“Cleared to exercise” at 6 weeks postpartum….what does this really mean?
After my first child was born, I had my 6th week postpartum visit, and was told I was “cleared for exercise.” I took that to mean I could return to my pre-pregnancy workouts. Excited to get back into things, I jumped right back into HIIT workouts and running, quickly adding in miles with my new adorable sidekick in her jogging stroller. Not long after, I developed a nagging hip pain that took less and less to aggravate it. Initially it hurt after 3 miles, then 2, then 1 and finally with just walking, and would last for several days. After a few years of seeking care and being recommended surgery for a minor labral tear and hip impingement (which I declined since I was pretty confident that wasn’t what was causing my pain), I delved into physical therapy continuing ed and certification courses with a focus on pregnancy/postpartum, pelvic health, and back/hip/spine. I’ve made a full recovery and am so very happy to be running pain free again, with my first post-baby half marathon coming up next week!
Knowing what I know now, I could have saved myself several years of “not running”, and all the time, money and energy spent on seeking help from different providers, had I known more about the changes that occur during and after pregnancy, and how to safely return to fitness.
I’ve met so many new mom’s who have made the same mistake I did. They assumed “cleared to exercise” meant they could hop right back into their pre-pregnancy workouts. Some have been totally fine with no issues at all, while others have had nagging injuries as a result, back pain, pelvic organ prolapse, leaking, increased diastasis recti, etc. Save yourself the time, energy and heartache by returning to exercise safely after having your cute little bundle. It’s always better to get into it safely and thoughtfully, than to plow ahead full steam and pay for it with not being able to do what you love for a few years.
Why are we more susceptible to injury postpartum?
Your body goes through so many changes during pregnancy and in the postpartum period. To name a few, you have 9-10 months of your uterus and abdomen expanding, hormones changing, relaxin kicking in to relax your pelvic (and other) ligaments, blood volume increasing, rapidly changing posture and gait, and decreasing sleep. Follow this up by the big event of childbirth. With a vaginal birth, your muscles stretch out to 2-3x their original size, and it’s not uncommon to have some perineal tearing. With a c-section, the surgeon goes through 7 layers of tissues. Can you imagine your hamstring being stretched 2-3x it’s normal length or having an ACL tear and not have physical therapy rehab after? There is a reason pelvic floor physical therapy is standard of care in many countries.
Hormone changes continue during the postpartum period and for as long as you breastfeed. You then recover while simultaneously caring for an itty bitty little one whom you give your full love and attention to. While our bodies are absolutely INCREDIBLE and I’m blown away at how resilient we are, sometimes we need a little TLC and thoughtful progressions to get back into our normal routine.
So what happens at your 6 week postpartum ob/gyn checkup?
– Check on incisions/tears, whether c-section or perineal.
– Make sure your uterus is returning to it’s pre-pregnancy size and has no signs of infection.
– Make sure cervix looks healthy, closing and that any tears are healing.
– Oftentimes a pap smear
– Breast exam and discuss breastfeeding questions
– Postpartum depression screening
– Discuss birth control
– Possible glucose challenge if history of gestational diabetes while pregnant.
What does “cleared to exercise” at your 6 week ob/gyn checkup mean?
“Cleared to exercise” from your ob/gyn means that you have no signs of infection, your cervix is closing and healing, and your uterus is close to its pre-pregnancy size. While this is all very important and essential for recovery, there is A LOT more information needed in order to know what types of exercise someone’s body can safely incorporate 6 weeks after having a baby.
Important info to know for reintroducing and progressing exercise postpartum:
– Are your pelvic floor muscles flexible, coordinated and strong enough for you to workout at the intensity you are planning?
-Are you leaking when you exercise or with exertion?
-Diastasis Recti? Do you have an abdominal separation and/or core weakness or instability?
-Prolapse? Do you have one? What grade is it? Is it symptomatic? Do you know how to manage pressure in your body, and are your surrounding muscles strong and coordinated enough to keep it from getting worse as you jump into your exercise routine?
-How is your back/hips/pelvis? Ligament laxity increases significantly during pregnancy, which allows our pelvis to make more room for baby. In addition to this, our stomach and pelvic floor muscles expand significantly as baby grows and during delivery. Ligament laxity continues while breastfeeding. Oftentimes extra focus on stabilization and coordination is needed before jumping into our pre-pregnancy workout routine in order to avoid injury (this was my mistake after having my first child!).
Other things are assessed with postpartum physical therapy as well, but these are just a few areas specific to exercise that are important to consider. Sometimes just a few physical therapy sessions are all you need to make sure you’re on the right track.
What is a more realistic expectation for safely returning to exercise?
While everyone is different, for most people, progressing to your pre-pregnancy levels safely can take anywhere from 6-24 months. It may differ with each childbirth as well. With individualized physical therapy to address your unique needs, it can speed up your unique recovery timeline and help prevent, manage and improve upon injuries/issues to help you achieve your goals and feel your best.
If you have questions about return to fitness postpartum and how it can pertain to you specifically, reach out for a free 15 minute consultation by emailing Jess@bloomptwellness.com or send us a quick note by contacting us here: