Long And Short Term Potential Effects Of Early Return To Moderate- Vigorous Exercise Postpartum Part 1

​There is no shortage of messages that pushes women to rush back to high level workouts ASAP postpartum. The question is, what are the risks and benefits of choosing to do so? It seems as if the story is different depending on with whom you speak and with what website you find. Finding answers about what to do and when can be exhausting. Let's talk about the Risks and Benefits of High Intensity Exercise during the early postpartum months. This blog will outline the Risks and Benefits. Part 2 will go over some tips and guidelines.

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                         Photo by Charlotte Karlsen on Unsplash

 When I had my first child 10 years ago it was standard to wait 6 weeks whether you had a c section or uncomplicated vaginal delivery, and you would be magically cleared to return to your previous workouts. Recently, I have read some articles that say you can return to exercise within a few days of delivery and others that recommend the 6 week waiting period or more! It is impossible to not be confused.  The Continence Foundation of Australia recommends a slow progression of activity and full resumption of prior level of activity at 16 weeks postpartum. The ACOG (American College of Obstetricians and Gynecologists) notes that there is a variance in what is an appropriate return to exercise based on the pregnancy and delivery, but does note that some can begin exercise within days of giving birth. It recommends exercises such as lifting weights, sit ups, push ups, yoga and pilates. It also recommends Kegels. The ACOG recommends women start with simple postpartum exercises (but doesn’t list a single one or any references) and suggests a progression to moderate and vigorous exercise.  This makes it very difficult for women to make smart choices with regards to their postpartum return to exercise. The terminology- return to light exercise is vague and open to interpretation. How long should one take to progress to vigorous exercise? The timeline is variable based on several factors.

The Variables That Impact Return To Exercise Include:

• Complications during pregnancy
• What number birth is this for a given mom
• What are prior injuries of mom
• What is genetic make up of mom (ie did she have lax ligaments prior to pregnancy?)
• Complications during labor- ie. How long did she push? Did she have a C-Section?
• What was prior fitness level of mom

The Short & Long Term Benefits of Exercise Postpartum

There are 6 guidelines worldwide that discuss the benefits of postpartum exercise. Some benefits include:

• Help strengthen and tone abdominal muscles (but doesn’t mention that the exercises must be done properly)
• boost energy
• may be useful in preventing postpartum depression
• promote better sleep.
• relieve stress.
• Returning to high level exercise may load a pelvic floor for improved function (provided there is no dysfunction prior to initiating exercise
  
• High Intensity exercise may increase total body strength for overall health
  

The Short Term Risks of Early Return to High Impact Exercise

• Prolonged healing of injured tissue
• Overstrain to pelvic floor, abdominal wall or back
• Continuation of incontinence if experienced during pregnancy (50% of women experience some incontinence post baby. Don’t allow your body to potentially develop a faulty compensation pattern.)

The Long Term Risks of Early Return to High Impact Exercise

• Pelvic floor dysfunction (painful sex, stress urinary incontinence, fecal incontinence, etc).  This can begin soon after during pregnancy, months or even years after delivery. 
• Over stressing loose ligaments causing foot malformation, pelvic/back instability/injury, other orthopedic injury. ​

Take Home Message

There are short and long term consequences for everything and you cannot prepare for them all. We each need to take into account the long and short term benefits and risks of each choice. There is no dispute that in most cases return to light exercise (walking, proper breathing technique) is beneficial postpartum. But, when and how to progress to moderate-vigorous exercise is more complicated.