When climber Beth Rodden was a child, she asked her mom why she chose to walk, instead of run, with her friends. One of her mother’s friends laughed and said, “When you have kids, you’ll understand. It’s just not appropriate anymore.” Rodden recounted the memory on Instagram last August, next to a photo of herself in wet running shorts. Her six-year-old son, Theo, had asked what happened. “Mom’s pelvic floor never fully recovered after having you, so I pee when I run,” she told him.
The challenges of returning to sports after childbirth go far beyond finding the time and energy as a new mom. When Rodden had Theo, she figured she’d bounce back quickly. After all, her body had already carried her through an illustrious athletic career that included the first free ascent of Lurking Fear on Yosemite’s El Cap with Tommy Caldwell and the first ascent of Meltdown (5.14c), one of the hardest crack climbs in the world, a feat which wasn’t repeated for ten years. But her return to sports called for more patience than she expected.
“Being a professional athlete, I just wanted to go back to normal after giving birth, but my body changed a lot,” she says. “That was a huge shift for me to understand and accept.”
She experienced cystocele, also known as bladder prolapse, where the bladder drops from its normal position in the pelvis and pushes on the vagina, as defined by the Mayo Clinic. Then she dealt with mastitis infections and difficulty nursing. When she returned to climbing around nine months postpartum, Rodden discovered she had diastasis recti, or split abs. These conditions are surprisingly common postpartum. One study found that upward of 60 percent of pregnancies lead to some degree of diastasis recti. Pelvic-organ prolapse affects nearly 20 percent of pregnant people, and the prevalence of postpartum incontinence occurs in 33 percent of women.
The Pregnant Body
“I wish every single person who goes through a pregnancy, whether they deliver or not, could automatically see a pelvic-floor specialist and have physical therapy,” says Nicole Haas, a doctor of physical therapy and the founder of Boulder Physiolab in Boulder, Colorado. “In an ideal world, you’d have a whole team—an OBGYN, a physical therapist, a psychologist, a nutritionist, childcare support—to help manage these major physiological and life changes.”
The body undergoes three broad categories of change during pregnancy and childbirth: hormonal, physical, and postural, Haas explains.
From an athlete’s perspective, an important hormone of note is relaxin, which is produced by the ovaries and the placenta. It leads to ligament laxity, particularly in the pelvic area, to accommodate childbirth. That laxity can cause joint dysfunction where the pelvis and spine meet. But like most hormones, relaxin circulates in the blood and can affect all ligaments, not just those associated with pregnancy. This can result in other injuries, says Haas, like plantar fasciitis, which is exacerbated by carrying extra weight. And because relaxin continues to have a strong presence throughout breastfeeding, loose ligaments can persist long after childbirth.
Besides the obvious baby bump and weight gain, the musculoskeletal system undergoes many unseen changes during pregnancy. The pelvic structure loosens so the hips can widen, which can also lead to a bit of external rotation of the hips, says Haas. Joints become unstable. The ribs expand to make more room for the growing baby. Myofascial tissue, such as the pelvic floor and the abdominal wall, begins to expand from the inside out. The linea alba, connective tissue that forms the vertical centerline of the six-pack, begins to thin and separate. “Things stretch out,” says Haas, “and they don’t just bounce back like a rubber band after pregnancy.” Recovery time will look a little different for everyone.
As the body loosens, shifts, and grows, your posture will adapt to accommodate the physical changes. “When you carry something heavy in front of you, for example, you tend to lean back at the shoulders to counteract that force, which means your head is going to come forward, and then your hips and pelvis are going to go into an anterior pelvic tilt,” says Haas. This strains the muscles through the shoulders and neck, the lower back, and the hips.
These are major changes, and returning to pre-baby athletic performance will take time. “If I could give one piece of advice, I’d say just be patient with yourself and know that it might take you longer to recover, and that’s fine,” Rodden says.
When you think of core workouts, you might think of crunches or seven-minute abs circuits, which mainly target the superficial abs. But postpartum, you want to avoid any type of forward-flexion-based moves, like crunches, for at least a couple of months, says Ziel. That forward folding and engagement can stress the pelvic floor and exacerbate diastasis recti. The moves in the next section will help you safely improve strength, stability, and posture before fully returning to any sport. They can also alleviate lower-back pain, since they encourage your body to return to balance and lessen any stress in that area.
“Always start with smaller ranges of motion, and gradually increase that range as you start getting stronger,” says Ziel. “Listen to your body. If you’re hurting, peeing your pants, or seeing coning of the belly, those are all signs that your body is saying, ‘I’m just not ready yet,’” says Ziel. “Yet is the key word, because you will get there eventually.”
Try to fit these in whenever you can throughout the day. “I’d rather see you do 10 or 15 minutes on a daily basis than two hourlong sessions a week,” says Ziel.
Pay close attention to posture and mechanics in every movement, rather than high reps and additional load. It’s always better to do fewer high-quality reps than more sloppy reps. And be sure to check in with your doctor before increasing your intensity and volume of activity after pregnancy.
Aim for one to three sets per move in each time block, two to three times per week, but don’t worry if they’re not all back to back or even on the same day.
Up to Two Weeks Postpartum:
What it does: Pregnancy stretches the abdominal wall, pushes the diaphragm from its normal position, and changes your breathing patterns. “Over the first couple of weeks postpartum, it’s important to relearn how to breathe and get the cardiovascular-diaphragmatic system back on track,” says Haas. Deep breathing also calms the sympathetic nervous system and relieves stress.
How to do it: Slowly breathe in through your nose for a count of three to four seconds, hold your breath for three to four seconds, then slowly exhale for another three to four seconds. Repeat. You can do this lying down, sitting, or standing, anytime throughout the day.
Volume: Aim for at least a few minutes each session and a total of 10 to 15 minutes per day.
Pelvic Tilt to Hip Roll
What it does: Activates the pelvic floor and other deep core muscles to prepare them for more challenging exercises in the weeks to come. “Pelvic tilts and hips rolls are my initial go-tos to wake up the core,” says Ziel. “These are very gentle. I look at them more as movements than exercises.”
How to do a pelvic tilt: Lie on your back, with your knees bent and your feet flat on the floor. Inhale deeply, letting your pelvis tilt forward and arching your lower back a little. Then exhale completely as you tilt back your pelvis, flattening your lower back against the floor. Hold the tension for a second or two. Then inhale once again, allowing your pelvis to tilt forward, and repeat.
How to do a hip roll: When you’re comfortable with the pelvic tilt, it’s time to add another step. From the same starting position, exhale and tilt back your pelvis, then squeeze your glutes and hamstrings to slowly raise your hips, peeling up one vertebra at a time. At the top, inhale and hold your breath a few seconds, then exhale and slowly roll back down one vertebra at a time. At the bottom, inhale and relax the back of your legs to allow your pelvis to tilt forward. Repeat.
Volume: Aim to perform each movement for 30 seconds to one minute.
Standing Cat-Cow Pose
What it does: Increases mobility in the spine to improve posture, along with a gentle activation of the core muscles.
How to do it: Do this just like you would on the floor for classic yoga flow, but standing with your hands on a table, or kneeling on the floor for balance. Inhale as you slowly lean your head back, letting your tummy protrude forward and bringing in your tailbone to curve your spine backwards. Then exhale as you tuck your tailbone under, letting your head relax forward and arching your spine. Continue alternating back and forth.
Volume: Aim for 30 seconds to a minute.
Two to Four Weeks Postpartum (with Your Doctor’s Approval):
What it does: Strengthens the core muscles and posterior chain (the lower back, glutes, and hamstrings) through an isometric hold. This move also gently stretches the hip flexors.
How to do it: Lie on your back, with your feet flat on the floor and hip width apart. Engage your core, and squeeze your glutes as you press down through your heels to lift your hips off the floor. Continue rising until your thighs are in line with your torso, then hold the position.
Volume: Aim to hold the position for 30 seconds.
What it does: Strengthens the core, lower back, and glutes while training cross-body stability.
How to do it: Start in a tabletop position, with your hands below your shoulders, your knees below your hips, and your spine neutral. Slowly lift and extend your opposite arm and leg until they are parallel to the floor (being mindful not to curve your spine or rotate your hips), and pause for a couple of seconds. Then bring your raised arm and leg back in to touch your elbow to your knee beneath your torso, and pause again. Extend them out once again, and repeat. Keep your hips level and your back flat throughout the movement. (Imagine you have a bowl of water on your lower back and don’t want to spill it.)
Volume: Aim for 10 to 15 reps on each side. Rest for 30 seconds or longer, if needed, between sides.
What it does: Strengthens the abdominal muscles safely, without forward flexion or extension, along with the hip flexors.
How to do it: Lie on your back, bring your legs up into a tabletop position, then straighten them vertically toward the ceiling, above your hips. Engage your core to press your lower back against the floor. Then inhale as you slowly lower one leg toward the floor and exhale as you lift it back to vertical. Repeat on the other side, and continue alternating legs each rep. Start with a small range of motion, and gradually increase that range until you can lower your legs to just above the floor without arching your back. If your back begins to arch at any point, decrease the range of motion or do the exercise with your knees bent to 90 degrees.
Volume: Aim for 10 to 15 reps on each side.
Four to Six Weeks Postpartum:
Modified (Wall) Plank Slide
What it does: Primarily strengthens the transverse abdominis, the deepest ab muscles, through an isometric hold.
How to do it: Place your hands shoulder width apart on a wall or countertop. Engage your core, then walk back your feet as far as you’re comfortable (the farther they are, the more difficult the move). Hold your body in a rigid, straight line from your head to your heels. Then slowly press up with your toes and lower yourself, as you would for a calf or heel raise, which helps with core activation, says Ziel. Continue rocking forward and backward in the plank position for the duration. Focus on your breath.
Volume: Aim to hold for 30 seconds to a minute.
Kneeling Side Reach
What it does: Strengthens the transverse abdominis, the obliques, and the glutei medii (stabilizer muscles at the back of the hip) through a modified side plank, with very gentle flexion and extension of the spine.
How to do it: Start in a modified side plank, with your hand planted on the floor below your shoulder, your arm straight, and your bottom knee bent to 90 degrees and below your hip. Engage your core, press your shoulder away from your ear, and lengthen your spine. Then raise your free leg out to the side and your free arm toward the ceiling, like a starfish. This is the starting position. If it feels challenging enough, stay here and hold for 30 seconds or longer.
If you feel comfortable, add the reach component to the exercise: inhale, gently reach backward with your free leg and arm, and curve your spine. Then exhale and gently round your spine forward as you bring in your elbow and your knee to tap each other. Inhale to reverse the movement, and repeat.
Volume: Either hold for 30 seconds to a minute or complete five to ten reps on each side
What it does: A harder progression from the single-leg lower, this move continues to safely strengthen the abdominal muscles and hip flexors without flexion or extension.
How to do it: Perform the leg lowers as described above but with both legs at the same time. Once again, start with a smaller range of motion and gradually progress until you can lower your legs to just above the floor without arching your lower back. Keep your core engaged, and really focus on pressing your back into the floor throughout the movement.
Volume: Aim for 10 to 15 reps.
Six to Eight Weeks Postpartum:
What it does: Builds strength and stability in the deep core muscles (transverse abdominis) through an isometric hold.
How to do it: From a kneeling position, place your forearms on the floor and shoulder width apart, with your elbows directly below your shoulders. Extend your legs behind you, with your feet together and your toes tucked under, so that your body forms a straight line from your heels to your head. Keep your core engaged and your back flat—no sagging, arching, or rotating the hips—and head up so your neck is in line with your spine. Hold this position until you begin to shake or break form.
Volume: Aim to hold this plank for 30 seconds to one minute or until your form begins to break. If you lose form in less than a minute, begin with multiple shorter holds (such as six reps of 15-second holds, with 15 to 30 seconds of rest between each), and work your way up to a minute.
What it does: Strengthens the core, with an emphasis on the obliques, through an isometric hold.
How to do it: Starting on your side, plant one hand on the ground directly below your shoulders, keeping your arm straight. Extend your legs, and stagger your feet heel to toe. Then lift your hips until your body forms a straight line from your feet to your head. Raise your free hand toward the ceiling, and hold this position. Repeat on the other side. Keep your hips vertical and level (don’t let them lift or sag).
If the full side plank is too challenging at this point, try it with your lower knee on the floor instead of your foot. You can also do this with a bent elbow and your forearm on the floor.
Volume: Aim to hold for 30 seconds on each side.
Single-Leg Straight-Leg Deadlift (Runner’s Deadlift)
What it does: Activates the entire core for balance and stability without flexion or extension, while strengthening the hamstrings and the glutes through a functional movement pattern.
How to do it: Stand on one leg, with a slight bend in your knee. Engage your core, hinge forward at your hips, and lower your torso toward the floor as you lift your free leg behind you. Continue until your upper body and raised leg—which should be on one plane—are parallel to the floor (or as far as you can lower yourself without losing form or knee control). Then reverse the movement for one repetition. Move slowly and in control. Keep your hips level (aim the toes of your raised foot at the floor) and your back flat throughout the movement.
Start with your body weight only and a smaller range of motion. Once you can perform this exercise with proper form, gradually increase the range of motion and make it harder by holding a weight in your hand on the side of the grounded leg.
Volume: Aim for 10 to 15 reps on each leg.