5 Tips for the Postpartum Triathlete

Are you a triathlete who just had a baby? Or maybe you just had a baby and have the idea to participate in your first triathlon? A lot of women are eager to jump right back into exercise after having a baby, but there are many reasons to take an educated and thoughtful approach to resuming endurance sports. Here are some considerations when starting triathlon training in the postpartum year to promote healthy habits and decrease the risk of injury.

Clearance from OB team and pelvic floor PT

First, get clearance from your OBGYN and medical team to resume exercise including swimming, cycling, and running. Childbirth is a medically complex procedure that can involve surgery so making sure you follow your doctor’s advice is necessary to ensure a safe return to triathlon. Every birth experience is different. Some women have uncomplicated births (which is still a very complex situation and requires prolonged recovery) and others have multiple medical interventions including multiple surgeries or extended stay in the hospital. During pregnancy, the pelvic floor muscles become stretched and strained which is exaggerated after vaginal delivery. Even post cesarean section, women can experience pelvic floor loosening along with risk of scar tissue build up. All women during postpartum have a high risk for pelvic floor dysfunction and at least half of postpartum women are experience Diastasis Recti (DRA).  Pelvic floor dysfunction involves abnormal activity or function of the pelvic floor musculature and can cause many symptoms including urinary incontinence and pelvic pain. Diastasis Recti is the separation of the two muscle bellies of the rectus abdominus which leads to limited support to the spine and abdominal cavity causing abdominal and lower back pain. A pelvic floor physical therapist can help diagnose and treat pelvic floor dysfunction, diastasis recti, and low back pain to help alleviate some of the issues women experience during the postpartum year. I highly recommend seeing a pelvic floor physical therapist before returning to triathlon to ensure that your body is ready to undergo increased stress from all 3 sports. Personally, I was able to return to triathlon at 6 weeks after a relatively uncomplicated birth and I attribute a lot of that to knowledge I acquired from a close friend and a coworker who are both pelvic floor physical therapists.

Core strength, hips, strength program first

If you are pregnant, I cannot stress enough the importance of working on overall strength to prepare the body for delivery and to improve your recovery time during postpartum. Not only does stretching and yoga help with flexibility for delivery, but attention to core, hips, and pelvic floor muscle strengthening will help support baby while you carry and provide quicker recovery time. After delivery, physical exercise should focus on regaining strength of the pelvic floor muscles, core, and hips to provide stability to the pelvis and spine. This is especially important when returning to running due to the high forces that puts stress on the bladder and the pelvis which can cause stress incontinence, pelvic pain, and lower back pain. Seeing a pelvic floor physical therapist early on in your recovery can really make a huge difference in your ability to return to high intensity weight bearing exercise. Some women can tolerate working on low level pelvic floor and core exercises within the first few weeks after delivery such as Kegel’s and posterior pelvic tilts. As you can tolerate these exercises with no adverse effects, you can progress to further glute and core strengthening exercises in lying along with body weight functional exercises such as a proper squat. Pairing a progression of pelvic floor, core, hips strengthening program along with a daily walking program will help prime the body to start swimming, cycling, and running when given medical clearance. While working with my clients, I discuss what they are working on with their pelvic floor therapist and from there progress them with a specific strength training program to compliment their needs. During postpartum, strengthening is a priority within the triathlon training program.

Swim, bike, run form focus

When you return to swimming, cycling, and running postpartum, it will feel different. Your body has been through 40 weeks of growth and stretching and after delivery, your body has new changes: pelvic widening, enlarged breasts, pelvic floor weakness, core weakness to name a few. I remember the first time swimming, I felt so odd. I wasn’t sure if I would even find my center positioning again but it only took a few sessions to re-engage my core appropriately and center my body in the water. The focus should be on form whenever you return to swimming, cycling, and running. Start with the basics and ensure good form before progressing duration and intensity.

Limitations to time, lack of sleep, childcare

One of the biggest complaints women have when returning to triathlon postpartum is the time to dedicate to training. Triathlon training takes a lot of time to begin with. Add in caring for a child and returning to a full-time job and it can create further challenges to training.  Going back to work may mean adding time to your commute for daycare drop off/pick-ups taking out some of your training time or logistics to after work runs/rides. Lack of sleep in the first year can have a large impact on your recovery, energy levels, and hormones. For the stay-at-home moms, lack of childcare can also be a barrier to triathlon training. Breastfeeding, pumping, and storing milk can be a time-consuming challenge. Considering all these challenges, give yourself grace! We are hard working women, but we are also human. Life happens. The hardest characteristic to learn as a Type A hardworking triathlete is flexibility, but as a new mom, this will develop over time. Moderation is the key. Here are some tips that helped me get in some training when my daughter was born.

·         Take your baby for daily walks and then runs in the stroller appropriate for their age. Jogging is not recommended with baby until at least 6-9mo for proper head support. If it is too hot or cold for you to be comfortable, then don’t take your baby. You want to ensure safety of your child as top priority. Living in TX, that means I don’t stroller run over 80deg. Make sure they have appropriate clothing, sunscreen, hats, little toys, books, music, stops at the playground etc. to keep them occupied. For the first year, my daughter would fall asleep during all stroller runs, I would try to time it up with a nap.

·         If you can put baby down for a nap, do some core and strengthening exercises while they are napping during the day. Another good time to fit in core and strength is when you first put baby down for bed prior to your bedtime or first thing in the morning before baby wakes.

·         If you know your baby will nap for a longer stretch, try hopping on the bike trainer or the treadmill and keep your monitor at your side- just expect that baby can wake at any time. If you are in the middle of a more important workout, consider that the end of your ride. If baby goes back down, try to hop back on the bike or treadmill. Be flexible with this. I remember hopping on the bike at 7pm, then would have to hop off at 745 to feed and calm my daughter. Now that she is taking a 2hr nap on the weekends consistently, I plan my longer trainer rides during nap time.

·         If you have help from a spouse or partner, dedicate time for yourself to do a workout each day. If this means pump milk for them to use, then pump before you leave. I would swim twice a week at 6am so I would pump at 5am and leave the fresh milk in the fridge just in case my daughter would wake before I returned home.

·         Ask a grandparent to babysit or have a trusted babysitter scheduled for an hour or two so you can get in a workout. A little bit of help can go a long way for your physical and mental health.

·         There may be mother’s day out program where you can drop off your child day off for a few hours. Check in with local churches as they may have childcare centers for a few hours a day.

Breastfeeding and nutrition

I am not a lactation consultant or a registered dietician, but I can give some general advice based on my own research for breastfeeding while training for triathlons. A great resource for evidence-based information on all things breastfeeding is Kellymom.com.

·         1oz of breastmilk pumped is roughly 20 calories so for a mom exclusively breastfeeding and/or pumping 24-32oz a day, the caloric expense is 480-640cals a day.

·         Try to keep a healthy diet consisting of 1800-2200cals on rest days, increase the amount of calories to make up for energy expenditure during exercise.

·         Breastmilk consists of 87-88% water so make a point to drink a healthy amount of water during the day, before and after exercise, and extra water.

·         The amount of water and food ingested throughout the day can influence your milk supply. If you have not nourished yourself enough, you cannot supply enough milk for your baby.

·         Milk supply varies throughout the day. Some women have more supply during the early morning hours and lighter supply at night.

·         Try to nurse/pump just prior to exercise to partially empty breasts. Depending on how long the workout is, you may need to nurse/pump directly after as well.

·         Nurse (if baby is with you) or pump prior to your race event. Some larger races are starting to offer lactating stations. Bring a battery powered pump or a manual pump just prior to your event but unfortunately you may have to dump the milk if it cannot be stored properly in a cold place. During a longer event, you may have to pump depending on storage capacity. If you have one day of decreased breastmilk expression, it should not affect your supply too much. But many days without consistent expression will decrease supply.

Remember, being a new mom is a wonderful and demanding experience. Be kind to yourself and enjoy the journey of motherhood while also training for a triathlon. With consistency and support, you can achieve your goals while balancing your family life.

Works Cited:

Keshwani, Nadia, et al. “Relationship Between Interrectus Distance and Symptom Severity in Women With Diastasis Recti Abdominis in the Early Postpartum Period.” Physical Therapy, vol. 98, no. 3, Oxford UP, Mar. 2018, pp. 182–90. https://doi.org/10.1093/ptj/pzx117.

Sperstad, Jorun Bakken, et al. “Diastasis Recti Abdominis During Pregnancy and 12 Months After Childbirth: Prevalence, Risk Factors and Report of Lumbopelvic Pain.” British Journal of Sports Medicine, vol. 50, no. 17, BMJ, Sept. 2016, pp. 1092–96. https://doi.org/10.1136/bjsports-2016-096065.

Donnelly, Gráinne M., et al. “Running During Pregnancy and Postpartum, Part B: How Does Running-Related Advice and Guidance Received During Pregnancy and Postpartum Affect Women’s Running Habits?” Journal of Women’s & Pelvic Health and Physical Therapy, vol. 46, no. 3, Mar. 2022, pp. 124–31. https://doi.org/10.1097/jwh.0000000000000240.

Goom, Tom, et al. “Returning to Running Postnatal- Guidelines for Medical, Health and Fitness Professionals Managing This Population.” Absolute Physio, Mar. 2019, absolute.physio/wp-content/uploads/2019/09/returning-to-running-postnatal-guidelines.pdf.

Donnelly, Gráinne M., Emma Brockwell, et al. “Beyond the Musculoskeletal System: Considering Whole-Systems Readiness for Running Postpartum.” Journal of Women’s Health Physical Therapy, vol. 46, no. 1, Jan. 2022, pp. 48–56. https://doi.org/10.1097/jwh.0000000000000218.

Davenport, Margie H., et al. “We’re Not Superhuman, We’re Human: A Qualitative Description Of Elite Athletes’ Experiences Of Return To Sport After Childbirth.” Sports Medicine, vol. 53, no. 1, Springer Science+Business Media, July 2022, pp. 269–79. https://doi.org/10.1007/s40279-022-01730-y.