Tuesday, July 1, 2014

Postpartum TriFit Update

Long time, no see, folks! After 29 hours of labor, I reasoned that a little break was warranted, since that amounts to the time spent doing 2 Ironman races! Violet is 7 weeks old now, and I have gone for 3 runs in the last week. I honestly thought I would be running sooner than that since I ran up until 39 weeks while pregnant (just swimming and walking once post-dates…mostly out of exhaustion and this weird feeling in my pelvic floor when I was running that last time out). I kind of assumed I'd be ready to rock 'n roll by 2 weeks postpartum after a vaginal delivery, probably because I read blogs/articles about women doing Olympic tri’s 5-6 weeks postpartum; clearly, everyone is different. I didn't really think I would listen to my OB when I called to ask about exercise and they told me to hold off until my postpartum check-up. Good thing my body knew to remind me. REALITY CHECK! Just walking 4 days out from a vaginal delivery was uncomfortable. Your body makes leaps and bounds by 2 weeks postpartum, and I was even napping a little by then and getting some sleep, so I thought about running (CRAZY IDEA), then got mastitis (I don’t recommend it), then recovered, then had another setback, and this all brought me to the 6 weeks postpartum that is recommended anyway. Go figure! Maybe doctors know what they’re talking about? I won’t tell anyone if you won’t. ;)

But, seriously, folks, having a baby—it’s kind of a big deal—maybe take some time off for once! If you have a more complicated delivery like I did, your obstetrician may tell you not to exercise for the first 6 weeks postpartum. This is always the case with a C-section because it is an abdominal surgery and the abdominal wall muscles need time to heal. Unless you have had a C-section or your doctor tells you otherwise, it is actually safe to go back to light exercise as soon as leave the hospital. Those that are very athletic may have to adjust their perceptions of what light exercise is--it is actually walking, swimming, stretching, yoga, Kegels (we will be talking a lot about this in a future blog!). And then you can progress from there, depending on how you feel.

So far, it’s really amazing and refreshing to be back to running. I miss my time with Violet, but it rejuvenates me so much to get my fresh-air-sunshine-sweat-endorphin-high, and then I come home to my baby girl and have so much more energy to take care of her, and I just fall in love with her all over again. Being a new mom is challenging, and it’s hard to remember the little things you need to do for yourself (like brush your teeth or eat a snack…or, in my case, go for a run) that will enable you to be a better mom and take care of your child. That being said, it will be interesting over the next several months as we roll through some of these postpartum fitness topics to see just how much fitness I am doing! I obviously want to lose more of my pregnancy weight (stay tuned), and I just miss feeling like a triathlete, to be honest. BUT, I will also be a full-time mom, full-time resident, and full-time Ironsherpa for my husband. I hadn't planned on doing very much endurance until after Curtis's race in November because we have decided to alternate who is racing so the other person can be more dedicated at home. I am, however, recently thinking that it might be longer than I thought. Violet is just so fun! And I am already missing so much time with her now that I am back at work. I mean, could you leave this face every day? 

EARLY POSTPARTUM EXERCISE TIPS:

-PUSH IT UP!
Push-ups strengthen your arms for holding your baby as he/she gets heavier and for getting rid of that pregnancy flab. There’s such a thing as mom strength and it comes from toting your baby/kid around as he or she gets bigger, and if you maximize the fun bouncing and swinging things you do, you’re golden…so pick your poison- push-ups to prepare or workouts later :)

-KEGELS!!!!
Ugh...these are super important. More on how to do them and why you should in an upcoming blog post.

-ABS
You may still have a space in your abdominal wall called diastasis recti where the muscles haven't come back together yet. Let's work on it!

Sometimes we use our Ergo in the apartment
when Violet gets very fussy...movement makes
everyone feel better, it seems! Not just adults!
-WALK!
One of my favorite things to do so far is to put Violet in a Boba wrap or Ergo carrier and just go for an adventure--leaving the apartment for an outdoor walk is an adventure when you're on maternity leave and also when you're a newborn, it turns out! This is really one of the easiest and most fun ways to get back to light exercise postpartum--go for a walk with your baby. It's great for both of you! A properly fitting stroller to accommodate a newborn without head control is also fine to use. But the great thing about carriers is that they remind the baby of being in the womb, similar to skin-to-skin time--they can hear your heartbeat and they are warm and can smell mommy! Women all over the world carry their babies on their person- see what all the fuss is about. Stroller or carrier, the best part is that both of you get fresh air. My mother-in-law swears Violet sleeps better after getting fresh air during the day. It's just healthy, folks, and a great way to fight baby blues and ward off postpartum depression.

-SUNSCREEN!
Remember a hat or covering clothing for your baby if you're taking him/her with you outside. No sunscreen for your baby until 6 months of age. This is because clothing is more protective for sun exposure anyway and new baby skin is oh so sensitive.  Sunscreen for you-- always, but especially postpartum. Any dark spots or melasma that you have from the hormones of pregnancy are only going to worsen if you go out in the sun without skin protection. So, hat- yes, glasses- yes, sunscreen everywhere- yes.

-HYDRATE/SLEEP/REPLENISH…
More on this when we talk about nutrition and exercising for the nursing mom, but even if you’re not nursing, err on the side of too much fluid intake. Another concern is sleep. It can be non-existent early on with a new baby. I know for me I felt like I adjusted to a much lower level of sleep than I was used to, especially once going back to work and coupling residency hours with mommy hours, but, remember that regardless of what you adapt to, your body will train and recover better with more sleep. If baby had a bad night, maybe skip the a.m. workout in favor of some extra shut-eye—that is, if your circadian rhythm isn’t totally caput like mine is! Last, remember to eat frequent nutritious meals to keep up energy and recovery; you have a lot of nutrient stores to replenish. You’re still anemic, whether it’s functional anemia or just a recovery anemia from childbirth, so continue taking those prenatal vitamins to pick up the slack.

-WATCH OUT, but enjoy the journey
My husband always makes fun of how much I fall—while walking, while running, while cycling. (I don’t fall in the pool, but probably only because it’s not possible!) I never really fell walking before pregnancy. There’s something about the increased joint laxity and the changes in your center of gravity that really throw you off! Now, postpartum, it’s time to get used to a modified body—it isn’t quite your pregnancy body after those first couple weeks of battle-scar recovery from birth and it isn’t nearly your pre-pregnancy one yet! Your body still has the increased joint laxity that it did during pregnancy when you are postpartum, so watch your footing even while walking and especially once you start running and biking. Getting the most sleep, hydration, and nutrition possible prior to and after workouts in prep and recovery will help you be alert and focused and avoid any unnecessary injuries. Your body has to re-learn your pre-pregnancy forms for running or any other exercise, so give it time to take shape and find its balance. Remember, this will be a journey back toward previous fitness.

-Swim
Probably safe earlier on than running is. Make sure your perineal tears or episiotomies have completely healed. Think about it- you wouldn't swim with an open wound, would you? For most people, I think this means wait at least 2-3 weeks.

-Bike/Run
Listen to your doc and then to your own body about when you are ready for these. I'm not too jazzed about getting on a bike anytime soon and will just settle for running now. Old-school obstetrical thinking is to wait 6 weeks to run since the uterus hasn't gone back to normal size until then. This doesn't make a lot of sense to me as an argument since I ran with a HUGE uterus and a full-term baby in it during pregnancy, but whatever. Listen to your doctor, and if you're not going to do that, at least listen to your body. To quote one of my mentors, "If it feels squishy, then maybe back off a bit." A lot of the new obstetrical thinking is to allow women to exercise after uncomplicated deliveries as soon as they are feeling up to it, within reason. Remember that you need your pelvic floor for the rest of your life and don't want to be incontinent during running or other everyday life activities, so taking 6 weeks off and spending that time with your baby really isn’t going to kill you (It didn't kill me.), especially if that’s what your body is telling you to do.

After a long winter and 6 weeks without running, I have such an endorphin high every time I go out for a run in this glorious, sunny summer we are having. It gives me so much energy to come back to my daughter, and there's no better motivation to finish strong than knowing your daughter is waiting at home for you (ok, for your boobies, but still). It'll be a while before Violet is old enough to go for runs in a stroller with her mom and dad and even longer before she's out doing her own fitness...but more on running stroller safety and fun topics coming up soon! I hope you have all missed the blog because we have some exciting posts on deck and lots of ideas and inspiration for the future! For those of you who haven’t checked the blog in 2014, you have a few posts to catch up on and keep you entertained, but some topics to look forward to in the coming months are:

For mommy:
- IT Band Syndrome
- Patellofemoral Pain Syndrome (we did this one last blog, but let me assure you it still applies postpartum, so read up!)
- Pelvic Floor Syndrome

For mommy and baby:
- Exercise & nutrition for the nursing mom
- Running stroller safety

For baby/kids: 
- Intoeing
- Neurodevelopment and sports training

So stay tuned!


Some helpful postpartum links for now:


The extreme:

A step-by-step slow progression:

Other perspectives/blogs: