Postpartum [Part III]: Exercising for lady manners + back to "me"

NOTE: Postpartum is a topic that seems silent much like the topic of infertility. So, I'm going to be real, raw, and hold nothing back. This journey is not all glamorous nor is it easy. But, the real beauty is the gift from God. Reader’s discretion advised. Everyone’s recovery is different and therefore, what I share is my experience; however, I would hope that I can help some new mom-to-bes feel a little more prepared or at least have some tools on hand to trial. No matter how many moms we talk to or watch through the process, postpartum and motherhood is something that can’t be understood until you face it and live it. 

As always, check with your doctor before starting any exercise or postpartum program even if you have exercised all through pregnancy (like me) or even if you feel you know your body. Your body parts have endured various levels of trauma (not in a negative connotation) but even if you feel good, more harm can be done than good. My exercises were guided by a physical therapist who specializes in sports and pelvic floor therapy. This was also written and completed pre-COVID-19 outbreak. 

One of my happy places...outside, with my running buddy again...back into the game.

As a first time mom in postpartum recovery, I couldn’t have been more relieved to reach 6 weeks. I was feeling a bit anxious for my first postpartum appointment. Six weeks postpartum is a pretty standard follow-up time with the OB. Of course, that all depends on the delivery outcomes and whether or not there were complications. Cesarean deliveries will have a follow-up much sooner and the recovery journey is much different. The baby however, might have already seen their pediatrician at least 2-3 times between birth and the 6-week follow up. I simply could not wait to have my bottom checked for I was terrified to look or feel the stitched up perineal tear. In fact, it was hard for me to even clean the area during shower time mainly because it was sore and felt VERY swollen, and therefore, soaking in a tub did many wonders. The constant pressure of feeling like everything was inside-out kept me from overdoing anything. But, before my 6-weeks appointment, I gradually increased my walking distance as tolerated and was able to walk up to nearly a mile. While I may have felt like a wimp so many times as a new mom, I realized how much I have learned with the recovery progress from similar principles as an athlete and basic knowledge as an occupational therapist. This time also forced me to slow down (okay, maybe a little).

Building up

During any course of training whether you’re a beginner or a pro, there is always the time to build up. The same goes for those in rehab or recovering from injuries or surgeries and even mothers recovering from giving birth. No one jumps from the bed to walking or into a game, a match, an Ironman, or a 5K run or walk without building up their training. It’s been done but the recovery is rough and injuries / consequences may follow. I also knew that sitting for long durations or no exercise for weeks lead to muscle weakness / imbalance, decreased endurance, and more. Same applies to being in a hospital bed for days. That meant, I needed to gradually get back into the game starting with walking and gradually increase my time and distance without feeling discomfort below. Before I saw my doctor, I heard about a local mom who is a fitness trainer and shared some prenatal and postpartum exercises on her Instagram feed (see resources below). So, I started some very small core exercises but didn’t do them every day. 

Once I went back to my doctor, she cleared me for exercising and running again! I was thrilled but I still didn’t jump back onto the streets, trails, or on the treadmill for running since I was still sore and felt pressure mainly from the scar tissue of the tear. I didn’t start running until I reached about 7-8 weeks postpartum and started running 1 mile at a time. I’ve heard of Pelvic Floor therapy from many and knew all along that I wanted to see a physical therapist after giving birth. One of my close friends even suggested maybe going before I gave birth, but my doctor referred me after at my 6 weeks appointment. 

My love language...the great outdoors for family walks! 

Pelvic Floor Therapy

Pelvic floor therapy (not just Kegels) has been around for many years; however significant benefits to the postpartum recovery has caused a resurgence of popularity. It’s not always just for postpartum recovery either. It’s never too late to check it out. I didn’t really know what to expect during my first visit, my evaluation. I had my baby with me…in his pumpkin seat in the monster 3-wheeler (aka, jogging stroller). That was challenge number one. Maneuvering what felt like a giant wheel barrel bumping into every chair, door, and corner. The ADA or handicap bathrooms are simply not big enough for strollers and barely enough space to maneuver a wheelchair (hence, why I started a business focused on Universal Design and accessibility: Blue Day 2 Designs). I’m learning even more about limitations in public places with a baby. Luckily, there was an automatic door to enter the rehab space (which is usually not on inside office doors in medical buildings). I think we would all benefit from automatic or power assist doors whether you’re a mom herding kids, carrying a pumpkin seat, pushing a stroller, or simply delivering a package. Try opening a door with your hands full (lever door handles are very practical!). As I entered the sports rehab center, sweating bullets already. I stood to fill out my paperwork. Mainly because a couple of older women just stared at me and didn’t offer to move to some empty seats across from them so I could fit myself and a stroller in the tiny waiting area without blocking 2 doors. They stated there are some empty seats (so thoughtful and I clearly see the empty seats) but no one thought about where I’d put my baby in a stroller. While standing and waiting, I was suddenly reminded why I was there. My bowels were moving and my butthole was screaming, “quick, restroom!!” I might have released a little gush of air. I squeezed myself and my giant 3-wheeler into the bathroom right by the waiting room. I didn’t even care if the door would be cracked open. Once again, I barely made it. 

I met my physical therapist (PT) who I felt very comfortable with and it helps that she loves her job AND babies…even if they’re screaming the entire time. I swear I feed my baby before every visit and then when we show up, he acts like I starve him dry. He shows up content and sleepy, then the minute we start my treatments, he fusses and my entire insides tense up. The evaluation is very thorough and involved. They literally evaluate your vaginal, perineal, and sphincter muscle functions and assess the scar. I’m thinking wow, this is pretty involved. I’m always weary and even embarrassed about exposing my bottom. However, the more it healed and the more I soaked, I felt a little more secure. My doctor had prescribed me an estrogen cream, but I don’t know why I never even tried it out. Estrogen cream is also good to use to help with the vaginal humidity (you know what I mean).

She asked me tons of questions (like we therapists do during evaluations) and I’m thinking, how long is my baby going to be content and should I feed him while we are talking. She even asked me what my poop looked like. I told her it’s the biggest poop of my life! And, yes, there is a chart (like a pain scale) rating what your poop looks like. Well, it’s not supposed to look like that. It needs to look more like a sausage. Okay, noted and back off the Colace. Then it was time to assess my muscles…externally and internally. By that time, I had a fussy baby and I couldn’t relax. She held my baby in her left arm all while testing my hip muscles against her right hand. Sheesh, she’s talented. I wish I could multi-task like that and talk and listen all at once! I can barely focus while NOT holding my crying baby and follow her commands. My brain was overstimulated. After the exam, I went to the gym floor for a series of tests to determine the circuit of exercises to prescribe. I did a jump test for one minute and yup, it happened. I farted. Not a little one either…it was a quick “toot, toot” in sync with the jumps. It happened in front of other patients and therapists then I proceeded to say while short of breath and sweating, “and…this is why I’m here.”

Each week, I could feel my hip strength gaining by leaps and bounds. My running gait was evaluated during another visit because our bodies change so much during and after pregnancy that it can affect our posture and our gait. My running form changed and I’m sure my bike fit will be much different too. Regardless if you’re an athlete or not, it doesn’t hurt to see a PT anytime postpartum or anytime for that matter. As moms, our posture is affected by breastfeeding or holding a baby in general. Our core is splitting into different directions and most women that have had a baby, will have some degree of what’s called, diastemas where the abdomen muscle splits apart. Proper core strengthening exercises target those muscles and mine showed signs of recovering and closing up just within 2 weeks. 

Getting back into the game and getting my gait checked...

My little spectators for indoor runs. 

Not only was my running getting stronger, I was feeling more confident with my lady manners in public again. By 11 weeks postpartum I could run over 3 miles comfortably. Needless to say, running and feeling like a lady were my motivation to complete daily exercises, scar massaging, and circuit workouts. Of course, I had my little “toots” here and there but I gained more control each week. I’m thankful for this time of healing because it has slowed me down to focus on the important things such as strengthening (the thing that I’d always skip for a quick dose of adrenaline). 

Yoga (completed pre-COVID-19 outbreak)

As mentioned in my pregnancy and exercise post, yoga provides a lot of health benefits physically and mentally. I attended pre-natal yoga regularly for 3 months prior to the birth of our baby. I then wanted to continue yoga postpartum and started the ‘Mommy and Me’ yoga classes where once again, you learn about various resources especially for postpartum. You learn about how the hormones relax your body and you can actually harm yourself by overstretching because the hormones increase your flexibility. You also learn about your baby and their development and hear from other moms on any challenges or strategies they have tried for specific challenges. My favorite is singing “Wheels on the Bus” and moving my baby’s legs and body which helps with digestion and body functions. The instructors are certified in postpartum yoga and know a lot about the body, as well as the hormones after birth. They are certainly patient and must love their jobs too because I can’t even concentrate on my body movements with a fussy baby. The best part is breathing and relaxation at the end with my baby asleep on his tummy while lying on my chest which is calming for the baby to hear the breathing and heartbeat. 

Needless to say, don’t be afraid to talk to your doctor or ask about postpartum pelvic floor therapy. And, much like pregnancy or raising a child(ren), avoid comparing yourself to others for every woman’s body heals differently and at different paces because all our babies are unique and arrive into the world their own, special way. 

Instagram followers on postpartum exercises

(as approved by my PT but please check with your healthcare provider before trying something new)

@momsintofitness (Lindsay Brin, certified fitness trainer) – she even includes workouts for kids during this quarantine time

@brianna.battles (Brianna Battles, certified coach)

@carriepagliano (Physical Therapist)