Postpartum Exercise Program: How to Safely Return to Exercise and Running

Whether you are newly postpartum or getting back into exercise a little later than you anticipated, you have come to the right place. This resource is all about practical ways to get back to the movement you love.

The basics:

One of my biggest pet peeves in the world of pregnancy is blanket statements, and typical return to exercise “guidelines” are far from individualized. It’s likely that you heard “don’t lift more than 20 lbs for the foreseeable future” or “don’t do sit ups because of your c-section scar" as general advice from a physician. Often that comes from a provider who sees you ONE time after birth and doesn’t know what they are looking at in the first place.

The research around postpartum exercise used to be vague, but not anymore. We have great researchers like Gráinne Donnelly that have proven the safety and necessity of postpartum exercise. Check out her postpartum exercise guidelines here. Her work highlights how and when to progress running and returning to exercise postpartum.

When should I start exercising?

For most people, exercise is safe to begin when vaginal bleeding has subsided and mom is no longer having the symptoms from our own pelvic floor guide. Early mobilization before the 6-week postpartum checkup is associated with enhanced healing and recovery. Ideally, 3,000 steps prior to 6 weeks postpartum is the goal (checkout the article here from Margie Davenport). It is generally advised not to start returning to running activities until 3 months postpartum. All postpartum exercise programs should be well-rounded and include strength training and aerobic conditioning that builds to the level you want to achieve. 

Return to strength training:

Every strength training program postpartum should include 3 movements:

• Single leg work to improve leg strength, balance, and to get that BOOTY BACK amirite..

  • Examples: Bulgarian split squats (my fave), pistol squats, lunges, single leg balance, single leg RDLs

•  Plyometrics (jumping) to improve pelvic floor capacity and bone health

  • Examples: Box jumps, pogo hops, jump rope, squat jumps

• Core Work because those abs need some love after 9 months of hard work

  • Examples: Side plank variations, dead bugs, bird dogs and YES – even sit ups. Sit ups are super functional for the demands of your abs during the day. I always address sit ups specifically with my c-section mamas to get scar tissue tensile strength. WE DON’T FEAR SIT UPS.

But I have arms, too.

Correct. Upper body movements are also important. Back, shoulder, arm, and chest strength helps with back tension during breastfeeding, rib cage/diaphragm engagement that is stretched during pregnancy, and even lifting those heavy babies in and out of cars, cribs, and strollers. They don’t stay small very long!

• Exercise examples: Overhead pressing, bent over rows, lateral and front delt raises

Return to aerobic conditioning:

Getting back to your favorite aerobic activity is so important for a healthy postpartum physical and psychological recovery. My favorite way to progress is with a run:walk ratio. The idea is the same with a bike sprint:slow progression or whatever flavor of cardio you like.

Start with a small working ratio of 1 min of work : 1 min of rest/slow recovery. Once that is easy, add time to the “working/running” side of the ratio and increase the intensity until you’re doing a full workout without needing rest times.

Example Program:

We love simplicity! No need to make this part too complex. Pick one strength exercise in each category listed above and superset them together 2x/week. Then choose a cardio workout and a working ratio to perform 2x/week.   BAM, you have a killer postpartum workout.

It might look something like this:

• DAY 1: 

  • Bulgarian split squats 3x10 superset with – Overhead dumbbell press 3x10 

  • Squat jumps 3x10 superset with – Side plank clam shells 3x10

• DAY 2:

  • 20 minutes of walking:jogging at a 1:1 ratio

• DAY 3:

  • Single leg pistol squats 3x10 each leg superset with… bent over row 3x10 sets

  • Jump rope 30 sec superset with… bird dog holds 5 sec each side x8 reps

When to progress:

If muscle soreness is present for 24-48 hours after a workout, but no pain, leakage, or vaginal bleeding is present, you’re good to slowly progress. For example, increasing weight 5-10# or increasing your run/walk intervals by a minute or 2. 

When to seek help: 

If you experience pelvic pressure, pelvic heaviness, leakage, bleeding, or pain, it may be a sign that the exercise intensity is too much. Don’t forget, we have a free guide here that has some helpful movement recommendations for returning to exercise postpartum. 

If you’re having any of these symptoms, need help with progression, or just don’t know where to start, the PTs at Revive Rehab are experts in pelvic health and return to activity guidelines. We literally do this all day, and we love it! Call the office to schedule an evaluation and get a program designed for your body and your goals.

Now get moving!

Dr. Sarah Miller, owner of Revive Rehab Physical Therapy