How To Start Working Out: Framework for Moms

Whether you’re pregnant and want to begin exercising to have a more comfortable pregnancy or a new mom ready to focus on fitness again, with all of the apps and internet clutter it can be hard to figure out where to begin. That is why I’m sharing the method I developed and have used with hundreds of moms and moms-to-be. It’s called Core, Function & Fitness (CFF). CFF is an approach. It’s a strategy. It’s a guide to help you determine where to begin your fitness journey and a framework to help you prioritize what to focus on during your workouts.

Whether you’re pregnant and want to begin exercising to have a more comfortable pregnancy or a new mom ready to focus on fitness again, with all of the apps and internet clutter it can be hard to figure out where to begin. That is why I’m sharing the method I developed and have used with hundreds of moms and moms-to-be. It’s called Core, Function & Fitness (CFF). CFF is an approach. It’s a strategy. It’s a guide to help you determine where to begin your fitness journey and a framework to help you prioritize what to focus on during your workouts.

The Foundation

During and after pregnancy, the foundation of your fitness program should be core strength and function. Core refers to the 360-degree cylinder from your diaphragm to your pelvic floor, including both abdominal and back muscles. A functional core means that your deep stabilizing muscles activate to support your spine before any movement. A functional core also means, you know how to breathe (exhale on exertion) with movement, and that you’re treating any pelvic floor concerns like tight pelvic floor muscles or urinary incontinence. A strong and functional core will enhance your ability to advance in exercise and will make daily life more comfortable.

If we look at CFF as a pyramid, “core” is the base layer and what you’ll prioritize when you begin an exercise program. This doesn’t mean that core needs to be your only focus, but if you’re short on time or searching for workouts, this will help you strategize and select the correct exercises. If time and energy aren’t an issue you can certainly do workouts that are more than core, but keep in mind that if your core isn’t yet strong and functional, you’ll want to ensure any other formats of exercise you’re choosing don’t require more core strength then you presently have.

For example, if you’re pregnant and beginning an exercise program, you can focus on breathing and engaging your abs with each movement you perform. So if you’re doing squats, lunges, and arm exercises, rather than just going through the motion, you’re exhaling on exertion or engaging the deep abs as you curl the dumbbell during a biceps exercise.

Middle of the Pyramid

So now that you’ve spent some time activating your pelvic floor, deep abs, and using your breath, you’re ready to shift your focus to “function”. The term functional training is a bit trendy so I’ll provide you with my simple definition. Functional training is performing exercises that help you meet the physical demands in your life. This means factoring in the type of job you have, the workouts you plan to do, or the physical demands of caring for your child at different stages. During pregnancy functional training can be performing exercises that help you better adapt to the changes your body is experiencing, like strengthening your back because you’re being pulled forward due to the weight of your breasts and belly. Function is the next step in my model because you should be able to feel good moving through your daily life before setting more lofty fitness goals (for example if your back hurts every time you lift your child, doing an hour spin class maybe shouldn’t be your priority). Functional training also means addressing pain and specific weaknesses. It is easier to attain function when you have a strong core, so for that reason “function” sits on top of the “core” layer in my pyramid.

Top of the Pyramid

You’re ready to move up the pyramid when you have a solid core foundation and you’re functionally moving well during the day and your workouts. “Fitness” is the top piece and refers to goals such as muscle definition, weight loss, sports performance, and running. This is the last step along the CFF progression because you’ll have a better chance of achieving fitness when you effectively know how to engage your core and you know how to perform exercises correctly and without pain. I’ll reiterate that it doesn’t mean that you have to wait to set your fitness goals, but increasing your run distance shouldn’t be the priority before you’ve spent time on the other components. When you move to the top of the pyramid, the idea is that you’ve already set yourself up to achieve your specific fitness goals.

For example, if you do have a goal to run postpartum, you can first focus on making sure your core can support proper running form, and that your pelvic floor muscles can handle the impact and load. Functional training might include single-leg strength activities so that when you do run, your body is better prepared. 

Summary

I developed the Core, Function and Fitness method to help you prioritize your efforts, and make workout selection less overwhelming. The pyramid can also be explained as a pie chart with the percentages of core, function and fitness components shifting as your needs are being met. Maybe you’re starting with core being 80% of the chart because you just had a baby, but after a few months of training, core might then become just 30% and fitness taking the majority. This pie chart is a good visual because it emphasizes that you’re never solely focusing on just one thing. All components are important and will be integrated into your plan.

Whether you like the pyramid or the pie chart, the main point I'm making is that this is a tool that can keep you active through all 40 weeks of pregnancy, and help you feel stronger than ever after having a baby.

Have You Been Cleared for Exercise?

If you’re currently pregnant and have been consistent with exercise, you’re probably already planning your return to exercise postpartum, especially if exercise has always been a part of your life. I know most of my clients who have continued to stay active during pregnancy have goals to return to fitness as soon as their doctor gives the OK postpartum.

If you’ve recently had a baby, you may be awaiting your postpartum appointment to find out if you are “cleared for exercise”. Getting cleared for exercise can feel liberating if you’ve been missing that sense of control over your body. However, it’s important to understand what being cleared means as well as how to return to physical activity after pregnancy.

What Does "Cleared for Exercise" Mean?

Being cleared for exercise is your doctor’s medical opinion that you are physically ready to start increasing physical activity, or that it’s generally safe for you to exercise. This typically happens at your 6-week postpartum check-up, but if you’ve had complications like tearing or are recovering from a c-section, that may happen a bit later. 

In other words, your doctor will either tell you it’s safe, or that it’s not. Which, don’t get me wrong is important information. You shouldn’t begin to increase physical activity or exercise if you have contraindications. However, the trouble with the yay or nay approach is that it’s one size fits all. Postpartum exercise clearance usually comes with the advice that you should ease back into it and listen to your body. This is not inherently bad advice, but it’s pretty subjective and doesn’t educate you on what a proper progression looks like, or why easing back into it is essential. Fortunately for you, if you’re reading this, you probably already have an understanding that there are important considerations when returning to exercise after having a baby. In the rest of this article, I’ll provide you with tips and strategies to guide you in your return to fitness.

What do the postpartum exercise guidelines say?

At the time of this article (12/2023), postpartum exercise guidelines have not been published. BUT, there is encouraging news that they’re finally in the works and should be released soon. I’ll link to them when they come out, but in the meantime, I’m going to provide you with some tips inferred from the research that exists, my background in exercise science, as well as the practical experience I have working with pregnant and postpartum moms.

Do you need to see a pelvic floor physical therapist or postpartum exercise specialist?

The ideal answer is yes, it would be great if everyone was able to receive personal guidance from a professional after having a baby. The more realistic answer for most people is that it depends. If you have any concerning symptoms like incontinence, pelvic or back pain, abdominal separation, or others then I strongly encourage you to see a pelvic floor physical therapist as a starting point. If you live in a major city there are probably those that accept insurance, as well as cash-based, but you should be able to see someone. Additionally, if you are concerned about excessive fatigue, anxiety, or depression, I’d also recommend seeing a professional before beginning a structured exercise program beyond general physical activity. If you were not active during pregnancy or you’re new to strength training or core exercises, a postpartum exercise specialist can save you a lot of time and energy in the long run by helping you determine which exercises are best for you.

Time for the Tips

Aerobic

The general physical activity guidelines for adults recommend 150 minutes per week of moderate or moderate-vigorous physical activity, with activity occurring on most days. The postpartum guidelines may skew a bit, but will not be drastically different. In any case, that duration and intensity is what you’re working up to and not where you’re starting. For most moms that I’ve worked with, getting out and pushing the baby in the stroller for 10-20 minutes every day is a great starting point. Walking is great because you can still spend time with your baby, being outside may boost your mental health, it’s a low-impact activity ensuring you’re not stressing your healing pelvic floor too soon, and it’s a trackable activity that you can strategically progress to longer durations, distances, and intensities. 

Strength

Here’s where I plug the method I developed called the Core, Function & Fitness approach. The idea is that the core is the foundation of fitness and where you should prioritize your efforts. During the postpartum period, this most often means addressing any pelvic floor concerns and coordinating breath with your deep ab muscle activation. Initially, this could be through pelvic tilts or heel slides but can progress to exercises like the deadbug. After you’ve made some progress in core strength and function, you can add in functional strength training. So this might mean you’re spending 5-10 minutes on isolated core exercises and then doing a full body circuit focusing on muscles you need to move through your day pain-free, as well as the major movement patterns. For example, lengthening chest muscles and strengthening upper back muscles is usually a necessary focus for moms due to the feeding posture. 

After you’ve laid a solid foundation of core training and strength training you can continue to increase the duration, frequency, and intensity of your workouts, while also setting more specific goals like running.

Don’t Forget About Lifestyle Factors

To benefit from exercise, there are more factors than the workout or activity. Things like sleep, nutrition, hormones, childcare, the ability to be consistent, and the ability to recover all determine whether you’ll get the benefits you’re expecting from exercise. For this reason, not jumping back into structured workouts until you are more healed, getting a bit more sleep, and have found ways to stay hydrated and eat a balanced meal is a reasonable decision and it’s smart. Now this doesn’t mean you should do anything. You should begin to increase physical activity and address core strength at a minimum, but it means that rather than aiming for pre-pregnancy 60-minute workouts at the gym, your starting point might be daily walks and two minutes of isolated core work when the baby is doing tummy time.

On the flip side, if you have childcare help, you’re feeling healed and sleep deprivation isn’t an issue, you may be feeling like you’re ready to get back to your old routine. To that I’ll say, remember that your abdominal and pelvic floor muscles and tissues are still healing and your hormones are still fluctuating, so even if you’re feeling good, I’d suggest the same gradual core, function then fitness framework. You may move through the progression quicker than someone else but don’t skip the gradual transition.

The Takeaway

This article is just one piece of the postpartum exercise puzzle, but I hope it gave you some perspective on getting cleared for exercise. To summarize:

• Prioritize healing

• Remember that lifestyle factors should support the type of workouts you’re doing

• Core, then add functional strength then set fitness goals

Being an active mom is a lifestyle and will look different as you move through different stages of motherhood. The fourth trimester is not even the first chapter, we’ll call it the introduction :)

When Can I Start to Exercise After Having a Baby?

“When can I exercise again after having the baby?”, OR “Do I have to wait until my 6-week postpartum appointment to get back to physical activity?” The answers to these questions are going to vary based on your individual situation and needs. In general, it is safe for most moms to begin connecting with their deep abs and pelvic floor muscles using breath. Low-intensity walking and mobility exercises may be beneficial for you as well. Let comfort and energy level be your guide. Remember movement is good, but you don’t want to interfere with healing, especially if you had tearing or a c-section. You should not return to anything more vigorous before a doctor can tell you that there are no medical contraindications. If bleeding increases following even light activity, that may indicate that you are doing too much and you should contact your physician.

If you are “cleared” for exercise at your postpartum visit, this means that your doctor from a medical perspective thinks you can begin to be more physically active. You should still approach exercise with a gradual and progressive approach. This is not a green light to jump into your old routine. Abdominal and pelvic floor tissues can take up to 9-12 months to heal.

If your doctor approves and you’re ready to exercise, the progression below might help you prioritize your first steps back to fitness.

1. Heal: Whether you’ve had a c-section or vaginal delivery you have tissues that need to heal. Your initial focus should be on promoting healing by getting enough water, and nutrients and resting when you can. You should not begin to exercise until you know that any tears or incisions have healed properly. You’ll also want to address any scar tissue. Part of healing may also mean addressing concerns like incontinence, the feeling of pressure or bulging in your vagina, or abdominal separation. These are all common conditions, but not normal. It may not necessarily mean that you can’t begin an exercise program simultaneously, but you should consult with a pelvic floor therapist and prioritize exercises that will help you improve those symptoms or conditions.

2. Core: Most muscles of your core are impacted by pregnancy and delivery. All moms should strengthen these muscles and ensure that they function optimally by working synergistically. This often means beginning with breath, transverse abdominis, and pelvic floor muscles.

3. Function: Being a mom is physically demanding. Part of your return to fitness should be mastering repetitive movements like hip hinges or getting up off of the floor (think deadlifts and lunges), strengthening muscles that impact posture (think back and glutes, and focusing on mobility (think upper back, ankles, hamstrings and hip flexors).

4. Strength: After you have foundational core strength and have mastered movement patterns, you can begin to think about gradually progressing your program. This could include adding more resistance, moving to moderate to high-impact activity, and performing more demanding abdominal exercises like rotations or exercises in positions against gravity.

Other considerations of when it’s best for you to begin to exercise include sleep (ability to recover), support from family/friends, and mental state. Hopefully, this doesn’t sound overwhelming because there are many positives to postpartum exercise like establishing a healthy lifestyle for your family, and training in a way that you can become stronger than you were before pregnancy. And remember, exercise as a mom is not a luxury, it is essential in meeting the physical and emotional demands of motherhood.

Running After Having a Baby: Guidelines for Postpartum Running

You’re six weeks postpartum and you’ve just been cleared for exercise. You may be wondering if you are ready to get back into running. Or maybe you’ve gone for your first run after having a baby and you’re wondering why it feels so hard. Either way, the purpose of this article is to tell you NOT to run as soon as you’re cleared for exercise, and to encourage you to take the proper steps so your first return runs feel good.

Unfortunately you can’t search the internet for standardized postpartum running guidelines. You may find blogs with suggestions and advice, but research-backed guidelines are hard to come by. The best ones I’ve found were created by Gráinne Donnelly, Emma Brockwell, and Tom Goom in 2019, which I will summarize in this post. The following information is to help you 1) determine if you’re ready to run 2) make you aware of concerns, and the suggested progression of exercise leading up to running.

Running is a high-impact activity requiring core strength and function. To manage the intra-abdominal pressure that stabilizes your body during running, your abdominal and pelvic floor muscles need to be strong and functional. These muscles are weakened during pregnancy and can be further impacted during labor and delivery (cesarean and vaginal). Therefore, incontinence and prolapse can be a concern in postpartum running. You have to allow yourself enough time to heal and strengthen. How will you know if you have pelvic floor or abdominal wall issues? The following is a list of symptoms that could indicate dysfunction and should be addressed with a pelvic floor physical therapist before running.

• Urinary and/or fecal incontinence

• Urinary and/or fecal urgency

• Heaviness/pressure/bulging in the pelvic area

• Pain with intercourse

• Separated abdominal muscles and/or decreased abdominal strength and function

• Low back/pelvic pain

Based on evidence, these experts state that return to running is not advised prior to 3-6 months postpartum or beyond if any symptoms of pelvic floor dysfunction are experienced before running or after attempting to run. Furthermore, even if you don’t have symptoms, 3-6 months is still a minimum guideline to allow your tissue and muscles time to heal and strengthen. For example, it’s been found that after a c-section, your abdominal wall has only regained 51% of its tensile strength by 6 weeks postpartum, and reaches 73-93% only at 6-7 months postpartum.

After (or while) addressing any pelvic floor and/or abdominal concerns, it’s time for you to focus on building overall strength, with a focus on the core and lower body (I recommend glutes for all moms!). Stronger muscles will allow you to better manage the load/demand running puts on your body. If you’re able to work with a qualified postpartum exercise professional they can lead you through the proper training progression. When I work with people I start with making sure all of the muscles that attach to the pelvis are strong, functional, and know how to work together. I then move on to bigger movement patterns like squats, hinges, and lunges. The guidelines referred to in this article use the following exercises to assess readiness to run:

• Walking 30 minutes

• Single leg balance 10 seconds

• Single leg squat 10 repetitions each side

• Jog on the spot 1 minute

• Forward bounds 10 repetitions

• Hop in place 10 repetitions each leg

• Single leg ‘running man’10 repetitions each side

• Single leg calf raise 20x

• Single leg bridge 20x

• Single leg sit to stand 20x

• Side lying abduction 20x

Keep in mind that this is not a prescriptive list, but it gives you an idea of what you should be working toward. You want to be able to do these exercises (or exercises that require similar load and strength) without pain or incontinence before returning to running.

So mama, before you break out the running shoes (which by the way, make sure they support your new postpartum feet), take the time to heal, strengthen, and get assessed by a pelvic floor PT if you have access to one. You have your entire life to be active (with your children!) and you don’t want to have any setbacks…so remember progression is essential.

And PS. This article doesn’t account for other factors like sleep, scar tissue, weight, breathing, breast size/breastfeeding, jogging strollers, or emotional readiness, which all will factor into your readiness and ability to run.

Stages of Being an Active Mom

You care about being an active role model for your family. You see exercise as a tool for both physical and mental health. You recognize that a mom's body needs to be trained differently, and that strength and core training is important. You also understand the need to be flexible, stay committed, and get creative when it comes to finding time for fitness and family. Your goal to be an Active Mom might not waiver, but how you attain this vision looks different at various stages of motherhood.

Based on my personal experience, as well as many of yours, here's what I've come up with as a quick guide for all stages.

Pre-conception/Get Healthy Stage: You’re assessing whether your physical health will support fertility and pregnancy. You might be considering your weight and stress levels. You have a desire to “be in shape” for pregnancy.

What exercise could look like: Start by meeting the physical activity guidelines. Use exercise as a tool to decrease mental stress. Using resistance training and aerobic exercise to achieve a healthy weight. Make sure your calorie intake supports your activity so as to not impact your menstrual cycle.

Prenatal/Pregnant Stage: Your doctor is recommending exercise. Your energy levels fluctuate. You’re adjusting to the changes in your body. You may experience aches and pains.

What exercise could look like: Aim to meet the physical activity guidelines for pregnant people. Enlist the help of a prenatal exercise specialist. Prioritize muscle groups impacted by pregnancy such as the pelvic floor, core, glutes, and upper back. Consider whether a shift to low-impact aerobic activity is right for you. Include mobility work in your routine. Adjust exercise intensity according to your energy level. Ensure you eat a snack before activity to maintain energy and blood sugar levels.

Newborn/Fourth Trimester: Your newborn baby is your priority. Your schedule is completely unpredictable. You feel disconnected from your body (even if you were active during pregnancy). Your tissue is healing. You are sleep-deprived.

What exercise could look like: Recovery is your priority. If you’ve had a c-section or any vaginal delivery complications, healing before increasing activity is key. When you’re ready, begin with stretching and activation of your deeper core muscles through breath. Try to reconnect with pelvic floor muscles (see a pelvic floor PT). Take short walks with the baby in the stroller. Walking is a great form of exercise early on in addition to your short 5-10 minute bouts of core strengthening. Gradually increase the duration of your walks and add bodyweight strength exercises. Focus on posture and stretching.

Baby’s first year/Postpartum: You’re still tired, but you’re feeling motivated to start to feel like yourself again. You have very little time for yourself and your schedule is dictated by baby/work/family. You may be feeling the overuse aches in your feet, wrists, and back from taking care of the baby. Hormones may still be shifting. You may have weight loss goals. Your abs are different and the pelvic floor may be giving you trouble.

What exercise could look like: Enlist the help of a postnatal exercise specialist. Walking is still one of the best modes of exercise because it can be conveniently worked into your day, outdoors can boost your mood/energy, and your baby can join you. Gradually progress in your core exercises, but still prioritize deep abdominal muscles and pelvic floor through breathing. You can begin to incorporate more strength training, with a focus on movement patterns (squats, deadlifts, lunges), core, and muscles to help with aches like upper back and glutes. You’ll have the most success with short 10-15 minute bouts of exercise each day.

Toddler years/Pre-Conception: You still may be juggling an inconsistent schedule with naps and nighttime sleep habits, but you’re less sleep-deprived. Your energy is challenged by keeping up with a toddler. You’re starting to feel like yourself again, but may not be completely pleased with your inconsistent exercise routine. You might be motivated by the fact you’re going to try for another baby, or the idea that your body won’t endure another pregnancy…either way, you want to ramp up your fitness routine. You appreciate the role of physical activity in your mental health, but also the fact you now have to role model healthy behaviors for your family.

What exercise could look like: Assuming you’ve rebuilt your core strength and have a fitness foundation, you have many options for exercise. Strength training should still play a major role in helping you meet the demands of motherhood, and continue to build the body you aesthetically want (aim for a minimum of two times per week, more if you’re really aiming for muscle definition or weight loss). Aerobic activity can vary according to your likes. Consider home workouts not just for convenience, but to begin to model exercise to your children as a habit and priority. Your child will most likely try to interrupt. Try to remain patient, but also firm in letting them know it’s important to you. Ask them to join. Thirty-minute workouts are probably the most feasible, sneaking in longer ones when you can/if you want. Outside of structured workouts, walks, hiking, and playground activity are great ways to be active with the family, and encourage your child to love activity too.

School-age years/perimenopause: Just when you think you’ll get some time back, your child starts to have their own activity calendar. Your energy and time balancing fitness and family is manageable but has to be intentional. You’ve learned that mornings might be your most reliable time for exercise. You might be back to some of your old activities or taken up new ones. Your postpartum hormones are stable, but you might be experiencing minor symptoms of menopause, finding that your body fat distribution is changing/feeling like your metabolism isn’t functioning like it used to. You might be experiencing more anxiety or depression.

What exercise could look like: Exercise is a great tool during this stage to manage stress, promote mental well-being, spend time with your older child, prepare your body for the changes associated with age/menopause, and as a social activity with your friends. Strength training should still be a major component. This will be the key to protecting your bones as you get older and maintaining the physique you’ve grown to love. This stage is an opportunity to start exploring new activities with your child like hiking, ice skating, tennis, or biking. Aiming to exercise at least 30 minutes most days of the week is your goal. Strength training at least 2-3 times per week is ideal and will help maintain lean body mass. It’s basically the stage you’ve been working so hard for….you get to be a healthy and active mom, enjoying physical activity by yourself and with your family!