由于文化强调“产后的身体”，难怪许多新妈妈想知道分娩后什么时候可以安全地恢复锻炼，以及哪种锻炼最好。不幸的是，在产后健身方面几乎没有硬性规定，因为每个身体和每次分娩都是独一无二的。
With so much cultural emphasis on "body after baby," it's no wonder that many new moms want to know when it's safe to return to exercise after delivering and which exercises are best. Unfortunately, there's little in the way of hard-and-fast rules when it comes to postpartum fitness because each body and each delivery is unique.
哥伦布俄亥俄州立大学韦克斯纳医学中心专门从事骨盆健康和女性健康康复的物理治疗师劳拉·沃德说：“从技术上讲，您可以在产后六到八周内让您的妇产科医生或助产士恢复锻炼。” .
"Technically you'll be cleared to return to exercises by your OB-GYN or midwife six to eight weeks postpartum," says Laura Ward, a physical therapist specializing in pelvic health and women's health rehabilitation at the Ohio State University Wexner Medical Center in Columbus.
但是，她补充说，“根据您的分娩情况和之前的健康水平，最好等到大约 12 周，当您的组织 100% 愈合后才能恢复锻炼。在 12 周之前可以进行安全锻炼，但是它们可能与您的正常锻炼水平不同。”
However, she adds that "depending on your delivery and previous fitness levels it may be better to wait until around 12 weeks when your tissue is 100% healed to return to working out. There are safe exercises that can be performed before 12 weeks, but they may not be at the same level as your normal workout."
她指出，软组织完全愈合需要 12 周时间，“并且可能需要 4 到 8 周时间才能获得力量”。
She notes that it takes 12 weeks for soft tissue to fully heal "and can take four to eight weeks to gain strength."
从生产中恢复
Recovering from Delivery
然而，加利福尼亚州圣何塞圣克拉拉谷医疗中心的妇产科医生 Sarah Isquick 博士指出，根据您对“锻炼”的分类方式，有些女性几乎可以在分娩后立即恢复锻炼。 “如果您的阴道分娩并不复杂，您通常可以在感觉准备好后立即开始锻炼。对于某些人来说，这可能最早在您出生后一两天。如果您进行了剖腹产，我们建议您等到六岁出生后数周恢复阻力训练或更剧烈的有氧运动。”
However, Dr. Sarah Isquick, an OB-GYN with Santa Clara Valley Medical Center in San Jose, California, notes that depending on how you're classifying "exercise," some women can get back to it almost immediately after delivery. "If you had an uncomplicated vaginal birth, you can typically start exercising as soon as you feel ready. For some, this can be as early as a day or two after your birth. If you had a cesarean birth, we recommend waiting until six weeks after birth to resume resistance training or more vigorous aerobic exercise."
Sarah Bowmar 是一名认证营养专家、私人教练和产前产后培训师，她建议您从医院回家后尽快步行，“每天至少步行 1 到 2 英里。这是走出家门生孩子的好方法习惯了他们的婴儿车。”
Sarah Bowmar, a certified nutrition specialist, personal trainer and prenatal and postpartum trainer, recommends walking soon after you get home from the hospital, "at least 1 to 2 miles a day. It's a great way to get out of the house and get baby used to their stroller."
鲍马尔说，除了进行一些急需的运动外，每天出去散步也有助于保持心理健康。 “在血清素和褪黑激素水平方面，阳光有很大帮助，这两种大脑化学物质有助于调节情绪和睡眠周期。阳光也有助于“维生素 D 带来的整体幸福感。运动的感觉简直棒极了。”
In addition to getting some much-needed exercise, getting out for a walk every day can also help with your mental health, says Bowmar. "Sunshine helps so much when it comes to serotonin and melatonin levels, two brain chemicals that help regulate feelings and sleep cycles. And sunshine can also contribute to "overall happiness due to vitamin D. And movement simply feels amazing."
Randy Fiorentino 博士是加利福尼亚州奥兰治县普罗维登斯圣约瑟夫医院的妇产科医生，他补充说，您越早恢复锻炼越好。 “产后体力活动对于预防产后女性常见的抑郁症状或疾病非常有帮助。”
Dr. Randy Fiorentino, an OB-GYN with Providence St. Joseph Hospital in Orange County, California, adds that the sooner you can get back to exercise, the better. "Physical activity postpartum can be very helpful in preventing depressive symptoms or disorders that are common among women in the postpartum period."
综上所述，如果您因怀孕或分娩而出现并发症，最好寻求量身定制的指导，Isquick 说。 “对于在分娩过程中出现并发症（例如三度或四度撕裂、出血过多或已有医疗问题）的人，最好咨询您的医疗保健提供者，了解何时开始产后锻炼是安全的。”
All that said, if you had complications from your pregnancy or delivery, it's best to ask for tailored guidance, Isquick says. "For individuals who experienced complications during a birth such as third- or fourth-degree tears, excessive bleeding or who have preexisting medical issues, it's best to ask your health care provider about when it is safe to start exercising postpartum."
Bowmar 同意：“你应该听从你的医生和你的身体的意见，特别是如果你做过剖腹产的话。”
Bowmar agrees: "You should listen to your doctor and your body, especially if you've had a C-section."
怀孕后的锻炼
Exercises to Include After Pregnancy
有如此多的锻炼活动选择，可能很难知道您在分娩后可以立即进行哪些最佳锻炼。
With so many choices for exercise activities, it can be difficult to know what the best exercises you can do right after giving birth .
Ward 建议专注于针对以下领域的练习：
Ward recommends focusing on exercises that target the following areas:
核心：以核心肌肉为目标的核心强化练习，如平板支撑、仰卧起坐和各种瑜伽姿势，有助于稳定和重建在怀孕期间经常变弱的腹部肌肉。然而，伊斯奎克警告说，“至少在阴道分娩后的前六周内以及剖腹产后可能更长的时间里”，您应该避免做仰卧起坐或仰卧起坐。
Core. Core strengthening exercises like planks, crunches and various yoga poses that target the core muscles can be helpful for stabilizing and rebuilding the abdominal muscles that often weaken during pregnancy. However, Isquick cautions that you should avoid doing sit-ups or crunches "for at least the first six weeks after a vaginal birth and potentially longer after a cesarean birth."
骨盆底：凯格尔运动是一系列骨盆底肌肉的收缩和放松运动，可以帮助您在分娩后重建这些肌肉。骨盆底肌肉是您可以用来阻止尿液中流流动的肌肉。横膈膜呼吸也有利于加强盆底肌肉。
Pelvic floor. Kegel exercises are a series of contraction and relaxation movements of the pelvic floor muscles that can help you rebuild those muscles after childbirth. The pelvic floor muscles are the ones you can engage to stop the flow of urine mid-stream. Diaphragmatic breathing is also good for strengthening the muscles of the pelvic floor.
臀部：臀桥有助于建立臀肌或臀部肌肉，进一步帮助稳定核心和骨盆底。
Glutes. Glute bridges help build up the glutes, or butt muscles, which further help stabilize the core and pelvic floor.
此外，“中背部和姿势练习可以帮助避免产后早期常见的不适和疼痛，”沃德说。
In addition, "mid-back and posture exercises can help avoid the discomforts and pain that are common in the early phases of postpartum," Ward says.
在制定恢复健身计划时，Isquick 建议“每周至少进行 30 分钟的有氧运动——可提高心率和出汗的活动——至少 5 次。慢慢开始，从步行和建立更有活力的活动。”
As you create a return-to-fitness routine, Isquick recommends "working up to a routine of 30 minutes of aerobic exercise – activities that get your heart rate up and make you sweat – at least five times per week. Start slowly with walking and build up to more vigorous activities."
她指出，“如果你有一个特定的问题，比如腹直肌分离，也称为腹肌持续分离，那么在怀孕后，你可以使用更有针对性的锻炼方案。”如果这对您来说是个问题，请咨询您的医生。
And she notes that "if you have a specific concern like a diastasis recti, also called persistent separation of the abdominal muscles, after pregnancy, there are more focused exercise regimens that you can use." Talk to your doctor if this is an issue for you.
应避免的产后运动
Postpartum Exercises to Avoid
另一方面，有些运动你最好避免，直到你产后走得更远。沃德指出，生完孩子后要避免的锻炼包括：
On the other hand, there are some exercises that you'd be better off avoiding until you've gotten a little farther postpartum. Ward notes that exercises to avoid after having a baby include:
任何痛苦的事情。
任何导致腹部隆起的东西，直肠分离的另一个术语。
任何导致骨盆疼痛的东西。
任何导致任何漏尿的东西。
Anything that's painful.
Anything that causes abdominal doming, another term for diastasis recti.
Anything that causes pelvic pain.
Anything that causes any urinary leakage.
“这些都是功能障碍的迹象，需要您的医疗保健提供者或骨盆底物理治疗师进行评估，”沃德说。
"These are all signs of dysfunction and would warrant an assessment from your health care provider or a pelvic floor physical therapist," Ward says.
Bowmar 补充说：“说到你的盆底，如果你在怀孕期间没有放松和收缩它，你应该联系物理治疗师进行适当的康复治疗，以确保你不会过早提升太多并造成伤害不稳定的骨盆底。”
Bowmar adds that "when it comes to your pelvic floor, if you haven't been relaxing and contracting it while pregnant, you should be contacting a physical therapist to go over proper rehab to ensure you're not lifting too much too soon and damaging an unstable pelvic floor."
隔膜呼吸的好处
Benefits of Diaphragm Breathing
Bowmar 指出，“你还想确保你正在做适当的横膈膜呼吸来恢复你的核心。”也称为腹式呼吸，横膈膜呼吸使腹部的大肌肉参与以帮助完全填充肺部。定期练习腹式呼吸有很多好处，包括在怀孕期间或之后增强横膈膜的力量。
Bowmar notes that "you also want to ensure you're doing proper diaphragmatic breathing to restore your core." Also called belly breathing, diaphragmatic breathing engages the large muscle in the abdomen to help fully fill the lungs. Practicing belly breathing regularly offers many benefits, including building strength in the diaphragm during or after pregnancy.
以下是如何进行横膈膜呼吸：
Here's how to perform diaphragmatic breathing:
躺在平坦的表面上或坐直，背部挺直。
Lie down on a flat surface or sit up tall with your back straight.
将一只手放在上胸部的中间，另一只手放在胸腔正下方的腹部。
Place one hand in the middle of the upper chest and the other on the stomach just under your rib cage.
通过鼻子慢慢吸气，引导呼吸向下流向胃。感觉腹部的手被向外推。
Inhale slowly through the nose and guide the breath down toward the stomach. Feel the hand on your belly being pushed outwards.
当你呼气时，收紧你的腹肌，当你通过撅起的嘴唇呼气时，让腹部向内下沉。呼吸时，放在上胸部的手不应该移动。
When you exhale, tighten your abs and let the stomach fall inwards as you breath out through pursed lips. The hand on the upper chest shouldn't move during the breath.
如果你做过剖腹产，Isquick 说最好“在头六周内避免剧烈的有氧运动或举起比宝宝重的东西”。
If you've had a C-section, Isquick says it's best to "avoid vigorous aerobic exercise or lifting anything heavier than your baby for the first six weeks."
Fiorentino 补充说：“与所有运动一样，过度使用负重或剧烈运动会增加产后立即受伤的风险，所有运动都应开始并进行适当的拉伸以防止肌肉损伤。”
Fiorentino adds that "as with all exercise, excessive use of weights or strenuous activity can increase risk of injury in the immediate postpartum period and all exercise should be begun and with appropriate stretching to prevent muscle injury."
不过，他指出，“体育锻炼基本上没有风险，对新妈妈有显着的好处，有助于鼓励终身健康的习惯。”
Still, he notes that "physical activity is largely without risk and associated with significant benefit to new moms and helps encourage lifelong healthy habits."
开始锻炼时要知道什么
What to Know When Starting to Exercise
当你开始恢复你的日常锻炼时，沃德警告说你需要慢慢来。 “生孩子是一件了不起的事情，但它也可能对您的身体造成创伤。无论您是阴道分娩还是剖腹产，您的身体都经历了一个需要时间恢复的惊人过程。可以花时间治愈并与宝宝建立联系。”
When you do start getting back to your workout routine, Ward cautions that you need to take it slowly. "Having a baby is an amazing, wonderful thing, but it can also be traumatic to your body. Whether you have a vaginal delivery or C-section, your body has gone through an amazing process that takes time to recover from. It's OK to take time to heal and bond with your baby."
鲍马尔指出，产后恢复体形需要多长时间“因人而异”。她说，与其担心“恢复”到怀孕前的身体，重要的是要尽可能地为您和您的宝宝保持健康。
Bowmar notes that how long it'll take to get back in shape postpartum "varies from person to person." Rather than worrying about "getting back" to your pre-pregnancy body, it's important to think about it as remaining as healthy as possible for yourself and your baby, she says.
沃德还指出，你应该对自己放轻松。 “您的身体与生孩子之前不同，因此可能需要时间来调整并恢复到以前的健康水平。”将自己与其他新妈妈进行比较并不是一个好主意。
Ward also notes that you should go easy on yourself. "Your body is different than it was before you had the baby, so it may also take time to adjust and return to your previous fitness levels." And it's not a good idea to compare yourself to other new moms.
“生完孩子后恢复体形因人而异，”基于某些变量，沃德说。对于同一位女性来说，恢复体形所需的时间也可能因怀孕而异。
"Getting back in shape after having a baby varies for each individual," based on certain variables, Ward says. The time it takes to get back in shape can vary from pregnancy to pregnancy for the same woman too.
例如，“如果您进行母乳喂养，您的荷尔蒙会保持更长时间的升高以允许您进行母乳喂养，因此‘恢复体形'可能需要更长的时间。如果你在生孩子之前非常健康，那么比在怀孕期间停止锻炼的人花费的时间更少。”
For example, "if you breastfeed, your hormones will stay elevated longer to allow you to breastfeed, so it can take longer to 'get back in shape.' If you were very fit before having a baby, it can take less time than someone who stopped working out during pregnancy."
Isquick 同意在产后健身方面存在很多可变性。 “怀孕和生孩子会导致一个人的身体发生巨大变化。尽量恢复锻炼，避免过度劳累，因为这需要时间让你的力量和耐力恢复到怀孕前的水平。”
Isquick agrees that there's a lot of variability when it comes to postpartum fitness. "Pregnancy and having a baby cause dramatic changes in a person's body. Try to ease back into an exercise routine and avoid overexertion as it will take time to build your strength and endurance back up to pre-pregnancy levels."
她补充说，你需要“在恢复到孕前锻炼的过程中，对自己保持耐心和友善。”
She adds that you'll need to "be patient and kind to yourself as you're working back up to your pre-pregnancy exercise routine."
鲍马尔说，最好从步行开始，慢慢来。 “努力从出生后康复，不要给自己太大压力。”
Starting slowly with walking is best, Bowmar says. "Work on recovery from birth, and don't put so much pressure on yourself."
沃德说，也有一些实际的考虑。例如，“如果你是母乳喂养，你要确保在恢复锻炼时你有一个非常有支撑力的胸罩。”
There are some practical considerations too, Ward says. For example, "if you're breastfeeding, you want to be sure you have a very supportive bra when returning to exercises."
考虑到所有这些因素，沃德说，对于大多数人来说，6 到 12 个月是恢复怀孕前身材的合理时间预期。 “给自己时间。你可能无法立即恢复跑步，或者恢复到你可以立即举起尽可能多的重量，这没关系。你可以到达那里。”
With all these considerations, Ward says six to 12 months is a reasonable time expectation for most people for getting back to pre-pregnancy shape. "Give yourself time. You may not be able to return to running right away, or back to lifting as much weight as you may have been able to right away, and that's OK. You can get there."
与您的医生保持联系
Keep in Touch With Your Doctor
在此过程中，如果您有任何迹象表明出现问题，请寻求帮助。 “如果您遇到任何骨盆症状，例如漏尿、骨盆压力或任何性交疼痛，请寻求骨盆底物理治疗师的护理。那里有帮助，”沃德说。
Along the way, if you have any signs that something's wrong, seek help. "If you're experiencing any pelvic symptoms, like urinary leakage, pelvic pressure or any pain with intercourse, please seek care with a pelvic floor physical therapist. There is help out there," Ward says.
Isquick 补充说，如果您“感到疼痛、尿液或大便渗漏、脱垂（膀胱、子宫或直肠变弱，导致骨盆向下运动）或在运动时发现更多出血，请与您的提供者联系，他们可能会鼓励你放慢速度或推荐盆底物理治疗。”
Isquick adds that if you're "experiencing pain, leakage of urine or stool, prolapse (weakening of the bladder, uterus or rectum, resulting in downward movement in the pelvis) or notice heavier bleeding while exercising, follow up with your provider who may encourage you to slow down or recommend pelvic floor physical therapy."
最后，Isquick 指出，产后锻炼可以成为一种很好的终生新习惯。 “如果你在怀孕前或怀孕期间没有坚持锻炼，产后是开始为你和你的家人建立健康习惯的好时机。除了帮助减轻婴儿多余的体重外，定期锻炼还能促进更好的睡眠、减轻压力、改善情绪并可能有助于预防产后抑郁症。”
Lastly, Isquick notes that exercising postpartum can be a great new lifetime habit. "If you didn't have a consistent exercise practice before or during pregnancy, the postpartum period is a great time to start building healthy habits for you and your family. In addition to helping to lose excess baby weight, having a regular exercise routine promotes better sleep, reduces stress, boosts your mood and may help to prevent postpartum depression."
