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POSTPARTUM FITNESS

By Jill Tomlin

If it's been several weeks since the birth of your baby and you feel ready to start exercising, a postnatal fitness program can help you regain fitness and speed up weight loss. The key, however, is to exercise moderately and progress slowly. Here are guidelines and exercises that will help you safely and effectively include exercise in your postpartum recovery.

Postpartum exercise pointers

Start by consulting your doctor before beginning any exercise program. In general, most moms should give themselves up to 4 weeks following delivery to recover. Those who have a cesarean section or medical complications may need additional time to heal.
The American College of Obstetricians and Gynecologists reminds new moms that many of the changes that took place during pregnancy will persist for 4 to 6 weeks following birth, so you should resume exercise gradually.
If you develop severe or chronic pain, increased vaginal bleeding or discharge, faintness, nausea, shortness of breath, extreme fatigue, or muscle weakness, stop exercise and consult your doctor immediately.
Make sure your exercise shoes fit properly. Your feet may have increased up to a full size following pregnancy. Don't squeeze your feet into too small shoes -- it can cause chronic foot problems.
Find a bra that provides support without chafing or discomfort. Some nursing moms find that wearing two exercise bras provides comfortable support.
Keep a water bottle handy and drink frequently. You need additional fluids when breastfeeding and with exercise. It's also a good idea to have a high protein and carbohydrate snack an hour or so before exercise.
Make sure your fitness program includes aerobic, strength, and flexibility components as well as a warm-up and cool-down.
Try to spend 20 to 60 minutes 3 to 5 days a week doing some form of aerobic exercise. Activities such as walking, biking, jogging, cross-country skiing, and swimming are great ways to get into shape. Choose an exercise that you enjoy and can easily include in your schedule.
Listen to your body and slow down or rest when you feel out of breath or uncomfortable. Increasing your exercise time and intensity too quickly sets you up for injury.

Exercises for new moms
All new moms can benefit from exercises that strengthen their pelvic floor and abdominal muscles. These muscles, which were weakened during pregnancy, need specific work to increase tone and prevent the development of incontinence and back problems. The following exercises will help you safely target and strengthen your tummy and pelvic floor muscles.

Pelvic floor exercise
The muscles that form the pelvic floor play a vital role in providing support. If these muscles are weak, problems with urine leakage (incontinence) can result. Pelvic floor exercises (sometimes called "Kegels") can help strengthen these muscles. These exercises are simple to perform, but to be effective, you need to learn how to contract the correct muscles.

The pelvic floor muscles form a figure 8 around the area that surrounds the urethra, vagina, and anus. You can feel the muscles contract by placing your fingers on your perineum (the area between the vagina and the rectum) and squeezing as you would to stop urine flow. You should feel the muscles pull up and away from your fingers. There are several methods for strengthening the pelvic floor:

Pelvic floor exercise 1: Slowly contract your pelvic floor muscles and hold for 10 seconds, then slowly release.
Pelvic floor exercise 2: This exercise consists of quick flicks where you pull the muscles in tight and fast then release them quickly.

You should build up to 20 repetitions of each exercise, 5 to 10 times each day. Try to make a habit of doing them during certain activities, such as feeding your baby, showering, or brushing your teeth, so you're reminded to do them each day. For the first 4 to 8 weeks following delivery, leaking a small amount of urine when you cough, laugh, or exert yourself is not abnormal. If leaking persists, it's a good idea to seek help from your doctor.

Lying back bend
This exercise will help stretch and strengthen your back. Start slowly and don't force the stretch -- it will take time to progress. Lie on your tummy with your arms at your side, elbows bent and hands at shoulder level, palms down. Slowly press your body up, keeping your hips touching the floor until you feel resistance in your lower back. Return to the floor. Repeat 3 to 5 times.

Standing back bend
This stretch will help prevent low-back tightness. Stand with your feet shoulder width apart. Put hands on your lower back, breathe out slowly, arch your back, and look up at the ceiling. Go only as far as is comfortable. Repeat this exercise after every feeding and diaper change.

Sahrmann's abdominal exercises

Sahrmann exercises were developed specifically to target the area of your tummy most in need of strengthening after delivery. Although there are a series of 5 exercises, these first 2 will get you started:

Sahrmann exercise 1: Lie on your back on the floor with your knees bent and your arms at your side. Tighten your tummy by pulling your belly button toward your spine. Keep breathing as you hold the muscles in, and slowly slide one leg out until it is straight with the floor, then slide it back to a bent knee position. Relax your tummy. Repeat the process with the other leg, keeping your tummy contracted as you slide your leg. When you can comfortably do 20 slides with each leg, progress on to the next exercise.
Sahrmann exercise 2: In the same position as Exercise 1, pull your tummy in and raise one leg up, knee bent, toward your chest. Slowly straighten your leg out so that it is parallel to but not touching the floor. Return to the starting position. Slowly work up to 20 repetitions for each leg. Remember to breathe out as you extend your leg and breathe in as you relax. Stop exercising and consult your doctor if you feel any pain or discomfort.

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