Postpartum Operating: How I Discovered to Settle for My Physique’s Modifications

Running wasn’t the activity that ultimately doomed my dreams of participating in a trail race postpartum. It was laundry.

Six months after having my baby, I was feeling ready to start running again. For the previous four months after getting cleared to work out by my OBGYN at my six-week postpartum visit, I’d done some strength training on Tonal, some group fitness classes here and there, a handful of baby-wearing workouts, a few short run-walks, and a whole lot of walking around my neighborhood (a much needed escape from the house for both me and my dog).

But I had no routine, and I was yearning for some structure. I wanted to build muscle and endurance, I wanted that solo time and a runner’s high, I was craving some accomplishment that was just for me. So I signed on to participate in a 10K trail race when I would be nearly 10 months postpartum.

I had done a 10K road race before becoming pregnant, so trying to train for that same distance, with the twist of doing so on a trail, felt like a challenging, yet reasonable, goal. Plus, I’d be learning how to trail run as part of a Hoka training team along with other runners. I’d have a plan, accountability, proper trail running gear and footwear, and moral support. This was when my body’s “bounce back” was supposed to happen, right?! Training for something felt like a good way to get there.

My running coach that Hoka paired me up with, a legendary trail runner and mom herself, Anna Frost, made a plan for me that involved easing into running with a few 30-minute jogs per week, in combination with strength training and some hiking (in case you didn’t know, hiking is part of trail running!). Sounds reasonable, right?

While my first foray into trail running on a group trip with the Hoka team was a success, I hit my first roadblock right away while training on my own. Sticking to any sort of schedule as I juggled work, a baby whose needs and sleep were constantly changing, and my own energy levels and exercise moods, simply did not happen.

One weekend morning, I stretched and was fully outfitted for a run, and my hand was on the door handle—when my baby woke up early from a nap. My sports bra came off for nursing, and it did not go back on for the rest of the day. On days when I did find the time and energy to exercise, often the activity that was on the schedule was absolutely not what my body and mind wanted, not to mention the needs of my neglected dog or carrier walk-loving baby.

Nevertheless, I managed to run a couple times a week for about a month. And it did make me feel amazing, accomplished, and energized—just like how runs made me feel before a baby entered my life. I started with run-walks, the way I had trained for my 10K pre-baby. Then slowly decreased the walking and added in mileage, doing one easy run and one longer run per week. I worked my way back up to running four miles, and I was even running faster than I had been before my baby.

Meanwhile, I noticed a bit of pain around my left knee. I’d felt this before, just some twinges after runs, but it always went away. Then, after a long run, I felt the pain more strongly. But it was a Sunday, and there were piles and piles of laundry to be done. So down I squatted to put the clothes in the wash, up I rose to put the wash in the stacked dryer, my knee cracking and pulling each time. By the time Sunday evening rolled around, my knee was swollen and I had to elevate and ice it.

My coach advised me to stay off my knee so I didn’t hurt myself further. Then, for the next few weeks, I would take a training pause, try another run, and the pain would return—and even spread to my hip, back, and foot, all on the same side. I got an Echelon Stride-6 treadmill ($1,200)—which is foldable and stores upright so it fit in my already-cramped home gym—so I could try walking uphill or doing shorter runs that didn’t involve the herculean effort of leaving the house. I tried hiking out in nature on softer ground, I tried strength training, I tried indoor cycling, stretching, even a chiropractor.

The pain throughout the left side of my body remained. What was going on? I was easing back in, I felt ready to get back to my body. Where was the “bounce back” I’d been working toward? “You’re not broken,” trainer, researcher, and kinesiology professor Kara Radzak, PhD, ACT, told me. “But your relationship with your body…it’s not going to be the same.”

“You don’t need to do what you used to do in your workouts prior to being pregnant.” —Betina Gozo Shimonek, CPT

6 ways your body continues to change postpartum

When I signed up for that trail 10K, my postpartum recovery had been pretty standard. Based on how I was feeling physically, I had no reason to think easing into running approximately seven months after giving birth would be different from doing so before I got pregnant. But that was not the case.

“When it comes to postpartum, I think a lot of [people] try to be the person they were before they were pregnant, and they forget there were so many changes that happened in the months you were pregnant—and not to mention giving birth,” certified personal trainer Betina Gozo Shimonek, who leads Tonal’s prenatal strength-training program, says.

That was, essentially, the news my doctor delivered. She told me that my joints were probably different than they were pre-pregnancy, and that, with my injuries not going away with time and strength training, it was probably just not the right time to train for a race.

This blew my mind. So, other than feeling constantly sleep deprived, I generally felt the same—but my body was actually different in unseen ways? What else could I not sense about myself?

“There’s this incredible physical thing that happens to your body [during pregnancy and childbirth], and that physical thing is happening well after that six-week postpartum visit,” Tia’s chief clinical officer Jessica Horwitz, MPH FNP-C, a board certified family nurse practitioner and public health clinician, says. “We actually talk about this whole fourth trimester, and then this whole sort of year postpartum, as a year of recovery as your body is sort of physically changing. And when I say ‘changing,’ it’s really intentional. It’s changing, and it’s not going back to the way that it was.”

The following list of ways your body changes after pregnancy isn’t necessarily exhaustive, and it doesn’t even get into body changes for people who have had a C-section, which is a major abdominal surgery since it fully cuts through your abdominal muscles. (FYI: Radzak implores people who have had a C-section to consider doing physical therapy).

Rather, this list provides some more information about why “generally speaking, someone’s fitness experience in the six-month postpartum period is going to look different than before they had a baby, and that is totally normal, totally okay,” Horwitz says. “It’s not a sign of failure or that you’re not doing enough or that you also will never get back to your pre-pregnancy fitness goals. And the more we can talk about that earlier and earlier and earlier so that you don’t experience the kind of let down or feeling of failure that people experience, the better.”

1. Your joints may be looser

The changes your joints undergo during pregnancy don’t necessarily reverse quickly, or even at all, postpartum. During pregnancy, a hormone that loosens your joints, called relaxin, surges so that your pelvis can open to deliver your baby, according to a 2013 article¹ in the Annals of the New York Academy of Sciences. This affects joints throughout your body, not just in your pelvis. My hip joints were so loose during pregnancy that I felt like I was walking on stilts by the end.

I expected that more than half a year after being pregnant, my joints would have stabilized. I definitely felt less wobbly. But relaxin stays elevated if you’re breastfeeding, which I was. The hormone is not at pregnancy levels, but during the postpartum period, it’s not back to “normal” either. Your muscles need to work overtime to ensure your joints are stable. If they’re not, that can lead to injury.

“If our muscles don’t literally pick up the slack of being able to stabilize our joints, then we’re all loosey goosey,” Radzak says. “You’re at an increased risk for an acute injury because you’re just neuromuscularly a little bit outside of your normal control range.”

2. Your bones might be aligned differently

Your feet famously get bigger during pregnancy, but it’s not just from water retention. Relaxin loosens your foot joints, and the pressure of standing on those joints (with some additional load) means the space between the bones can get bigger—and they don’t always return to their original distance. A similar thing can actually happen to other joints in your body.

“The physical anatomy of how your hips sit on the top of your legs changes forever,” Horwitz says. “If you look at X-rays of a person who has not yet had their first child, and then postpartum—even many years postpartum—you can see anatomical differences in the hips and pelvis in particular. And that changes your alignment.”

Horwitz notes this anatomical change can affect running in particular, since a different or uneven alignment can affect your gait. Discomfort probably won’t be long term, but learning how to run in your “new body” might just take some getting used to.

3. Your core—including your pelvic floor—needs recovery time and re-training

Every pregnant person’s abs separate during pregnancy, and they take time to both knit back together and re-strengthen. The same goes for the pelvic floor, which is part of the core. Those muscles are put under a lot of stress, and might undergo trauma during childbirth.

So until your abs come back together, your pelvic floor heals, and all your core muscles get re-strengthened, your core might not be able to adequately support you during a high-impact activity like running that requires a lot of core engagement. If you don’t engage your core while you run, you may experience lower back pain, which can further affect your alignment and lead to injury.

This is why Shimonek always incorporates breathwork with her clients, both to help them strengthen and mentally connect with their core so that they can engage that support system during activities.

“A lot of [people] need to start slow,” Shimonek says. “You don’t need to do what you used to do in your workouts prior to being pregnant. Incorporate that breathwork, and incorporate core work with pelvic floor work so that when you get out for your run, you feel comfortable.”

4. Your body might be generally out of whack

I have persistent lower back pain from sleeping in a twisted position for a month after giving birth because that’s what felt most comfortable as my milk was coming in and my supply was modulating for breastfeeding. My theory is that all the ailments on my left side stem from whatever muscle tightness is causing this pain.

I’m certainly not alone in having body aches and weirdness as a new parent. Breastfeeding, carrying a baby on one hip, and contorting yourself in weird positions to accommodate your sleeping child can all cause imbalances in your body—all of which can make you more prone to injury during exercise.

“It’s just going to make your movement patterns different,” Radzak says. “If you have different movement patterns for long enough, it’s going to become ingrained.”

5. You’ve gone through “de-training”

On top of all the physical changes of pregnancy and childbirth, you’re likely experiencing the changes of what Radzak calls “de-training.” Meaning, the strength and endurance you had before has likely waned in the months you were not able to exercise. That requires a slow and steady re-training program.

“Anybody who is physically active and de-trains for six weeks [minimum], that’s going to have ramifications on their ability to get back into shape and their potential injury risk,” Radzak says. “So you’ve got all of these things going on at the exact same time.”

6. You’re not getting the necessary recovery

Sleep, rest, hydration, nutrition. These are the essential building blocks of recovery, and parents of babies know sleep can be hard to come by.

“Sleep and recovery is such an important part of any fitness journey, and sleep and recovery is deeply affected for new parents and particularly moms,” Horwitz says.

Sleep and rest is when your body repairs the damage done by exercise and gets stronger. So if you’re trying to build strength or get into running shape, you might have a harder time in general because you’re not getting enough rest.

“[When you’re tired], there’s that increased potential risk of acute injury, like an ankle sprain from stepping on a rock wrong,” Radzak says. “But there’s also that repetitive micro-trauma of the fact that when we sleep, that’s when our body rests and regenerates. If you’re not getting that, then you’re not filling your cup back up. If you’re not fully rested, then you’re going to have a potential increased risk of musculoskeletal injury.”

“If you’re really driven, you probably put so much pressure on yourself, and I think that we just need to really give ourselves grace.” —Betina Gozo Shimonek, CPT

Your body is only part of the equation

When I finally made the call with my coach and Hoka to back out of the 10K, I felt disappointment and shame, but I also felt relief. I wondered if I’d been able to follow the training plan more closely, maybe I wouldn’t have gotten injured. If I’d decided to strength train or run on days when I opted to walk with my dog and baby because that’s what felt best for my family and for me in that moment, maybe I could have had a steadier ramp-up.

I’d wanted to do the race because I wanted some sort of external motivation. But what I really needed—what I still need—was for exercise to be a way to connect with myself internally. So lifting the pressure of a training plan felt like a weight off of my shoulders—similar to how letting go of the need to “bounce back” in general might feel for others.

“It’s unfortunately such a common experience for new [parents] to feel the weight of the world, balancing caring for this new person and time for yourself,” Horwitz says. “How do you incorporate exercise as a way to make you feel good once again, release endorphins once again, and not have it feel like another area where it’s just overwhelming and you feel inadequate, because it’s a really important way to build resiliency and strength in this important time.”

According to Radzak’s surveys of postpartum people (which will be published in an upcoming research paper), 81 percent of them want to be more active than they are. After that six week postpartum visit, it’s almost as if there’s this ticking clock that says it’s time to bounce back.

“If you’re really driven, you probably put so much pressure on yourself, and I think that we just need to really give ourselves grace because what we’re doing is so wonderful and it’s really challenging, but know that you’re not alone and that so many [people] are going through it,” Shimonek says.

Despite what celebrities or influencers posting videos of them fitting into their old clothing might broadcast, there is not, in fact, a bounce back you “should” expect to go through. When it comes to achieving your fitness goals in a changed body with changed time constraints and priorities, there’s just a new normal—a new you to get yourself acquainted with for the rest of your life.