After my wife gave birth to our son on January 31, a Tuesday, she was back in the gym by Friday. She did a few easy bodyweight moves and followed my advice on exercises like dead bugs and bird dogs to help rebuild core strength and stability.
Postpartum training is a tricky and serious topic. Many women jump back into intense exercise before their bodies are ready and end up paying the price. In today’s guest post, Dr. Sarah Ellis Duvall offers some clarity on the issue.
Recently, I saw a great Instagram post by Tony about his wife Lisa, who was maxing out on bench press just weeks after giving birth. Go Lisa! She’s doing amazing, and I was genuinely impressed. Note from TG: this is the post Sarah refers to. It was an incredible lift, but another trainer stepped in to insist it was dangerous to lift so heavy so soon after birth, even though Lisa trained throughout her pregnancy, took time after birth to rebuild, and was cleared by her doctor.
If you’re postpartum and returning to the gym without a coach guiding you, here are five things to consider before you push to a max.
1) Do you have full core strength back?
Start by checking for a diastasis. This is a thinning of the connective tissue that supports the front of your abdomen. It should feel like a trampoline when you lift your head and press your abdomen. If your fingers sink in, that indicates the core isn’t connecting well yet. To test, lie on your back with knees bent, place your fingers in the middle of your stomach, lift your head slightly and push. Do your fingers sink or spring? Check the area halfway between your ribcage and belly button, just above the belly button. If what sinks in or the gap is wider than about two fingers, that’s a diastasis. The sinking part matters more than the width, because it reflects how well your core can transfer load.
2) Check for doming
During a crunch, sit-up, or plank, your abs should flatten. If they dome outward, your core isn’t firing properly together. Doming can also fail to support the spine and pelvis and may increase the risk of hernias. Prevention is best.
3) Is your deep breathing system in place?
Does your inhale reach your pelvic floor, or is it mostly up in your shoulders or belly? Proper breathing is part of building correct core strength. Think of your diaphragm as the top of a pressure system that helps stabilize the spine. If the diaphragm and core muscles aren’t firing correctly, you can create too much or too little pressure. The pelvic floor dislikes either extreme. Aim to breathe into the back, sides, and front around your ribcage so every breath expands your entire torso.
4) Make sure your pelvic floor is timed with your diaphragm
Long pushing phases or holding too much pelvic floor tension can disrupt natural movement. You should feel your inhale push down on the pelvic floor, which then relaxes as you exhale. The timing matters for safe function.
5) Be aware of what happens under exertion
As exertion increases and you exhale more forcefully, your pelvic floor should contract. Sometimes people instead bear down, which can cause leaks or pelvic organ prolapse. I’ve connected with many women who develop prolapse months after birth, even after feeling fine for a while. It’s not that exercise is off-limits, but you need a solid foundation first. If you don’t understand how your pelvic floor behaves under pressure, you’re missing a crucial signal, much like not knowing your knee caves in during a squat.
Pelvic floor prolapse is a real issue with real consequences, and taking the proper precautions before pushing hard can help prevent it.
About the author
Dr. Sarah Ellis Duvall is a wife, mom, and adventure-sports athlete who specializes in women’s health. She focuses on pelvic floor issues, diastasis, and building strength safely, and she shares results-driven online programs through Core Exercise Solutions. When she’s not climbing mountains, she writes and speaks to help women pursue strong, adventurous lives. Learn more about her Pelvic Floor and Diastasis Programs at CoreExerciseSolutions.com.
