Tips For Understanding And Running With Your Post-Pregnancy Body

Read my latest post for Women's Running here or below:

Pregnancy can be a lot like training for an endurance event–it’s just spread out for nearly 10 months. But once the “race” is over, the accolades of your accomplishment don’t fade away: you’re still in charge of keeping a tiny human alive, all while trying to recover physically and keep your headspace balanced. When you do come out of the fog of those early weeks of parenthood and want to resume some sort of exercise routine, what should you expect? Here are some tips about how to approach the journey of postpartum exercise.

First Postpartum Checkup: Ask Questions

Usually this occurs about six to eight weeks after delivery. In most cases, your doctor will “clear” you for exercise. Make sure to probe about what this actually means and discuss what your goals might be. A lot of this depends on your previous activity history, as well as your labor and delivery. Even if you were active throughout your pregnancy and had a fast labor, it still takes weeks or even months for your body to heal. Have your doctor examine your pelvic floor strength and check to see if you have any abdominal separation (which is quite common). Ask for a referral for a pelvic floor therapist if there are concerns, or get a second opinion if something doesn’t feel right.

Be Body Positive

Both pregnancy and exercise allow you to get to know your body in different ways. If you were active while pregnant, it probably gave you a deeper understanding of how your body responds to stress, as well as to changes in weight gain and distribution, blood volume, oxygen capacity and digestion. It also likely helped you understand your approach to body image and self-appreciation. During labor, your body is literally pushed to its extremes in every way–physically, mentally and emotionally. When the baby does arrive, our bodies can feel like a wreck of what they once were: we’re engorged, bloated and squishy in areas that we don’t want to be. In those early postpartum weeks and months, the physical and emotional extremes linger, making it easy to slip into negativity. While you may feel like there are never enough hours in the day for yourself, try to practice mindful body positivity. Replacing negative thoughts with positive ones during exercise will leave you with a stronger core and better sense of self-worth.

Prepare To Work Out With A Stroller

Once the baby arrives, you may need to do the majority of your workouts with a stroller. You will probably run at a slower pace: after all, you’ll be pushing the stroller, the car seat (if your child is younger than 6 months old) and your baby! Chances are, that’s at least 25 extra pounds that you are pushing forward. This can be quite physically challenging, so starting with a run/walk method is quite effective. If you don’t have a jogging stroller, long walks and even stationary strength training with the stroller are great ways to get your heart rate up. It’s always an added bonus when your baby falls asleep: being able to have your baby nap AND get a workout in can leave you with a sense of accomplishment. Embrace that “super mom” feeling!

Get Good Breast Support

If you plan to do any sort of impact activity, you’ll know immediately if you need a more supportive sports bra the second you take your first step out the door. Wearing two bras isn’t ideal, so invest in a supportive bra; or, better yet, get a sports bra specifically designed for nursing, if you are actively breastfeeding. Since you may need to stop mid-run to breastfeed (or know you’ll need to once you return home), having a nursing sports bra can make your life a little easier.

Be Flexible With Your Time

Regardless of whether you’re breastfeeding or bottle-feeding, you’ll need to be flexible with the time you allot for your workout and plan your route ahead of time. There have been countless times when I had to stop and feed my son on a park bench mid-run, which added at least 30 minutes to the time I’d planned to be out–all because my little man decided he was ravenously hungry or had an epic diaper blowout (or both).

Adjust Your Pace

When you resume running after pregnancy, your perceived effort and sense of pace will likely be different. In a sense, you may feel like you are starting running all over again. Even if you aren’t training for anything, you should approach running as if you are and gradual increase your distance, intensity and speed.

Strengthen Your Core

Your core is weak(er) postpartum, and you may even have some form of diastasis recti (the natural separation of the two abdominal walls). A weak core may cause a muscular imbalance (or can lead to future injury) in the hip flexors, glutes, lower back and legs. It’s a good idea to complement running with strengthening exercises that focus specifically on the postpartum body, including preventative and corrective diastasis recti exercises. You can start with some basic diaphragmatic breathing–which, done regularly, can help to gradually knit the abdominal wall back together.

Expect Soreness And Fatigue

Even if you ran all nine months of your pregnancy or exercised in other ways, chances are that your stride length will have decreased, your pace will have slowed and your form will have shifted during that time. When you start running again, be very cautious with your pace and increase your distance gradually. Relaxin, the hormone that allows your ligaments to stretch and expand over the course of your pregnancy, is still at an all time high for as long as six weeks postpartum. Once you’re cleared for exercise before or after this period, you will still be at risk for over-extending your muscles and ligaments. Starting at a slower pace is key to preventing injury.

Pay Attention To Your Pelvic Floor

No matter how many months postpartum you are, make sure to pay attention to your pelvic floor (the hammock-like structure of muscles and ligaments that support the organs of the pelvis, which include the bladder, uterus, bowels and vagina). High-impact activities like running can further weaken your pelvic floor, which can cause a variety of minor or major issues ranging from occasional urine leakage to organ prolapse. You’ll want to make pelvic exercises part of your regular routine, even if you don’t notice any problems. Sometimes it’s only when you exercise at a higher intensity, cough or sneeze mid-run or are more tired than usual that you notice a problem, so don’t assume you are exempt from practicing pelvic floor exercises. These muscles also weaken with age and inactivity, so making them part of your routine is critical.

It’s Worth It

Are all of these things really worth the trouble just so Mom can have a few active minutes to herself? Your body has endured a tremendous number of changes from pregnancy to postpartum, so of course it’s going to feel hard in the beginning. Acknowledging this and easing back into exercise with a better awareness of our new bodies takes time. Embrace the process and your new body. Focus on the positives, the milestones and the way you’re feeling. Getting back in touch with your body and finding a rhythm and routine takes a lot of practice, so be kind to yourself as you adjust to your new routine.

Downsides to Running a Marathon

It's no secret how much I love running, especially long distances.  But there are some downsides, or at least some things that one ought to consider if training for marathons.  Read all about them here, in my latest piece for POPSUGAR, or below:

Running a marathon is a huge accomplishment. No matter what one's finish time is, crossing the finish at 26.2 miles is a major milestone in anyone's life. Whether it's a first marathon or a 50th marathon, it is the culmination of months of training, time, and above all, dedication to running. The feeling of elation and self-awe is something that never really leaves you when you finish. Even the most confident runner will remember his or her first marathon, and that feeling of "I did this" will stay with them forever. It's an amazing feeling to accomplish something so big after months of wondering how it could be possible to get there. Despite all this, there are some downsides to consider when running a marathon.

1. Marathons may make you gain weight

Think all that running and high mileage weeks will make the pounds melt off? Think again. When you're running, you need fuel. You'll probably be hungrier than ever before. You'll also be gaining muscle. If you're not varying up your routine with pace, intervals, and elevation, your body may start to adjust to one thing and therefore be less efficient about burning calories. If you're not careful, weight gain can happen. If this is the case, pay attention to eating more balanced meals during training — full of healthy protein and whole grains — so you'll stay fuller for longer. 

Of course, gaining a couple pounds isn't necessarily a bad thing, as a lot depends on your perspective. If you feel stronger and proud of what your body can do, then embrace those few extra pounds. If the unexpected weight gain causes you to feel down on yourself or you feel like it's somehow hindering your performance, figure out why this may make you unhappy and reconsider what your primary goal was when training for the marathon. Never define your self-worth by the number on the scale. Training for a marathon should not be about trying to lose weight, or certainly not the primary reason. It may be a time goal, just finishing the race, overall self-improvement, or becoming a stronger person — physically and mentally. 

 

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2. Marathons may hurt your immune system

Regular exercise is great for your immune system, but sometimes too much exercise or extremely taxing workouts can actually suppress or weaken it. If you're like me and have found yourself consistently coming down with a cold either right before a marathon or immediately following one, you know firsthand this is true. Certainly proper rest and nutrition can help counter this, but it's worth acknowledging that running a marathon can be hard on not only your muscles but the rest of your body's systems. That's yet another reason why one should allow one's self to fully recover in between intense workouts and certainly following a macro-training cycle (i.e., training for a marathon).

 

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3. Marathons increase your risk of injury

Statistically, the higher the mileage, the higher the risk of injury. Running so many miles and so frequently may also exacerbate old injuries — or create new ones. So, in training for any long distance race, you'll need to be extremely careful with how you progress the more you spend time running and logging high mileage. It's very important that when beginning any training plan, no matter what the distance, there is a base-building period before the training season even starts. During training, it's so important that you allow yourself at least one or two rest days each week, and on your easy running days, you slow your pace and your effort down significantly. Doing too much, too soon, is one of the cardinal rules of what not to do when running or exercising in general, as this will inevitably lead to over training and injury.

4. Marathons are addicting

It's true that when you accomplish something you didn't think you could ever do before, you might want to do it again. Races tend to be like this . . . especially marathons. You finish one, and then you realize that maybe you could either do better next time, or maybe you crave that feeling of accomplishment all over again, so you sign up for another race. 

When I decided to run my first marathon, I had only previously run a half-marathon and was an inexperienced runner. I probably did everything wrong in my training and during the race in terms of strategy, nutrition, hydration, etc., yet I still finished with a decent time. Even though I could barely walk in the days that followed, I knew I had to do another. I wanted to be faster. I wanted to say that I could run a marathon in under four hours. I wanted to be smarter about my training the next time around. Now, eight years later and seven marathons under my belt, I'm a Boston Marathon qualifier, and yet I still want to run to beat my current PR. I know at some point I will "hit a wall" and start to slow down — this is inevitable — but because I accomplished something I never thought I would be capable of doing, I wonder if I can do better than before. So can self-improvement be a bad thing? Perhaps. One needs to be very careful not to push your limits too much. This could lead to physical injury, burnout, or being so compulsive that running comes at a sacrifice to the rest of your life. Allow running to be just a part of your life, but don't let it consume you. 

5. Marathons change your perspective

After running a marathon, suddenly a half-marathon or 10k and definitely a 5k can seem too short. When you train for a marathon, you're used to thinking about distance in terms of "long runs" or "medium" runs, combined with tempo, intervals, and hill workouts — which are still usually more than a couple miles. During training, short runs sometimes get sidelined, or aren't thought of as very important as they tend to get classified as "shakeouts" or "warm-ups." Running two, three, or even four miles may be perceived as not a legitimate running distance. Yet it shouldn't be this way. Running any distance — no matter how far or how slow is a workout. It's always better than the alternative. But after taking a hiatus from running, whether by choice or because of injury, starting all over is really hard. Suddenly, a "short" run feels incredibly difficult, as if it's a marathon itself, and yet it's nowhere near the distance of one. This can be a huge blow to one's confidence. Try to separate the past and the present. There will always be a constant urge to compare your new self to your old self. Think about the marathon that you ran as a physical accomplishment and the "starting over" as more of a mental test. Move past the negative thoughts, and just focus on the very act of moving forward.

Despite these drawbacks, there are so many wonderful things about training for and running marathons, but it's worth being realistic about our reasons for doing so. Especially when trying something new, it's always important to factor in the pros and cons. Since most people spend months training for a marathon, it's important to know that there can be downsides when deciding to train for one. And, while marathon participation is at an all time high, this doesn't mean they are for everyone. Just because you may not have run a marathon, a half marathon, or any race distance for that matter, doesn't mean you're less of a runner than the experienced marathoner. What matters is that you move, and you allow running to be part of who you are, but not let the distance you decide to run define you.

The Elephant in the Room: Running & the Pelvic Floor

A few months ago, a new app, B-wom, which acts as a personal trainer for your pelvic floor, contacted me about being an Ambassador to their platform.  Definitely check it out--having more control and awareness of your pelvic floor is SO IMPORTANT in women's health.  I was invited to share my own experiences with them about fitness and my postpartum journey on their blog; you can read it here or below:

When I was discharged from the hospital after having my first child, I was given a “welcome home” packet with information about how to care for my newborn, breastfeeding advice, warning signs to look out for in the immediate days postpartum, and general advice about my new postpartum body.  In the fog of new motherhood and extreme sleep deprivation, I barely touched the pages of literature that were there to “aid” me. I spent the initial postpartum days hobbling around our NYC apartment trying to figure out how to swaddle my baby, change his diapers, and breastfeed, all while trying to wean myself off pain medication I was given to help me cope with my badly bruised tailbone, tearing, and my episiotomy.  

Unlike many other countries, in the US, a couple xerox copies of literature are generally all the help new mothers are given immediately after having a baby, if any.  A lot of times there isn’t even a couple printouts of information hastily thrown at the mother as she’s leaving the hospital to help guide her in the unchartered world of motherhood. Aside from 6-week postpartum checkup, you’re on your own.  Unless you’re willing to pay hundreds if not thousands of dollars for a doula who may (or may not) provide a postpartum follow up or have a lactation consultant visit your home, the proverbial village of raising a child and helping the mother recover doesn’t really exist. 

When I finally got around to reviewing the literature during a neverending pre-dawn cluster feed, there was one paragraph that mentioned women should start doing pelvic floor exercises “immediately postpartum.”  I honestly didn’t really know what that meant at the time, let alone the importance of this.  Frankly, thinking about “exercising” my pelvic floor made me nauseous, as EVERYTHING hurt so much in that region.  Anything that involved sitting, squatting, or going to the bathroom was excruciating.  Walking was incredibly difficult, as was going up and down stairs. Little did I know that a relatively “normal” vaginal birth would be just as difficult to recover from than a C-section.  As a person who was very used to an active lifestyle pre pregnancy and throughout the nearly 10 months of it, not being able to do the most basic movements without debilitating pain was a huge blow mentally, emotionally, and physically.

 

Elephant in the Room by Mark Bryan

Friends, family, and even strangers that I came to know through online blogs told me this was completely normal to feel this way. Everyone said to take it day by day, and they were right.  One week postpartum, I was able to walk multiple city blocks and navigate subway stairs, though very slowly and gingerly.  Two weeks, I was up to over a mile.  By 4 weeks, while I still was bleeding occasionally, I was able to walk 4 miles.  It was still painful from time to time, especially when I overly exerted myself.  I had to be very careful.  And yet by the 6-week mark, I was able to go on my first 3 mile run, which (fortunately) was nearly pain-free.  Yet things felt “different” in my pelvic region in the weeks (and months) that followed.  It felt “heavy” and often sore, and I sometimes leaked urine if I wasn’t careful.  When my doctor “cleared me” for exercise at 6 weeks, I mentioned this to her.  It seemed embarrassing to talk about it at first.  It was only during that checkup that she told me my pelvic floor was weak and that I should be doing pelvic floor exercises every day, and equally as important, she told me the reasons why. She even showed me how properly release and contract my muscles.  Little did I realize that while all OBGYN’s should be encouraging their patients to do this, it’s actually not very common practice.  How many other women out there don’t even realize this is so important to not only know about, let alone do?

Pelvic floor muscles are really a hammock of support for your bladder, uterus, vagina, and rectum.  So if your pelvic floor muscles are weak, these areas won’t function as well as they should.  The pelvic floor is also part of your general core. When you think “abs” and “core”–this also includes your pelvic floor muscles.  They support your lower back (lumbar spine area) and your hips.  So, when one has weak pelvic floor muscles, there can be cascading negative effects on all these areas.  Postpartum women are more apt to suffer from these effects, as especially if there is vaginal delivery, there can be some form of “trauma” to this region. Even if there is no tearing or episiotomy involved, the very act of pushing a baby out of the birth canal stretches the pelvic floor beyond its limits and therefore strains and weakens these muscles.  And yet, it’s not just this group of the population that may have issues–it can affect everyone (men and women, of all ages), not just post partum or post menopause women.  

In my own experience, because I talked about my issues with my doctor early on, did more research on my own in the months that followed, and began to integrate pelvic floor exercises in my routine, I was able to resume my active lifestyle pretty quickly after giving birth.  Since I didn’t have any severe issues like organ prolapse and I closely monitored my progress, I even was able to run a marathon less than five months postpartum with little pelvic floor issues during training.  I was lucky.  While I am a more informed individual about the pelvic floor and more attune to its interconnectedness with my own body, I still have flair-ups from time to time, even two years after giving birth.  I still dread coughing or sneezing especially when I am running as I know I may pee just a bit.  I still get embarrassed when I talk about these “incidents” sometimes.  Even writing about my experiences gives me pause.  But being open about this is extremely important to discuss with others.  I’ve now learned so many of my friends and family suffer from a weak pelvic floor, and yet didn’t know what to do, and most just sort of accept it as “that’s life.”  I find women tend to be more apt to think we can handle this on our own, it will go away with time, or “that’s the way things are,” and not to seek help if there is an issue, no matter how minor.  We joke about peeing when we sneeze, but we may not do something about it.

However, there are some solutions.  First and foremost, it’s educating women to be more open about discussing their issues–no matter how minor–with their doctors, and their community.  And taking action to prevent things from getting worse is also key, as inaction can actually make it worse.  Having a weak pelvic floor may even prevent some women from doing things they love to do, or used to do.  Regaining strength and control to these muscles will help, and yet it takes time and regular practice as often as one brushes their teeth.  Talking the right steps to mitigate this can also be at your fingertips -whether it’s finding a physical therapist who specializes in the pelvic floor or even easier- the B-wom app, which acts as your own personal pelvic floor fitness coach.  Seeking help now will give you more confidence in yourself and allow you to move forward and take control of your life.  

The Best Hidden Exercise You Should Do Every Day

This post was originally published in Red Tricycle, where I am also a contributor.  You can also read the whole article here:

Recently, a friend of mine mentioned that she didn’t like running that much.  It wasn’t because she wasn’t in shape, or she wasn’t fast, or she didn’t have the time…it was because she felt like she had to pee every time she took a step and that was holding her back from doing what she once loved to do years ago.

Ladies, if you had to pick ONE exercise to do every single day, it should be training and toning your pelvic floor. 

I used to think that the pelvic floor, or “doing your Kegels” had more to do with enhancing your sexual pleasure than really anything else.  We’ve all seen Sex and the City and heard the talk (mainly from Samantha) about the importance of doing Kegels and why.  It’s true that having a strong pelvic floor can definitely help in this department but that’s only one reason.  The other (in my view, even more important) reasons why having a strong pelvic floor is so important isn’t really discussed as much, or at least as openly, as it should.  Yet it affects everyone (men and women, of all ages), not just post partum or post menopause women.  Especially if you are active, here are some reasons why strengthening your pelvic floor NOW is so helpful:

●The pelvic floor is part of your general core. When you think “abs” and “core”–this also includes your pelvic floor muscles.  In fact, your Deep Core Stability Muscles include the pelvic floor.  Having strong pelvic floor muscles help support your overall core stability and strength.  When you have a strong core, it helps with your overall stability, posture, and form, all of which make you a better runner and athlete.  If you want to be a faster and stronger runner, you should be doing your pelvic floor exercises.

●The pelvic floor supports your lower back (lumbar spine area) and your hips.  If your pelvic floor is weak, it further increases your risk of injury to this area (or other areas that are supported by the pelvis, lower back, and general core…like glutes, hamstrings, groin).  Doing pelvic floor strengthening can also help with any pain management you may have in your have lower back pain or pain in your hips.

●A strong pelvic floor will help with incontinence issues.  Just because you feel like you may need to urgently pee when you are exercising at a higher intensity doesn’t mean you’re exempt from training your pelvic floor.  Or that one time you sneezed and you felt like you needed to pee (or maybe you even leaked a bit of urine)…or even worse–you sneezed during exercise, that’s probably when you really noticed an issue.  Developing a stronger pelvic floor can help with any incontinence issues, no matter how minor they may seem. 

●A weak pelvic floor can make constipation worse.  The pelvic floor muscles are really a hammock of support for your bladder, uterus, vagina, and rectum.  So if your pelvic floor muscles are weak, these areas won’t function as well as they should.  When you train your pelvic floor, you are more able to have a healthy elimination.

●A strong pelvic floor helps with childbirth and postpartum recovery.  If you are thinking about having a child, whether you are a first time mom or not, having better control of your pelvic floor will help with delivery (it helps move the baby down the birth canal, and during the “pushing” phase of birth).  And doing pelvic floor exercises immediately after giving birth can be a great way to help regain strength in this area (again, it’s part of your core), and also promotes healing from any tearing sustained during childbirth.  Your pelvic floor muscles get stretched out in just a matter of hours during childbirth vs. the 40 weeks that it takes your abdominal muscles to stretch out, so it’s extremely important to begin a regular strengthening routine for your pelvic floor.  Once you are “cleared” for other exercise, having a well-established deep core routine and stronger pelvic floor muscles will be so beneficial to a mother’s mental and physical wellbeing.  While there is a lot of discussion in our culture about “getting our bodies back” and “getting rid of our mommy’s pooch,” working towards a strong pelvic floor should be the primary go-to exercise in the postpartum exercise routine.

●Your pelvic floor muscles will get weaker with age and non-activity.  Just like any other muscle, if you don’t focus on strengthening or using it properly on a regular basis, it becomes weaker over time.  And hormones won’t help, which is why postmenopausal women suffer more from pelvic floor dysfunction. 

So, how do you begin?  There are lots of variations, but the most basic one is that of a Kegel.  You can do this sitting or standing, anywhere and everywhere.  Begin by tightening your pelvic floor muscles, starting from the back to the front (anal sphincter to vaginal sphincter), and hold for a few seconds.  Then release, allowing your muscles to soften and then gradually relax for a few seconds.  Remember to breath throughout this process (have your breath start with your diaphragm, then chest), as you would when you are doing any other strength training exercise. You can repeat this sequence 10 times, and do 3 reps. You can gradually work up to tightening your hold for more seconds at a time, increasing the intensity of your effort, and the frequency of these exercise.  Like any strengthening routine, it takes time to see results.  But doing them on a regular basis, especially combined with diaphragmatic breathing, will eventually give you a stronger inner core.

For those that think they have more of a severe issue, the good news is there is additional help out there.  You can talk to your OB GYN (who should be checking your pelvic floor strength as often as they see you, but many of them do not), or you can also go to a Physical Therapist who specializes in the pelvic floor.  If you also practice yoga or Pilates, you can also talk to your instructor about additional exercises to do to help with pelvic floor awareness and strengthening.

In my own practice, I have found that incorporating them into my daily activities like putting my makeup on, eating breakfast, riding the subway, or washing dishes help me to be as regular about doing them as I am about brushing my teeth.  Aside from the stated benefits above, training my pelvic floor has helped me become more aware of my entire body, especially my core, and not just the “outer unit” muscles. As an athlete, it’s extremely important to be attune to not only the muscles that you think you may use in a specific exercise, but to be aware that your body is a system of interconnectivity.  If one area is (or becomes) weak, it’s going to eventually affect another area that is more dominant. The pelvic floor is unfortunately a very common weak area for most everyone, and yet if affects us in so many ways when we’re exercising or going about our daily lives.  The benefits of doing these exercises on a regular basis last a lifetime, so start today.