase in your breast size from pregnancy and then breastfeeding

3. Poor posture during nursing, changing diapers, carrying infant seat

4. Trauma from labor (if you got an epidural this is can happen)

5. Weakened core

6. Carrying your baby incorrectly on the hip or in baby carrier.
   

I see so many new moms (including myself) who jut out one hip, stand with all their weight on the other leg and hold their baby with one arm. While this is the most natural way to hold our babies, it is also the source of a lot of back and hip pain. If you feel like this is you, don’t worry! Bringing in back exercises into your life and working on strengthening your core, plus practicing good posture, etc. can fix it!

Incontinence

 Incontinence is one of the most common things that I see as a trainer with my postpartum clients, even in mom’s who are way past weeks 13-25 postpartum. Incontinence is when you pee yourself normally when you jump, laugh, sneeze— it is very common — 67% of women report incidents of incontinence three months after labor (Marshall, 1996).

In a study by DeFiorebb (2003) there are 4 factors that can contribute to incontinence after a vaginal birth or c-section:

1. one or more of the pelvic floor muscles are overstretched

2. Increased bladder neck mobility often caused from the weight of the baby during pregnancy

3. Overstretching of the Pudendal nerve: the nerve responsible for activating the pelvic floor (usually seen after a difficult labor)

4. A Forceps delivery: studies suggest this can increase the likelihood of incontinence tenfold (Kessel, 2001). Forceps deliveries are far less common now, as doctors now use the vacuum extractor.
   

Most of my clients assume that incontinence is just part of having a baby; but it doesn’t have to be. It is not normal to pee yourself when you laugh, exercises or sneeze! In most cases, if you perform exercises for the pelvic floor (like Kegels, followed by Kegels with abdominal work), you can resolve this issue and prevent the annoying feeling of peeing yourself when you do things. If you have been past a year pp and are still having these issues, going to see a pelvic floor physical therapist is always a great option! 

Weakened Abdominals

The abdominal wall consists of four main muscles: the external obliques, the internal obliques, the transverse abdominus, and the rectus abdominus. During pregnancy they are all stretched out and this leads to things like back pain, “mommy tummy” or a “pooch” and pelvic floor issues. I remember after my first pregnancy and after I gave birth, my stomach felt so stretched and squishy—like it would never be the same. But when given the time to heal and by doing core breathing, eating right and then when cleared— safe core exercises— I was able to get back to my flat stomach (although my skin will never be the same haha ).

Your transverse abdominals are usually the most compromised after childbirth. And they are the one that allow for pelvic stability and help you sitting or standing. If you have weak transverse abdominals, you may overcompensate when bending over and use your lower back muscles more. Strengthening the core, especially the transverse abdominals, is key to helping your client avoid upper and lower back pain and injury.

Be sure to check to see if you have closed your gap between your abdominals — I share how to check for diastasis recti on a blog post and safe core to heal it!

Goals for training during this period should be:

1. Correct/manage your postpartum ailments

• Training for Back Pain using these three things:

1. Correct posture

2. Strengthening of abdominals

3. Stretching of hamstrings, glutes, and hip flexors
   

Often back pain is a symptom of a number of factors. Focusing on good posture and stretching will make a huge difference.  

2. Training for Pelvic Floor/Incontinence

if you are still having issues with incontinence its best to avoid jumping (rope, jacks, etc) running, or jogging. Opt for more HIIT style workouts to get your heart rate up. Things like the stairmaster or climbing your stairs or doing super fast squats and lunges!

 I know I have said it a million times but research says that performing exercises for the pelvic floor cures up to 66% of stress incontinence in postnatal women (Morkved and Bo, 1996 and 2000). So keep doing your kegels!! 

3. Training for Abdominals

You will need to perform abdominal work to strengthen and repair your core muscles. The Kegel is the basis of all of this work—It is best to start from the bottom of the core (the pelvic floor) and then you can move up the core to the transverse abdominals (core breathing or TA breathing).  When a Kegel can be held while performing lower abdominal work, you move up to the top of the core to the rectus abdominals.  As a reminder, a strong pelvic floor helps make strong abdominals.

To help repair the interior abdominal walls of postpartum clients, you want to guide them through Kegels and add in transverse abdominal work. This will begin to repair diastasis recti and weak abdominal walls. The Kegels help strengthen the pelvic floor and a technique called “hollowing” can strengthen the transverse abdominals.

A general guideline to follow when training closing diastasis recti:

1. Kegel

2. Kegel with hollowing (transverse abdominal work)

3. Kegel with hollowing with pelvic tilts

4. Kegel with hollowing, partial rollup

5. Kegel with hollowing, with more advanced abdominal work (crunches, pilates work, etc).  
   

4. Increase your stamina

…“The number one thing every woman should do in the first month is to get out of the house and walk,” . read more about what I shared with the vitamin shoppe on getting back into shape after baby.

Also more ideas on the blog !

5. Find a routine that works for you

some days you may not make it to the gym and that is okay! For me getting outside (when the weather is good) cures my soul and you can use things like the playground tit fit in some exercise while the kids play or if you have your little ones in the stroller you can get out and move

getting back at it as soon as you are feeling good is so important. After the 4th trimester, this postpartum period is where it is go time. Adjusting to work life and mom life or stay at home mom life is tough, but having a routine is key!~

Conclusion

Key Moves for 13-25 Weeks Postpartum

1. Follow Diastasis Recti Healing Sequence (Kegels to Roll Ups)

2. Interval Training (HIIT training is a great option to burn a lot of calories, boost your endurance, and be time efficient)

3. Stretching your hamstrings, glutes and hip flexors

Cheers to getting back to feeling like you one day at a time. Remember that it took 9+ months for our bodies to adapt and grow our babies so be kind to yourself and allow your body to heal and regain strength. You can come back stronger xoxo #sweatyasamother