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How to safely return to exercise after having a baby

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How to safely return to exercise after having a baby

When Fan* gave birth to her first child almost two years ago, she was given little direction about how to return to exercise.

After a 20-minute session with a physio, they remember being given an A4 sheet of exercises to follow at home.

“It was all a bit of a blur, because I was sleep-deprived, and over-excited,” they said.

“For the first six weeks, those exercises were enough. But after that, I didn’t know what to do. 

“I had heard about people going back to sport after a few months, and others who didn’t do certain exercises for years, or ever.

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“It was pretty confusing.”

(*Fan uses she/they pronouns, and asks us to mix them up throughout the article).

Fan wasn’t sure where to turn when she wanted to exercise, so ended up consulting Google.

  (ABC Sport: Kate O’Halloran)

As is common among women who have given birth, Fan also experienced urinary incontinence.

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She was referred to a pelvic floor physiotherapist while in hospital, who gave her some exercises to strengthen her pelvic floor muscles.

But after being discharged from the hospital, there was no follow up:

“I wasn’t really sure what I was meant to do … so I turned to Google.”

Australian postpartum exercise guidelines ‘fall short’

Dr Melanie Hayman, an expert on exercise and pregnancy, says experiences like Fan’s are not unusual.

As she explains it, the regular six-week postpartum check-up typically focuses on the health of the newborn baby.

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“There are usually a couple of questions about mum’s health, but it can be quite superficial,” Dr Hayman said.

“[Topics like] returning to exercise, or the physiological changes that occur throughout pregnancy, or as a result of birthing, are not assessed.”

A woman sits on an exercise ball. She is wearing shorts and a crop top.

Many women experience core muscle separation and some form of incontinence after birth.

  (Getty Images: Gabriel Mello)

That’s despite the fact approximately one in two people who give birth experience symptoms like urinary incontinence (47 per cent), and pelvic organ prolapse (50 per cent), which can increase fear of exercising. An additional 17 per cent experience faecal incontinence.

Current Australian guidelines, however, do not provide specific advice for returning to exercise after pregnancy.

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Instead, those who are “healthy” are encouraged to meet the existing Australian adult exercise guidelines (for non-pregnant people).

“That’s where our current guidelines fall short,” Dr Hayman said.

“Someone who is five or six weeks postpartum is not your general population … [but] the issue is that we only have a certain body of literature at the moment.

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“So while the current recommendations are still accurate, there are some absences in them, and it would be great to able to provide more guidance, especially in the early phases of the postpartum period.”

She said one reason it was difficult to provide ‘one-size-fits-all’ guidelines is that individual experiences vary:

“Every birthing and postpartum experience is different, so one of the most important things is that return to exercise has to be individualised.”

Any form of activity, however, is better than none, with Dr Hayman advising starting with some gentle walking, even if this is just five minutes a day.

“Traditionally, pregnancy was considered a ‘delicate’ period in a woman’s life where they were advised to take it easy, because of fear that any sort of exertion might harm the mother and/or fetus,” she said.

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A little girl of Middle Eastern decent gives her mum a high-five as she works out in a small studio.

Individual experiences vary so much, exercise can’t be a one-size-fits-all approach. (Getty Images: Halfpoint)

“The issue is that being inactive actually increases the risk of adverse health outcomes. 

“The more women can be active in accordance with our guidelines, the better.”

Gyms with childcare and flexible times are hard to find

Finding a place to exercise is another reason many struggle to get active postpartum.

When Fan reached three months postpartum, they were determined to find a gym where they could return to greater levels of fitness.

But it was a task that proved more difficult than anticipated.

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Most commercial gyms wouldn’t allow Fan to bring her child, or if they did have a crèche, they had long registration waitlists, or were full at the times that suited her.

Eventually, Fan turned to local Preston gym 23W, a women-only strength and conditioning community with a specific focus on postpartum mums.

23W employs a full-time nanny, while the on-site creche is situated in the same room as other gym equipment, allowing parents to keep an eye on their child while exercising.

A nanny is watching kids in a gym creche.

23W employs a nanny to look after kids while their parent exercises in the gym.

  (ABC Sport: Kate O’Halloran)

“It just means our members can come in knowing they’ve got that support, whether it’s emotional support, [or just] knowing someone’s looking after their baby. It makes a big difference,” owner Ange Drake said.

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Drake also runs classes at different times throughout the day, to provide greater flexibility for her clients.

“In that first 12 months [postpartum], you’re probably not going to be training first thing in the morning, because you’re going to be pretty tired, or last thing at night.

“There’s some great postpartum programs out there, but where a lot of women come unstuck is that they’re only offered on one day, at one time in the week, and if you miss it, it’s gone.

“So having flexibility with timing is really important.”

Important to ‘normalise’ common postpartum symptoms

Drake, who has two children of her own, says one of the biggest barriers women face when returning to exercise is the “disconnect a lot of them feel with their body”:

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A woman stands in between two punching bags that hang from the ceiling.

Ange Drake sees a lot of women come into her gym with a somewhat disconnect to their body.

  (ABC Sport: Kate O’Halloran)

“After giving birth, things have stretched out, or moved and don’t feel the way they used to. A lot of women feel like whole muscle groups have gone offline.

“They have lost the trust in their body; knowing what it can do, and trying to navigate the new body they’re in.

“This includes how they can rebuild it, and make it stronger while looking after the needs of a little one.”

For many, this includes pelvic floor complaints, lower back pain and issues to do with abdominal separation.

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“When you’re in the moment, it’s really scary to think, ‘am I going to be able to run again?’ Or, ‘I’m leaking when I’m going grocery shopping,’” Drake said.

“These experiences can be really alienating … and a lot of women think ‘it’s just me’.

“So we try and help them understand that what they’re experiencing is not uncommon, and that women have been able to rehab whatever it is they’re going through.”

Fitness

Hawaii fitness center combats Parkinson’s with exercise

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Hawaii fitness center combats Parkinson’s with exercise

HONOLULU (KHON2) — A local fitness center specializes in preventative training programs targeting a disease that impacts our kupuna.

Fitness Therapy Hawaii specializes in step-by-step preventative training programs targeting Parkinson’s symptoms.

In the program, patients get a clearance with doctors, work with physical therapists and prescribed medication.

“Science shows that once you get diagnosed as soon as possible, right? What exercise will do is help you keep those neurons firing, because Parkinson’s is a neurodegenerative disease. The longer you wait for these patterns of movement, you will die,” George Ma, Fitness Therapy Hawaii owner, said.

According to Yale Medicine, exercise is an essential component of Parkinson’s disease management, saying “high-intensity exercise induces brain-protective effects that have the potential to not just slow down but possibly reverse the neurodegeneration associated with Parkinson’s Disease.”

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“When you get diagnosed with Parkinson’s, in the beginning, you have no hope. And then you come here, you do your tour, there’s hope. And then as they start moving through our exercise programs, they find purpose. And we have clients who have been with us for seven years at stage one,” Ma said.

Fighting the disease thats way might be intimidating to some… that’s why Fitness Therapy Hawaii lets caretakers work out with their loved ones.

Group classes are also available, which encourage socialization for what can be an isolating disease.

“In Hawaii, there is a stigma for Parkinson’s, and I think having a place and having that purpose and understanding that your fellow member has been fighting it with you,” Ma said.

Visit the Fitness Therapy Hawaii website for more information.

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The Gwyneth-approved exercise trend about to take over Australia

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The Gwyneth-approved exercise trend about to take over Australia

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Walking May Not Provide Enough Exercise to Maintain Fitness

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Walking May Not Provide Enough Exercise to Maintain Fitness
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Walking is the most popular physical activity in the U.S., but experts say this might not be enough to maintain fitness levels. Image Credit: Luke Mattson/Stocksy
  • Researchers report that walking is the most popular leisure activity in the United States.
  • They note urban dwellers also like to run and lift weights, while rural residents also enjoy gardening and hunting.
  • Experts say those activities may not be enough for some people to maintain a higher fitness level, so additional exercise may be needed.

Walking is the most popular leisure activity in the United States among both urban and rural residents, according to a new survey.

Researchers reported that urban dwellers also tend to engage in running, weightlifting, and dance, while people in rural areas also enjoy gardening, hunting, and fishing.

The researchers said the differences in leisure activity choices could reflect what people have access to or what is culturally supported in certain areas. They added that urban residents were more likely to meet physical activity guidelines than people living in rural regions.

The researchers, however, noted that even among walkers, only 25% met combined guidelines for aerobic and muscle-strengthening physical activity. About 22% did not meet either guideline.

The researchers reached their conclusions by analyzing telephone survey data collected from a national sample of 396,261 U.S. adults in 2019.

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They reported that 44% of respondents listed walking as the activity they spent the most time doing. The data closely matched another U.S. study from 2011.

The new findings were published today in the journal PLOS One.

The researchers said they hoped their study could help boost physical activity by encouraging people, as well as medical and fitness professionals, to tailor workouts to certain regions and demographics.

“We see a need to continue to support our partners in small towns and rural places by creating physical, social, and cultural conditions that support physical activity,” said Christiaan Abildso, PhD, a physical activity specialist at West Virginia University and a lead author of the study, in a statement.

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Everyone needs to ask, ‘how does what we’re doing affect physical activity,’ in order to help get people more active, more often, in more places,” he added.

Abildso listed several steps community leaders can take to improve fitness opportunities. Among the suggestions:

  • Create a wide shoulder on a country road for cycling and running.
  • Expand the national network of rail trails.
  • Help a senior center create a chair exercise program.
  • Create or improve green spaces such as parks.
  • Keep school facilities open to the public.

“This study aligns with other studies on physical activity in the U.S. population,” said Michael Fredericson, MD, a professor of orthopedic surgery at Stanford Medicine in California. Fredericson wasn’t involved in the study.

“This underscores the continued need to encourage easily accessible forms of exercise, such as walking, or more functional activities around the home, which are more doable for folks,” Fredericson told Healthline.

There are numerous benefits to daily walking, a low-stress activity that can help people exercise with a minimal risk of injury.

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A daily walking routine can also improve mood and support long-term weight management.

A 2023 review reported that walking 8,000 to 10,000 steps per day can provide substantial cardiovascular health benefits as well as psychological well-being.

Gardening can also be considered a moderate physical activity that supports weight management and helps build strength. The time outdoors in a garden can also help your body produce vitamin D, which supports bone strength, calcium absorption, and immune function.

Gardening may also support mental well-being by improving mood and reducing stress.

“Walking and gardening can meet exercise recommendations for most people if performed at sufficient intensity and duration,” said Fredericson. “Still, hunting and fishing, unless there is a lot of walking/hiking, typically do not provide adequate moderate-to-vigorous physical activity.”

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The Centers for Disease Control and Prevention (CDC) recommends that adults get at least 150 minutes of moderate-intensity aerobic activity per week.

The agency suggests that exercise could come in the form of brisk walking for 30 minutes a day, 5 days a week, or 75 minutes of vigorous-intensity aerobic activity each week, such as swimming laps.

The CDC also states that adults need at least 2 days a week of muscle-strengthening activity.

David Cutler, MD, a family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, recommends people try to meet these minimal time standards in their fitness routines.

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“There should be greater emphasis for all adults to meet the minimum exercise guideline of 150 minutes per week,” he told Healthline.

“Their exercise routine should include more than just aerobic exercise, like walking, running, biking, swimming, or dancing. There should also be time devoted to muscle-strengthening exercises of both the upper and lower extremities. This could be as simple as using hand weights and squats.”

Agency officials note that the “exact amount of physical activity needed to maintain a healthy weight varies greatly from person to person.”

Fredericson said a comprehensive weekly exercise program should contain four main components. Those are:

He also suggested people can do “exercise snacks,” which consist of physical activity lasting 1 to 5 minutes performed periodically throughout the day. Those quick exercises can include stair climbing, brisk walking, and jumping jacks.

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“This approach has demonstrated high compliance rates and can significantly improve cardiorespiratory fitness, particularly in physically inactive adults,” Fredericson said.

Cutler agrees a wide variety of exercise is the best approach.

“Individuals should supplement walking with muscle-strengthening exercises like yoga or resistance bands, and higher-intensity activities such as running, dancing, or cycling,” he said. “Effective ways to increase activity include utilizing community infrastructure like rail-trails, joining senior center programming, and creating local, accessible activity spaces.”

“Core exercises should also be incorporated in a weekly routine,” he added. “These strengthen the muscles in your pelvis, lower back, hips, and abdomen, leading to improved stability, better posture, and reduced back pain.”

“Stretching exercises are also important for health aging, injury prevention, and overall fitness,” Cutler noted. “Evidence supports that consistent stretching increases range of motion, reduces joint stiffness, and enhances vascular health.”

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