How to return to CrossFit Postpartum

Returning to CrossFit postpartum can be a scary next step. You get the “all clear from the doctor” but what does that mean? Where do you even begin?

We are going to be talking about how to protect/heal your pelvic floor and when to know you are ready for certain movements. 

But in order to know where to start, you first have to understand the changes that occurred. 

Changes that occurred to your body during pregnancy

During pregnancy, your body totally transforms. Many of these are gradual changes but changes nonetheless. Common changes include:

• Increased mobility in your pelvis (also widening of the pelvis)

• Abdominal separation (diastasis recti-don’t fret this is normal)

• Stress on your low back (increased low back curve)

• Increased resting heart rate and blood volume

• Lengthening/stretch on your pelvic floor

• Change in breathing patterns (shallow breathing pattern)

Although all of the changes are NECESSARY and NORMAL, the goal of postpartum recovery is to undo these changes. 

We need to:

• Strengthen the pelvic musculature

• Regain core strength/coordination

• Improve back strength

• Restore pelvic floor strength and mobility 

• Restore normal breathing pattern

Next, we need to understand the changes that occurred during delivery

Vaginal Delivery Considerations

Did you know that your pelvic floor muscles need to stretch between 200-300% percent to allow a baby to be born. Sometimes medical intervention is necessary (like forceps or vacuums). When this occurs, your pelvic floor needs to heal from the stretch injury, there is often more trauma when these interventions are used. Tearing can also occur, which results in more injury to the pelvic floor. All of these factors need to be considered when discussing returning to CrossFit. 

C-section

The most important thing to understand about a c-section is you just had major abdominal surgery. These tissues need to heal. The scar needs to be able to move and tolerate stretch across the abdomen. Core and gymnastics movements are going to take longer for you to return to. 

It is also important to remember that even though you had a c-section, you still may have decreased strength/lengthening of the pelvic floor (After all, your pelvic floor still supported the baby for ~9 months!)

How will these factors influence your return to CrossFit?

As you can see there are many different factors that are unique to you and your postpartum journey. All these factors will influence how quickly and to what degree you can return to CrossFit. 

Going forward you need to understand what to look out for. This includes:

1. Increased bleeding (early postpartum): Remember that can be normal for the ~8 weeks postpartum. But if bleeding increases, often this means you are doing too much too soon. Consult with your healthcare provider. 

2. Leaking urine or feces: Stress urinary incontinence (SUI): is usually the most common which causes leaking either during coughing, sneezing, laughing, jumping, or exercise. This is often a result of increased intra-abdominal pressure. Many people assume that this is due to the weakness of the pelvic floor. But this isn’t always true. Oftentimes (especially in weightlifters) it is too tight! Because of this, an assessment from a pelvic floor physical therapist is important to help ensure you are doing what is needed for YOUR pelvic floor.

3. Vaginal heaviness or bulging, deep abdominal ache: These are often symptoms of pelvic organ prolapse (POP). POP is the laxity of one of the vaginal walls causing due to the descent of one or more organs to come closer to the vaginal opening. Many women become very concerned and may even be told they can’t return to weight lifting. However, there are many ways to return to lifting. Consultation with a pelvic physical therapist can help guide you back to lifting AND protecting your pelvic floor.

4. Coning or doming along the midline of your core: This coning or doming is referred to as diastasis rectus (DR). This is very NORMAL and in fact, 100% of women will have this (because the baby has to grow somewhere). This can be often blown out of proportion and scare people into not exercising. But, women return all the time to exercise, you just need to know what to look out for. 

   • When you start to see coning or doming, it is a sign that you are pushing your body past the point it is ready for. That doesn’t mean you can never do that exercise, it just means that you need to get stronger first and learn how to manage intra-abdominal pressure. 

Now that you know what to look for, what is next?

It is important to remember that the “all clear” is a starting point. That does not mean go and PR your next lift or immediately start doing ALL CrossFit movements. All of the following are important variables to GRADUALLY progress and overload:

• Volume

• Load

How gradually improve the volume

Remember there are many ways to adjust volume, but here are just a few ideas

• Fewer days a weeks

• Fewer sets and reps

• Return to upper body strength first

• Add in cardio later

The problem with volume is most people might feel fine during the workout. For example, you might start leaking or feeling bulging later in the day after a workout. This means the pelvic floor wasn’t ready for that volume/load/impact. 

How to gradually return to load

It is super to remember that even if you have been lifting heavy during pregnancy, you need to let your core AND pelvic floor heal. Your body needs to adjust. Give it time. It can take 9-12 months to return to pre-pregnancy PR’s. 

Considerations for impacting (jumping and running)

Running and jumping or activities that should ideally be introduced after 3 months postpartum. These place a large amount of load/stress on your pelvic floor. After 3 months, start gradually by:

• Lowering the box

• Fewer reps

• Don’t rebound

Considerations for return gymnastic work

Due to the demand on your core during gymnastic work, we need to consider the following factors when returning to the bar:

• C-section scar mobility

  • In movements such as the kip, it places a lot of stretch through your abdomen. This often feel painful or uncomfortable. You need to slowly expose yourself to stretching across your c-section scar, improve scar tissue mobility and desensitization. 

• Upper body strength

  • Usually pulling strength is decreased as many of these exercises were probably modified during pregnancy. 

• Bodyweight

  • Remember that you need to make sure you have the strength and ability to transfer force at this new bodyweight

• Core control

  • Deep core muscles to regain strength and control. Don’t skip the groundwork on core work

Considerations for return to weightlifting postpartum 

Let’s chat about the variables we need to consider when returning to the clean and jerk and the snatch postpartum:

• Core control: YES. You need to be able to create good tension in your brace and gradually return to Valsalva 

• Balance: You need to re-establish your balance (your center of mass not only changed throughout pregnancy but also changed again after delivery!). 

• Impact: Leaking often occurs due to the increased impact (especially from the clean). Start slowly, with lighter weights, and no feet variations. Progress as tolerated from here. 

• Changes in mobility: many women are more mobile (thank you hormones) after pregnancy. This may cause you to have increased depth at the bottom of your squat. Remember this is a new range for your body and you are probably a bit weaker in this new range. Incorporate tempo squats and bottom-up squats to help with this!

YOU GOT THIS

Returning to CrossFit postpartum is no joke. It will take time and dedication but you can do it. Get help if you need it. There are many healthcare providers that are ready to help you succeed. 

Schedule your free consultation now if you are ready for some extra guidance or assistance getting back to CrossFit! In-person appointments are available in St. George, UT or can be done via phone consultation.