TIPS FOR POSTPARTUM FITNESS

Even after their doctor has cleared them to exercise, many postpartum women are confused about how to safely return to fitness.

For his clients, Crossfit coach and physical therapist Ryan Smith first evaluates their fitness levels and goals before, during and after giving birth.

“There’s a wide range of what women want, from simply feeling fit and healthy to running marathons,” he says. “We set up milestones for measurement from there.”

For instance, when can the patient run and jump without incontinence? Is her diastasis recti responding to treatment by getting smaller and shallower, or staying the same? “In an evaluation, I have women break down the movements they need to complete the exercises they want to do, whether aerobic activity or strength training,” he says. “It’s all about giving women the tools they need to improve and not normalize the conditions they experience postpartum.”

Jaclyn Bonder, medical director for Women’s Health Rehabilitation at New York Presbyterian-weill Cornell Medical Center, said women should be monitored by a health-care provider as they restart an exercise regimen. Her recommendations:

A woman should make sure all ■ post-delivery bleeding has stopped and any tearing healed before even thinking about resuming exercise. This can range from 10 days to six weeks in some cases.

For a caesarean section, look for incision healing and minimal abdominal pain, generally requiring six to eight weeks.

A good starting point for rebuilding stretched and weakened muscles is to focus on core strengthening exercises. They should emphasize deep-core muscles — those in the abdomen and back — and pelvic floor muscles, such as pelvic tilts, hip bridges and toe taps.

For aerobic activity, begin with

■ low-impact exercises such as walking, which in nice weather can easily be done with a newborn, elliptical training or swimming.

Amanda Loudin,

The Washington Post