In 2017, it seems to me that pregnant women exercising, CrossFitting especially, has gone from being the exception in our society to the new normal. And I couldn’t be more thrilled about this. Healthy pregnancies include exercise. Healthy pregnancies can include CrossFit. And women who have reported doing CrossFit throughout their pregnancies have reported better, faster, and less painful labors, healthy babies, and an easier time “bouncing back” after childbirth.
But what does “bouncing back” really mean, and what’s an appropriate timeline for a woman to resume a “normal” fitness routine post childbirth?
In the United States, most women are cleared to go back to exercise roughly 6-8 weeks after giving birth. I remember being pregnant and trying to figure out when my new-mom gym routine would resume--how soon I could get into the gym and get back to my normal CrossFitting life.
What I didn’t expect was that the recovery process for a mother’s body could take much longer than I expected. At my six-week postpartum appointment, my midwife had to prescribe me two different medications to help deal with ongoing physical pains I was having--pain from simple activities such as walking or going up and down the stairs in my house. At six weeks postpartum, I was cleared to “walk” and do “light yoga,” but nothing more strenuous for several more weeks.
She informed me that even if we (postpartum women) felt fine enough to resume our normal daily activities, it would still takes our bodies a full year to recover from pregnancy and childbirth. Simply, our insides have been through trauma. And my personal diagnosis was that (aside from my tearing that had not fully healed yet), my abdominal muscles still had about one centimeter of separation between them (a common condition called diastasis recti), and she also told me I needed to start working my pelvic floor muscles to avoid later incontinence issues in life.
As a trainer and coach, I have been working for years with women who have these issues, so they weren’t new to me. But it kind of hit me as a shock that I was suddenly the one who may have these same physical dysfunctions from carrying and birthing my baby.
I know that all women are different, but for me? I couldn’t perform a typical CrossFit workout until a good three months after I had my baby, and I wasn’t comfortable getting into a workout routine until about five months postpartum.
The six-week standard we’ve come to believe is attainable for us was completely laughable for me. And just from conversations I’ve had with other women, I know it’s the same for most of us--laughable and absurd. There is no “bouncing back” for us.
Currently, it’s been a little over a year since I birthed my baby girl and while I do feel much more like myself in the gym (just from basic exercise roughly three times a week), I’m still weaker than I’ve ever been, I have zero control over my bladder when I jump rope (if it’s not completely empty), and I swear it still hurts to lay down on a hard surface on my stomach.
I don’t like admitting any of this, but I know the information needs to be “out there” and I want women to understand two important concepts:
Before anything, we women need to be patient. It took roughly 40 weeks to grow our babies, hours of labor possibly resulting in abdominal and uterine surgery, and the recovery time shouldn’t be limited to a “standard” 6-8 week time frame.
I can’t stress enough: patience with yourself will go a long way towards your recovery.
One way to practice patience is that when you feel ready enough to resume physical activity, you resume the correct physical activity. You absolutely don’t want to worsen anything going on in your body after growing that precious baby!
Diastasis Recti is when the abdominal muscles and tissues weaken at the midline and the left and right side of the abs look and feel separated. The main thing to note here is that there are certain exercises to help both avoid and recover from this separation.
The exercises you want to do are abdominal stabilization exercises:
When you’re feeling stronger you can add:
Honestly, the rules here are kind of simple. Do exercises that force you to use your abs as stabilizing muscles. And with CrossFit, that means no abmat or GHD sit-ups for a while.
Licensed Physical Therapist Assistant Kate Zanoni states, “The biggest thing with diastasis recti is to avoid crunches and sit-ups and to learn to activate your transverse abdominus with bracing versus abdominal compression.
Nicole Crawford from Breaking Muscle has designed 12-Weeks of Workouts to Rebuild after Diastasis Recti. I like this program a lot. It begins with simpler exercises for the new mom bouncing back from childbirth and advances throughout the 12 weeks with similar exercises listed above like farmer carries and kettlebell swings. It even includes some core-bracing yoga.
Pelvic Floor Dysfunction--or the peeing when you do double unders in CrossFit issue--is likely more common than most people know. Chances are, if you’re still reading this post then you’re very familiar with issue--whether you’ve had a baby or not. I can’t tell you how many times I’ve heard, “I pee when I jump rope and I haven’t even had a baby!”
To fix or even prevent PFD, especially if the issue isn’t already serious, most doctors and physical therapists advise doing kegel exercises. Kegels are when you squeeze your vaginal muscles as if you’re trying to stop the flow of urine. But oftentimes, if you’re not doing the kegels properly (and even if you are), sometimes that’s just not enough to heal the problems or strengthen the muscles.
I’m lucky that one of my best friends is a specialist in pelvic floor dysfunction at the Cleveland Clinic in Ohio. When I told her that our gym manager had to completely rewrite the workout one day due to too many women peeing from all the double unders, the first thing she said was, “Stephanie. This is so sad. The issue is relatively easy to cure. They just need a urogyn.”
She then directed me to The Voices of PFD website--a very good resource for those looking to correct and strengthen their pelvic floors.
The Cleveland Clinic reports that even though sometimes surgery is needed to correct serious cases, it’s not always so. In fact, most cases can actually be treated through biofeedback with a physical therapist.
“This non-painful, non-surgical technique provides improvement in more than 75% of people with pelvic floor dysfunction. Physical therapists may take several approaches to biofeedback. These include using special sensors and video to monitor the pelvic floor muscles as the patient attempts to relax or contract them. The therapist then provides feedback and works with the patient on improving their muscle coordination.” https://my.clevelandclinic.org
Other corrective techniques include medication; relaxation techniques such as exercise, warm baths, and yoga; and then surgery if the dysfunction seems to be caused by a rectal prolapse.
By the way, did you know that pelvic floor rehab is often prescribed after childbirth for women in European countries, and is paid for by the government? It’s true! The National Institute for Health and Care Excellence states that any women who reports involuntary leakage of urine or feces at their six-week postpartum check-up are immediately referred to a Physiotherapist who specializes in Women’s Health.
Fortunately, the more I dig into the issues of incontinence after childbirth the more I realize that the United States is trying to catch up to its European counterparts--my midwife practice actually just hired a specialist for this--but for many women who don’t know of local practices who specialize in PFD, the ability to cure it may be something you have to take into your own hands and start researching on your own.
So for all our CrossFitting moms out there who are eager to get back in the gym and resume normal activity, let me just say that, as you’ve likely figured out already, there may no longer be a “normal” for you.
You may be looking at an extended recovery period, working with a physical therapist, slowing down your activity, and more than anything--being patient and forgiving with yourself.
You grew a baby inside you. Your internal organs shifted position in your body. You birthed a baby--whether you pushed it out of you or he/she was surgically removed--your body has been under tremendous stress! Don’t push fitness. Eat well. Take slow walks when you’re ready. Start some postnatal yoga or the 12-week workout I linked to earlier in this post. Don’t just assume after six weeks that you can do what you used to. I can tell you first hand, most of you can’t. And that’s ok. Because while you’re taking care of your new baby and growing family, now is the perfect time to take care of yourself.
Start a simple fitness routine ONLY when you’re ready. Work on stabilizing both your abdominals and your pelvic floor. Seek a urologist or physiotherapist as needed. Instead of joking about how much we pee while we perform double unders, why not start fixing the issues and bringing awareness to other women who may be struggling?
This is a guest post from Stephanie Walker, a CrossFit and Health Coach who believes everyone deserves to be fitter, healthier, and happier. Stephanie is the author of The Total Health and Fitness Makeover, and is passionate about helping others transform their lives through fitness and good foods--just as she did her own! You can follow Steph on Instagram, Facebook or Strongfigure.com.