Postpartum exercise: When it's safe to start running and lifting after pregnancy
May 11, 2021
Cardio exercise and weight training are two great ways for women to clear their minds and build strong, healthy bodies. It's normal to want to hop back into your regular workout routine – or start a new one – after your Ob/Gyn clears you at your six-week postpartum checkup.
But your body will still be healing for at least six more weeks for a typical vaginal birth. Most new moms should wait at least 12 weeks before easing back into more intense workouts, such as running or lifting weights.
The 2019 postpartum exercise guidelines, endorsed by the Association of Chartered Physiotherapists in Sports and Exercise Medicine, shows that waiting can reduce the risk of serious health conditions such as hernias, muscle tears, falls, urinary incontinence, and pelvic organ prolapse – when the bladder and uterus droop into the vagina.
The 12-week milestone is geared toward patients who had a normal pregnancy and vaginal delivery. Your doctor may suggest waiting longer if you had:
- A cesarean section (C-section)
- Obesity prior to pregnancy
- Postpartum depression
- Diastasis recti (improper healing of the abdominal muscles)
- Excessive scar tissue in the pelvic area
- Perineal tearing
But having to wait doesn't mean you can't do any exercise. In fact, staying idle will further delay your return to more intense workouts.
Most moms can start walking up to 30 minutes at a slow to moderate pace a few days after delivery. The best way to know what pace you need to go is to listen to your body. When walking, you should be able to easily carry a conversation or sing a song on your playlist.
Yoga is another great choice to improve flexibility, balance, and overall strength. During the postpartum period, it's also important to rebuild a strong pelvic floor – the muscles and tissues that hold up the bladder and uterus.
In a previous article, my physical therapy colleague Taylor Price, P.T., D.P.T., C.A.P.P., explained 10 pelvic floor strengthening exercises most patients can safely do two to six weeks postpartum. Now, she'll discuss how to safely return to running or lifting weights after having a baby.
Running after pregnancy
Why do I have to wait 12 weeks to start running?
Even if you had an easy pregnancy and delivery, your muscles and ligaments were stretched beyond their normal state, causing instability and weakening. These tissues take a long time to strengthen and heal – approximately 16 weeks at minimum, though many women need up to six months for complete healing.
How do I know I'm ready to run?
After 12 weeks, you can gauge your strength with a few physical tests. If you're ready to run, you should be able to:
- Complete your pelvic floor strength circuit without difficulty.
- Jog in place for one minute.
- Balance steadily on one leg (each side) for 10 seconds.
- Hop on one leg (each side) 10 times without pain or loss of balance.
- Perform single-leg "running man" moves (opposite arm and leg extension) 10 times on each side.
- Do 20 each of these single-leg exercises per side:
- Calf raises.
- Sit-to-stand movement.
- Bridge while lying on your back.
How much running is safe at first?
We recommend patients start with no more than three 20-minute sessions a week. Those should break down into intervals of 20 seconds jogging, followed by two minutes of walking. You'll run about three minutes and walk about 17, laying a solid base of continuous movement.
The next week, add 10 seconds to your running intervals, then 10 more the next week. In five weeks, you'll be running a full minute at a time. Over the next few weeks, you can gradually cut down your walk breaks and increase your run time until you're running a solid 20 minutes.
It's best to start without a jogging stroller, which requires a little more effort. If you choose to bring the baby, you'll want to progress even slower. Pay attention to your body mechanics – don't slouch as you run and remember to breathe as you rebuild musculature and endurance.
Related reading: 3 exercises to avoid during pregnancy – and 7 that are safer
Lifting weights after pregnancy
Why do I have to wait 12 weeks after giving birth to lift weights?
It only takes two weeks for the body to lose endurance and muscle. Even if you were working out until the day you delivered, you likely stopped during the postpartum period – that's a good thing.
In that time, your muscles likely lost some strength. It can also take up to 12 weeks for the muscles, vaginal tissues, and ligaments to completely heal. If you try to jump back in where you left off, you'll be at increased risk for injury.
But you can get your muscles back – safely – if you work toward incremental goals and listen to your body.
How do I know I'm ready to start lifting?
You should be able to complete your pelvic floor workouts with little or no difficulty. You should also be able to do at least 10 squats and 10 deadlifts (with a PVC pipe or broomstick) with no weight and proper form.
When starting to add weight, you should start with dumbbells (10-20 lbs.) then progress up to the weight of a barbell. Then, transition to the barbell. If at any point you are unable to maintain proper form, move back to the previous weight and try increasing repetitions.
Most importantly, you must be able to do all these things without holding your breath, which increases your risk of injury, such as pulling a muscle or falling. It also increases pressure on your pelvic floor, which can lead to developing pelvic organ prolapse. Breathing is key to healthy blood flow and oxygenation.
How much lifting is safe at first?
For most patients, we recommend resistance training 2-3 times a week for the first four weeks you return to exercise. Start by squatting without weight. Once that is easy, start using either a 10 lb. kettlebell or dumbbells.
Once you have worked up to 40 repetitions, you can consider increasing the weight by 5-10 lbs. From there, you can continue increasing until you reach your desired weight. Once you start getting into more challenging weights, you may only want to increase 2.5 lbs. at one time.
Forty repetitions is a general guideline. If you are:
- Training more for power, such as lifting large bags of soil a few times from the car to the garden, you may want to decrease with repetitions and increase the weight.
- Training to improve endurance for daily tasks, such as lifting laundry, your children, or groceries, you may want to increase the reps and maintain a lower weight.
Signs you might be overdoing it
If something doesn't feel right, it probably isn't. Doing too much too fast can increase your risk of injuries such as hernias, torn muscles, falls, or pelvic organ prolapse.
Stop your workouts and contact the doctor if you experience:
- Sharp, sudden pain anywhere
- Urine leakage
- Pain or pressure in your pelvic floor
Keep tabs on your mental health, too. Call your Ob/Gyn if you feel overly stressed or irritated about missing a workout or feel as if you aren't doing enough. You may be experiencing a form of postpartum anxiety.
Related reading: Urinary incontinence is not ‘normal’ – but it is treatable
When to see a pelvic floor physical therapist
If you are breastfeeding, your joints may be "looser" due to hormonal changes. The laxity may increase your risk of injury, such as overextended knees or rolled ankles. Before you start running, check with your doctor to make sure your body is ready to support your workouts.
If your Ob/Gyn has signed off on your health and you feel ready to ramp up, you can get started after that 12-week milestone. However, if you have pelvic health concerns or just want to get the healthiest start, consider seeing a pelvic floor physical therapist first. We can help you strengthen weak areas and create a plan to safely reach your goals.
As you resume intensive exercise, keep two things in mind:
- Your body just made and delivered a baby. That takes a lot of work, and almost no one bounces back overnight.
- Don't compare yourself to elite athletes or celebrities. They likely had extreme fitness training and medical supervision during pregnancy and postpartum, which is an unrealistic scenario for most people.
If you’re ready to get back to working out, visit with your Ob/Gyn or a pelvic floor physical therapist to help you rebuild a solid and safe foundation.