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Fitness: How soon is too soon to exercise after childbirth?

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Fitness: How soon is too soon to exercise after childbirth?

Despite the desire by millions of people to get back to the gym after giving birth, there are few hard and fast safety rules.

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For active women, returning to pre-pregnancy fitness levels is an important milestone.

Yet despite the desire by millions of people to get back to the gym after childbirth, there are few hard and fast rules as to what constitutes a safe and gradual return to sport/exercise. A paucity of scientific studies and a surprising lack of consensus on the length of the postpartum period makes it tough to create a firm set of exercise recommendations specific to the physiological changes that occur during pregnancy and childbirth.  

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People with an uncomplicated delivery generally get medical clearance to work out after their six-week checkup. But the body typically takes longer to recuperate, with vaginal and cesarean births reporting distinctly different timelines for recovery. Hence the difficulty when it comes to establishing a one-size-fits-all set of return-to-exercise guidelines.

Then there’s the numerous physiological and psychological challenges related to those first few months of motherhood, including lack of sleep, weight gain, urinary incontinence and breastfeeding, any one of which can be a barrier to establishing a regular workout routine after delivery. 

Studies of elite athletes who returned to rigorous training and competition early in the postpartum period suggest a predisposition to injury. But there’s little consensus — beyond the initial six weeks after delivery — about how soon is too soon and how vigorous is too vigorous. To make matters worse, most trainers, physicians and coaches have limited knowledge and experience with postpartum athletes, which makes a safe return to exercise more trial and error than informed actions.  

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Based on the struggles elite athletes have finding adequate support when trying to reestablish their athletic career after giving birth, it should be no surprise that the average fitness enthusiast is left largely on her own to figure out a return to exercise plan. Yet despite the lack of science-based recommendations, there’s no shortage of “experts” who feel compelled to weigh in with their opinion. Citing concerns about too much exercise hindering milk supply or adding to the already exhausting postpartum period, there’s plenty of misinformation surrounding the reintroduction of exercise after childbirth.

Science doesn’t back the common belief that intense exercise reduces milk production or its nutritional value. A 1994 study, published in the New England Journal of Medicine, monitored the milk supply of 33 women, six to eight weeks postpartum, 18 of whom participated in an aerobic fitness program five times a week for 45 minutes per session. Compared with the control group of 15 non-exercisers, there was no difference in breast milk concentration or the breast milk intake or body weight of the infants of the exercising mothers.

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What was different between the two groups is that the women in the exercise groups were more fit than the postpartum mothers who didn’t exercise.

That doesn’t mean the road back to exercise is easy. A large number of women experience stretching and separation of the abdominal muscles (think of a set of six-pack abs separating lengthwise down the middle) during pregnancy. When the muscles separate, abdominal weakness and pelvic pain is common, especially during the first few months postpartum, which can make certain exercises uncomfortable or difficult to perform.  

Urinary incontinence is another byproduct of pregnancy and delivery that can complicate a return to exercise. Estimates suggest over 50 percent of women suffer from some kind of weakening of the pelvic floor after a vaginal delivery, which when combined with any type of high impact or ballistic type movement can cause mild to moderate leaks that aren’t easily disguised during a fitness class or workout. 

Then there are the other challenges new mothers face, like hormonal changes, lack of spousal and/or family support, sore breasts and separation anxiety/guilt, all of which add to the myriad of physiological and psychological changes that occur during and after childbirth. Yet despite a tough first few months, many women have successfully navigated the sometimes rocky road back to the gym. Several elite athletes have had greater career success after the birth of a child, which proves that pregnancy and childbirth are only a hiccup in the pursuit of fitness and exercise goals.  

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The key to successfully returning to the gym is a slow start, focusing on simple abdominal and pelvic-floor strengthening exercises to start and progressing back to a normal exercise routine in small, manageable steps over the course of 12 months.

In the absence of expert-driven guidelines on the do’s and don’ts of postpartum exercise, common sense is your best guide. Give yourself permission to take days off, don’t ignore fatigue and back off if you feel discomfort or pain. Above all, don’t give up. Exercise is a proven energy and mood booster, two very valuable outcomes for postpartum mothers faced with a myriad of physical and emotional ups and downs. Set small goals and build on small successes.

And while it may be too late for first-time postpartum mothers, research suggests that mothers who stay active and exercise during their pregnancy have fewer physical challenges when returning to the gym. A strong, fit body recovers faster from the rigours of childbirth.

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Low intensity steady state exercise promises to be the simplest way to boost your fitness – 7 workouts to try

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Low intensity steady state exercise promises to be the simplest way to boost your fitness – 7 workouts to try

You’ve heard of hot girl walks and cosy cardio, but are you familiar with the term for the training style that describes these kinds of workouts? Low intensity steady state exercise, otherwise known as LISS, is the physical activity currently commandeering your social feeds.

Whether costumed as hot girl walks (the corresponding hashtag of which has upwards of 114k mentions on TikTok at the time of writing) or rucking (walking while wearing a weighted backpack), it’s essentially exactly what it says on the tin. And it’s a powerhouse where all-round health is concerned.

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Brett is the only bloke in his aqua aerobics class and says more men should give it a go

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Brett is the only bloke in his aqua aerobics class and says more men should give it a go

At 6 feet 2 inches tall, retired sheriff court officer Brett Rogers isn’t the sort to get intimidated easily.  

Not even, it would seem, when he’s thrown into a situation which, for many, would be out of one’s comfort zone. 

The 70-year-old is the only bloke in his aqua aerobics class, and he’s proud to admit he never felt fazed by that.

In fact, Mr Rogers was so impressed by how quickly the water-based exercise was able to relieve his arthritic pain, he started converting others. 

Wednesday morning aqua aerobics classes in Renmark are a hit with locals.(ABC News: Amelia Walters)
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After persuading his wife Susan to join him, the happy couple now attend aqua classes three days a week and say it’s the best way to keep fit during retirement.

“I get significant relief from it because I can exercise without pain,” Mr Rogers said.

“I make sure it is the worst-kept secret,” he joked.

Mr and Mrs Rogers are among 200,000 Australians who partake in weekly aqua aerobics and hydrotherapy classes.

Data released by the Australian Sports Commission shows water-based activities were the most popular forms of exercise in 2023 for those aged over 50.

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Regional boom

Sarah James, an aqua aerobics instructor at the Alan Coulter Recreation Centre in Renmark, South Australia, said she had seen a significant spike in participants attending since she first began teaching. 

A young woman with brown hair wearing a blue/orange shirt stands next in front of a fitness poster with a woman exercising

Sarah James says aqua aerobics has boomed in SA’s Riverland.(ABC News: Elyse Armanini)

“When I first started, we barely had anyone coming in, but now we have 20 sometimes even 30 people in the pool at any given time,” she said. 

The Alan Coulter Recreation Centre offers aqua aerobics classes four days a week, and class attendance is always near maximum capacity. 

Ms James said Riverland locals passed on feedback that they would love more classs.

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“The demand is definitely there,” she said.

“It would be nice to open up a lot more classes as we would see so many more people coming through the doors.”

Metro areas also take the plunge

It’s not just Riverland locals diving into aqua aerobics.

According to Royal Life Saving Australia, 78 per cent of aquatic facilities and swim schools across Australia offer water aerobics classes. 

Woman smiling at camera wears a blue polo shirt and stands to the left of an aqua aerobics class taking place.

Melissa Janisch says before COVID-19, group fitness class attendance was lower, at 50 per cent.(ABC News: Marco Catalano)
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The SA Aquatic and Leisure Centre’s health and wellness director Melissa Janisch said pre-COVID-19 they were looking at 7,000 to 8,000 people attending group fitness classes every month.

Now they have 14,000 people attending a month.

“In summer our classes are at 98 per cent attendance and in winter they are at 85 per cent,” Ms Janisch said.

“If we could, we would put more on!” 

Woman with grey hair in ponytail stands to the left of a swimming pool holding up two foam dumbells.

Dawn Ross encourages anyone struggling with pain to attend aqua aerobics classes. (ABC News: Marco Catalano)
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Adelaide aqua aerobics class instructor Dawn Ross has also seen a noticeable class attendance increase, with a change in gender and age participation.

“It’s starting to extend to younger people, normally we associate aqua aerobics with 50- to 85-year-olds, but now I have people who are 30 coming along,” Ms Ross said.

“More men are also starting to come.

“So it’s good that it is starting to be recognised by more diverse age demographics and genders.”

Caucasian Lady with grey hair in ponytail holding foam dumbells facing away from camera  instructs an aqua class

More people are doing SA Aquatics and Leisure Centre’s classes now than before the pandemic.(ABC News: Marco Catalano )
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Good for physical and mental health

 Director of Priority Physiotherapy Clinic in Berri Caitlin Prior said water-based therapy benefited all ages, not just the golden oldies. 

“When you hop into a pool that’s heated, you become buoyant and so it reduces that stress load and makes exercise easier,” she said.

“The water creates resistance, so rather than a band or a load, you get cardiovascular fitness and gain strength in the water.” 

A woman with blonde hair wearing a navy blue shirt sits at her desk typing on her computer

Caitlin Prior says aqua therapy suits all ages and has a multitude of health benefits.(ABC News: Amelia Walters)

Ms Prior said for older people, aqua therapy not only improved their physical and mental wellbeing but could keep them living independently for longer.

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“It’s not just looking at cardiovascular fitness, or strength or balance, it’s looking at mental health and wellbeing and having a purpose and catching up with people,” she said.

“We want to keep people active. The more we keep people active, the longer we can keep people at home.”

three elderly Caucasian ladies lean against the pool edge behind a set of foam dumbells.

Sharon, Lynn and Allison all attend  aqua aerobics in Adelaide more than five times a week.(ABC News: Marco Catalano )

Barmera locals Brett and Sue Rogers will continue to make a splash in the Riverland and encourage others to do so. 

“It’s certainly a great add [to my day], and it certainly helps my wellbeing,” Mr Rogers said.

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What to Eat Before and After Your Workout

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What to Eat Before and After Your Workout

Through the ages, humans have fueled their most physically demanding efforts with meaty proteins. Ancient Greeks loaded up on red meat before Olympic contests, and medieval knights recovered from war with venison and pork. The tradition continues today, with world-record-setting weightlifters breakfasting on chicken thighs, eggs, and bacon.

But experts recommend that the modern, average person eat several other foods before and after tough workouts, even if the knights may have tossed them from their castle windows.

The missing ingredients

During exercise, blood carries the nutrients we’ve consumed to our strained muscles, where they’re absorbed. “We are what we eat,” says Keith Baar, a molecular exercise physiologist at the University of California, Davis. “And when we exercise, we’re more of what we just ate.” With proper nourishment, our muscles perform better, exercise feels easier, and we recover faster.

The ancients weren’t exactly wrong about protein. It’s critical in forming the building blocks of muscle tissues during exercise and afterward, when the fibers are beaten up and need repairs. But many athletes and weekend warriors focus too much on protein, says David Nieman, who leads research on exercise and nutrition at Appalachian State University’s Human Performance Lab. “Unfortunately, a lot of people still act like protein is everything,” he says.

Carbohydrates matter just as much, especially for cardio workouts. (And high-fiber carbs, in particular, tend to support long-term health compared to carbs with fewer nutrients.) “We’ve known since the 1960s that the muscles want carbs,” Nieman says. After we eat carbs, they’re converted into something called glycogen, which is stored in muscles until it’s needed for energy. “The research is so strong, you’d be foolish not to use it,” Nieman adds.

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But the best exercise fuel you’re not eating may be fruits, nuts, dark greens, and other plants. They’re full of essential nutrients like folate, magnesium, and vitamins A, D, and E, which can reduce stress and inflammation from exercise. Yet most Americans don’t get enough. “Over 90% of our recommendations for many people come down to eating more whole plant-based foods,” Nieman says. For light exercisers, “everything else is minor.”

For people who are just trying to meet the minimum exercise recommendations of 150 minutes per week, try to follow the baseline, daily recommendations for vegetables, protein, and carbs. It doesn’t really matter whether you eat them before or after your workout, experts agree.

For more intensive exercise, though, you’ll want to adjust nutrition before and after—or your workout could involve more rigor than vigor.

Before your workout

Power up with nuts and berries

You may be surprised to find a ream of sports nutrition research pointing to a humble bowl of blueberries and almonds. Many ancient warriors overlooked these foods, but they offer an unusually high variety of polyphenols, compounds found in plant-based foods that reduce inflammation from prolonged workouts.

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Blueberries, especially wild ones that you can find frozen, have this effect in competitive cyclists and untrained athletes alike. Their polyphenols are antioxidants, meaning they counter harmful molecules caused by inflammation during exercise—like firefighters putting out flames. This speeds up the recovery process. Jenna Stangland, team dietitian for the Minnesota Timberwolves, infuses the NBA players’ diets with polyphenols, she says; the Timberwolves’ second-best regular season in franchise history was powered by blueberry vinaigrettes, added recently to the team’s salad station. (Stangland is also an advisor to Momentous, a supplement company.)

Nieman also has found that snacking on about 40 almonds per day for four weeks before heavy exercise contributed to less muscle damage. In a study this year, people who ate almonds for two weeks weren’t as sore after running 30 minutes downhill. Because almonds are high in calories, stay very active when upping your intake.

Decades of research support the general health benefits of polyphenols, but their role in exercise is a recent discovery. “They’re the future of sports nutrition,” Nieman says.

Eat a slice of sourdough two hours before

For tough exercise, increase your intake of carbs above the minimum guidelines. Swimmer Michael Phelps set a world record after having three slices of sugar-covered French toast (plus a five-egg omelet). However, Phelps isn’t your average human. Healthier sources of carbs are chickpeas, lentils, and sourdough bread. They take longer to digest, providing a slow, steady release of energy to fuel exercise later in the day. Aim to have these types of carbs about two hours before working out, says Elaine Lee, a kinesiologist who directs the University of Connecticut’s Human Performance Laboratory.

Eat a banana immediately before

Carbs with more sugar and less fiber, such as bananas, get broken down faster. If you time them just before or during your sweat session, the body can use them right away. (Bananas, a high-carb, polyphenol-rich fruit, promote recovery as well as sports drinks according to Nieman’s research.) 

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Stangland likes honey for her players because it contains the right mix of simple sugars for energy. “I give out honey sticks right before tipoff and at halftime,” she says. Eating these foods too early, by contrast, “can cause blood sugar to crash before exercise,” Baar says. “Then your performance will be very poor.”

Sate your hunger with eggs

You may benefit from combining pre-workout carbs with protein, such as eggs or Greek yogurt.  Because protein is more filling than other foods, it overcomes a big obstacle to exercise: hunger. “You’ll feel sated for longer, which can play a role in how you perform,” Baar says.

Vegetarians, worry not; recreational athletes do just as well with plant-based protein compared to meat. Lentils pack ample amounts. “We have some players who prefer plant protein,” says Stangland. Brown rice and pea protein powder is the perfect mix for them, since these two plant powders combined provide all of the amino acids that support exercise.

Consider coffee and collagen an hour before exercise

Research supports only a few pre-workout supplements, found in food, as safe and effective for athletic performance. One is caffeine. Fewer studies point to a protein called collagen for reducing joint pain; mixing it with orange juice, an hour before exercise, may increase absorption. (Stangland makes a pre-game “watermelon collagen shot” for her players, especially the ones who are more prone to tendon injuries.) Amy Bream, an adaptive CrossFit athlete from Nashville, says collagen has helped her back pain. “It’s in my coffee every morning,” she says.

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After your workout

Refuel with sweet potatoes 1 to 4 hours after

Post-exercise, it’s key to start replacing the fuel that was exhausted—especially the glycogen—to prepare for future workouts. Lee, who coached and rowed at the NCAA division 1 level, recommends combining high-fiber carbs, protein, dark greens, and hydration within 1 to 4 hours after exercise, saying, “That’s when your tissues are most metabolically active.” Sweet potatoes are ideal as the carb portion, offering plenty of fiber and nutrients such as polyphenols and electrolytes, good for rehydration. Stangland serves the Timberwolves sweet potatoes at least twice per day. “It’s great for them, and they like them—a win-win,” says Stangland.

If you’re older, have protein immediately after

Protein can be enjoyed when convenient throughout the day. Scientists used to think you had to eat it right after the gym to gain muscle, but recent studies find that the timing makes little or no difference in healthy younger people. Seniors benefit more from protein immediately following exercise, Baar says, because their bodies target it better to the muscles at this time. Another strategy that helps with protein absorption: chewing food thoroughly and opting for ground meats instead of steaks, Baar says.

Don’t overdo it with the vitamins

It’s possible to get too many antioxidants, including vitamins. If consumed post-workout, they could block the benefits of exercise. Studies show that athletes supplementing with excess vitamins C and E have more inflammation and molecular stress during their recoveries. But that’s no reason to skip your veggies. It’s next-to-impossible to reach this threshold from food alone, experts say.

Read More: Why Walking Isn’t Enough When It Comes to Exercise

Many studies do support taking a post-workout supplement called creatine, based on a natural compound in muscle cells. Taken daily, it boosts recovery and performance in weightlifting and high-intensity interval training.

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Experiment with recovery shakes and other combinations

“We don’t yet have a magic shake” for exercise recovery, Lee says. “Everyone has a different tolerance for what they can eat and how much.”

But you can test one dietary change at a time to see how it affects your performance and recovery. Maybe try having a post-workout, polyphenol-rich bowl of almonds, blueberries, and greens—an AB&G instead of a PB&J—each day to see if it improves your exercise over two weeks. If you measure your heart rate during and after exercise, keep track of the answers to questions like: can you push your heart rate higher than before the change? Or achieve the same workout at a lower heart rate? Afterward, does your heart rate return to normal faster than usual?

Stangland makes a different recovery shake for every player on the team, with extra carbs for Edwards’s all-out performances, for instance. Like all of nutrition science, ultimately “it’s a customization,” Lee says. “You have to find what works for you.”

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