Dr. Taryn Kilty

Time for Your Check-up

Ever wonder why the magical time for healing postpartum is 6 weeks? ME TOO!

The truth is…we don’t really have a good reason for 6 weeks.  The American College of Obstetrics and Gynecology’s (ACOG) old recommendations were 4-6 weeks. This guideline could be due to tissue healing time or…insurance coverage. You got it…insurance!

I met with a group of doctors a few months ago and when I asked them this very question their answer was insurance coverage. Sad but true.

The ACOG revamped their postpartum guidelines stating “postpartum care should be an ongoing process, rather than a single encounter and that all women have contact with their ob-gyns or other obstetric care providers within the first three weeks postpartum.”

Yes ma’am…within the first three weeks, women should be  getting care from not only their OB-GYN but other postpartum team members, with pelvic floor physical therapists being one of them.

The 4th Trimester

The 4^th trimester is a vulnerable time for healing postpartum. The 4^th trimester is not just limited to the first six weeks postpartum either, it is Day 1 to 4 months postpartum and honestly can take a full year to get to baseline strength after having a baby.

Your goal as a mom during the 4^th trimester is nurture the new babe and adjust to life as either a new mother or with an additional child in the house. The 4^th trimester is a vulnerable time for our healing bodies. Nutrition and sleep should be at most importance during this phase. During this time, you are building the foundation for fitness. After that, it is about your  capabilities and solid base of strength  rather than a specific time frame.

Do not be a dummy like yours truly! When cleared by my doctor at 6 weeks to return to all things fitness. I decided that the best way to get back into shape was signing up for a half marathon. I put the baby in a mamma-roo and jumped on the treadmill. Lesson was learned the hard way ladies! I started having leaking symptoms, foot pain, and the start of a 6 year struggle with chronic knee pain. My body was not ready.

I think we often forget that having a baby is trauma to our bodies. We need to allow them to heal just like any other injury. Especially if you had a C-section. This is major abdominal surgery! Just because you had a C-section doesn’t mean you are exempt from pelvic floor dysfunction either. If you experienced a perineum tear or an episiotomy, this too counts as a muscle tear!

How would you treat a quad tear or a rotator cuff tear? Would you go out and start running or throwing a baseball at 6 weeks? NO! You are doing more harm than good if you don’t start building a foundation of strength first before you jump back into life.

The reality is, mom’s do A LOT! We have to carry the groceries, while toting the giant baby carrier, and baby! If we don’t build the functional capacity to take on these everyday activities, our bodies will break down and injury will occur. This is why it is never too late to start building your strength base postpartum.

I put together a handy timeline to build strength postpartum. If you are years postpartum and never took the time to regain your strength, this may also be a great starting point for you!

Rebuilding Postpartum

The first 4 months postpartum is about rebuilding a foundation for fitness. After that, it is about the individual’s capabilities and solid base over time frames.

1-2 Weeks Postpartum

Goal: Take time to heal and rest

Taking care of a newborn is tough work! Take this time to try and get as much rest as possible and allow your body to heal. Make sure you are drinking plenty of water and getting good protein into every meal to help with healing.  You may start short walks during this period. By short I mean 5 to 10 minutes.

 

3-4 Weeks Postpartum (add two weeks if you had a C-section)

Goal: Working on your breath, regaining thoracic and rib mobility, and start beginning pelvic floor connection exercises.

Exercises:

• Increase your time of walks working up to 30 minutes
• 90:90 Breathing
• Pelvic Floor Contractions
• Sidelying Rib Mobility
• Squat (do not bear down)
• Bridges

 

4-8 weeks Postpartum

Goal: Working on thoracic mobility and building strength with more loading exercises.

Exercises:

• Incorporate low impact cardiovascular exercise: elliptical, stair climber, biking, rowing
• Continue 90:90 exercise
• Squat (do not bear down)
• Abdominal Work with marching progressions
• Foam roller thoracic mobilization

 

6-10 Weeks Postpartum

 Goal: Monitor doming with abs and pressure management while progressing exercises. Can start to add some weight to exercises.

Exercises

• Deadbugs
• Light deadlifts
• Progress Squats
• Lunges
• Rows
• Dumbbell Press Seated or ½ kneeling

 

Things to Monitor

• Doming of Abdominals
• Pressure in pelvic region or vagina
• Leaking- solids, liquids, gases, organs
• Fatigue
• Milk production
• Abnormal soreness that doesn’t get better after a few days of rest
• No breath holding (later on if you are going to lift heavy but now is not the time)

 

Tests for Re-entry back into Fitness (12 weeks)

• Pelvic Floor Muscle Contraction
  • 10 reps at 8-10 second hold f/b 5 quick contractions
• Double Leg Jump Test- 10  jumps
• Single leg jump test- 10 reps each leg
• Diastasis Recti Assessment-Find Here 
• Single Leg Raise Test
• Single Leg squat test- 20 reps each side
• Single leg bridge- 20 reps each side

For demonstrations of re-tests to fitness check out my social media pages tomorrow. Follow me on Instagram or Facebook @drtarynkilty or if you are mom and want to be a part of a super cool mom group, join us on Might As A Mother on Facebook!

As always…reach out to me for questions!

-taryn