Prenatal, Pregnancy, and Postpartum exercise tips. Let’s discuss the who, what, why, and how around a strong core and pelvic floor for athletes. 

I often get asked what exercises should be done postpartum and what should be avoided. If only it were that easy! Let’s discuss the who, what, why, and how around a strong core and pelvic floor.

First, this is not just a woman’s issue. Obviously, women are getting more attention for core and pelvic floor health because they carry babies. But listen...men often carry extra belly weight - not for months, but often years! They lift heavy things, have manual jobs, sit in poor posture, have abdominal and prostate surgeries, and so on. We will get back to the fellas in a bit. Let’s return to the mommas and their babies for a hot second.

Athletic agendas for returning to CrossFit, running, you name it, do not start AFTER the baby is born. Your agenda should start during pregnancy. Let’s call it Pre-Hab.

Both males and females need to discuss how and WHY you train. What is your intention? Core and pelvic floor balance is more than making temporary modifications and seeing how quickly you can return to making a PR. There is no cookie-cutter approach to a core and pelvic floor that can activate and move breath correctly.

Athletes and fitness enthusiasts struggle to self-regulate following injuries, surgeries, and setbacks. Often, coaches and trainers are looked to for guidance, but unfortunately, many coaches and trainers do not have the correct resources, tools, or education to modify, advise, or safely program correctly.

Please consider the Athletic Agenda for any pre-natal, pre-surgery (abdominal, hysterectomy, pelvic, hip, hernia, back, rib), pregnancy, post-partum and post-surgery rehab:

Pregnancy Specific:
1st Trimester: Be mindful of how you feel. You will experience nausea and fatigue, or perhaps you feel normal. This is a great time to implement excellent breath strategy and movement technique. Be aware of physiological changes as they occur and adjust your intensity to honor those changes. Be at ease with the idea that rest is part of the process and will make your work more efficient and reduce recovery time if you learn to balance the two now.

2nd Trimester:
You may find that your energy seems to return, and nausea dissipates. This may cause you to think you can ramp back up your training full force, however, your body is ramping up its “bendy hormones” to allow the joints to adjust to the growing baby. Your physical structure is changing, so your training should do likewise. Focus on breath, alignment, and moving in a correct range of motion (you may feel more flexible than usual, but now isn’t the time to break PR in deep squats or mileage in running). Understand how these changes affect your core and pelvic floor function. Rehab begins NOW! What you do at this stage can and will greatly affect your post-partum recovery.

3rd Trimester:
Just because you CAN do something doesn’t mean you SHOULD. Decrease volume, intensity, and load. Increase breath awareness and movement pattern adjustments. Many athletes do not need to demand a higher physical load to “prepare for birth” because their baseline of fitness is well established. You need to train your mindset to accept recovery times and awareness of potential core and pelvic floor issues such as leaking urine, painful sex, unexplained back pain, pelvic pain/pressure, and abdominal coning. They are not worth creating, aggravating, or dismissing during pregnancy.

Postpartum or Post-Surgical:
4th Trimester (post-natal or post-surgery 1-3 months) transitions from physical athletics to honoring the body’s need for rest and healing. It is a time to be deliberate in the intention of breath, recovery, and restorative movement instead of desperate attempts at pre-pregnancy numbers and exercises. Emphasize sleep and rest. Eat to nourish the body and the baby, not to restrict calories. Hydrate to expedite healing. Focus on breath work to integrate proper core and pelvic floor function as your body realigns into postural balance. These action items will implement big dynamics into your return to function, fitness, and performance. It is highly advised that a Pelvic Floor Physical Therapist assess you.

3-6 months Rehab:
The body begins to regulate, and you can reintroduce movement patterns. You can begin the building phase of training, such as volume, gradual load, and intensity. Work with a professional to have a solid strategy and be aware of current symptoms that throw caution flags (leaking urine, painful sex, painful urination, constipation, pelvic pain/pressure, uncontrolled bowels, etc.). Even the most experienced athletes are in the fundamentals in this stage as the body gets acquainted with the recent changes.

6-9 months:
Training and movement can become more consistent and familiar. This is still not the time to push for a PR in your preferred mode of fitness, but you can begin to progress load, volume, and intensity. Continue to work toward prior fitness levels while building upon fundamentals and monitoring all symptoms.

9-12 months:
Assuming through patience and persistence that a strong foundation of core and pelvic floor balance was established while also learning correct movement patterns for your altered body, you may now progress to your potential. Working on that strong foundation allows you to build strength, intensity, volume, and impact while managing or alleviating further symptoms.

"To Infinity and Beyond”

Life happens. Falls. Twisted joints. Traveling pains. More surgeries. Another baby.

Awareness, never obsession, allows athletes to make healthy decisions toward their goals, using modifications and progressions as needed.

Go back to Square One and rock on. You got this.