Dr. Rachel Miller is a Doctor of Physical Therapy, certified Pilates instructor, and founder of The Pilates PT. She graduated cum laude with a B.S. in Psychology from The Ohio State University and then earned her Doctorate in Physical Therapy from Northwestern University in 2004. She has advanced training in manual therapy, women's health, and Diastasis Recti. She is passionate about education and believes that understanding your body makes exercise even more effective.
Her dance background and love for fitness led her to Pilates. She became certified in mat and standing Pilates through the Physical Mind Institute in 2008 and has been teaching group mat classes ever since. She continued her Pilates training by earning a comprehensive equipment certification through Balanced Body. She also earned her group fitness instructor certification from ACE. When not treating patients or teaching classes, she enjoys spending time with her family and friends and working out. She is constantly trying to balance motherhood, marriage, friends, work, and self care.
Many moms are eagerly awaiting the green light to return to exercise at their appointment with their OBGYN around six weeks postpartum. Once you are given the green light from your doctor, what next? I see many moms jump right back into intense workouts- they want to shed the baby weight and get back to their pre-pregnancy activities. But is that best starting place?
Let's think back for a moment... Your body has experienced some major changes during pregnancy over the last nine months- including growing a tiny human. Then, the baby had to come out- either vaginally, where there is often tearing, or via c-section, which is a big abdominal surgery. Your body needs time to heal. Six weeks is a start but definitely doesn't mean you are fully healed. Let's add to that- most likely at six weeks, you are probably sleep deprived, possibly breastfeeding, and taking care of a newborn! I used to call it a win if I showered and ate three meals a day when my kids were babies. Here are some factors to consider when deciding if you are ready for postpartum exercise:
*Exercise activity during pregnancy- What type of exercise did you participate in while pregnant? At some point, did you stop or have to modify many of the exercises? If you have not worked out in three months for example, you may need to ease back in more than if you were working out up until delivery.
*Pelvic Floor - How are you feeling? Is there any feeling of heaviness in your pelvic floor? Are you still bleeding? Is there any urinary leakage (incontinence) while sneezing, laughing, coughing, jumping, or running? If you answered yes to any of these questions, please discuss with your OBGYN prior to returning to exercise. If you are experiencing pelvic pain, prolapse or incontinence, pelvic floor Physical Therapy may be appropriate.
*Diastasis Recti (abdominal separation)- Our "six pack" rectus abdominis muscle separates in the later stages of pregnancy as our belly gets bigger. That separation should naturally improve by eight weeks postpartum, but this doesn't always occur. Diastasis Recti often does not have symptoms, which means it is very important to check yourself or have your doctor or women's health Physical Therapist check for you. Participating in strenuous exercise- especially abdominal exercise and heavy lifting--- can put more stress on the abdominal wall, so it is important to assess.
* Relaxin- A hormone that is responsible for relaxing our joints and ligaments during pregnancy in order to allow our bodies to change to allow for growing and delivering a baby. It takes months for our relaxin levels to return to normal, even longer if you are breastfeeding. So be aware that high impact, jerky movements or aggressive stretching may not be ideal.
So what type of exercise is best? I like to recommend starting with walking and other light impact exercise. Gradually progress back to high impact and more intense exercise as your body allows. Sleep and nutrition are important for your body to recover from workouts, so if either of those are lacking, you will need to listen to your body even more. I want you to be able to return to whatever activity/sport you love, but I want you to get there in a smart way that your body will appreciate!