Disclaimer: This article is intended for general educational purposes and should not replace individualized medical advice, assessment, or treatment. Postpartum recovery and return to exercise are highly individual. If you are experiencing symptoms, have concerns about your recovery, or are unsure how to progress your activity, seek guidance from an appropriately qualified healthcare professional.

Introduction:

Staying active during pregnancy and returning to exercise postpartum can provide significant physiological benefits, regardless of previous training or activity level. Exercise can be defined as planned, structured, and repetitive physical activity performed with the aim of improving or maintaining one or more components of physical fitness, for example increased strength. However, to date, there is no rehabilitation model that assesses the full spectrum of return to exercise with guidelines on optimal progression alongside postpartum symptoms that may arise, and return to full activity.

The six-week postpartum check is often viewed as the point of medical clearance to return to normal activity. However, the “magic” six-week mark is not a universal starting point. Previous training experience, activity during pregnancy, mode of delivery, birth-related complications, symptoms, and individual recovery can all influence when and how someone returns to exercise. For some, this may mean delaying or modifying certain activities, while others may be ready to begin rehabilitation and physical activity before six weeks.

During postpartum healing and recovery, the pelvic floor and surrounding tissues may have a reduced capacity to tolerate repeated loading. For this reason, it can be helpful to consider all activity as part of the overall physical demand placed on the body, rather than looking at individual exercise sessions in isolation. This is especially important if you are experiencing symptoms. 

When considering returning to exercise, four variables provide a useful framework for progressing exercise postpartum: frequency, time (duration), intensity, and type of exercise (activity) also known as FITT. 

The four variables: 

1. Frequency 

Frequency refers to how often you exercise within a given period, usually across a week. It can refer to how many times you train a specific muscle group or how frequently you perform a particular type of activity, such as running.

The World Health Organization recommends strength training to be performed two times a week and moderate intensity activity 150-300 min a week. This may be a good starting point for most to lean on to as a general recommendation. 

When returning to exercise postpartum, increasing frequency too quickly may leave less time for adequate recovery between sessions. Recovery is influenced not only by the time between training sessions, but also by factors such as sleep, nutrition, and all the other physical demands of daily life, including a mum’s favourite pastime: walking! And, of course… carrying, lifting, and rocking the baby.

These activities are sometimes forgotten when we think about our overall exercise load, but they can add up to a significant amount of physical activity throughout the day, especially if you have a baby who isn’t particularly fond of lying in the baby carriage! And let’s not forget walking while carrying your baby in a wrap or sling.

All activity adds up. When considering how frequently you exercise, it’s important to look beyond your planned training sessions and consider the total amount of physical activity your body is managing throughout the day.

When considering frequency, ask yourself: Does my current combination of exercise, daily activity, and recovery allow me to recover well and feel ready for my next session? Am I experiencing symptoms from my pelvic floor?

Furthermore, when gradually returning to endurance training postpartum, adjusting the duration of each session may be more manageable than reducing how frequently you train. This also enables you to aim for 2-3 sessions per week that are favorable for cardiorespiratory, metabolic and psychological adaptations.

2. Time (duration)

How long is your session

Duration/time is the length of each exercise session. A 15-minute walk and a 60-minute walk may be the same activity, but they place very different demands on the body. The same applies to strength training, running, cycling, or other forms of exercise. However, it interacts closely with intensity as the intensity increases, the maximal duration that can be sustained will decrease. 

When considering strength training a longer session that includes a variety of standing and supine and/or prone positions may be tolerated better than a session that includes only standing exercises. The complexity of the exercise will also be something to consider, as more complex exercises challenge coordination and timing of the muscles, including the pelvic floor. What encompasses a complex exercise is highly individual. For one person it could be performing a snatch, for someone else it could be doing a squat. 

A reminder again is that during the postpartum period the pelvic floor (and abdominal muscles) are recovering and that includes not only anatomical healing of the muscles and nerves that supply the muscles (so that they can actually contract) but also connective tissue recovery that is important for support.  A longer exercise session may place greater demands on the body and the capacity of the tissues to tolerate sustained or repeated load. 

When those demands exceed your current capacity, fatigue may develop and, in relation to the pelvic floor, you may notice symptoms such as heaviness, leakage, or pain in the pelvic region. Symptoms provide information that can help guide how an activity may need to be modified. 

Importantly, it doesn’t necessarily mean that you need to avoid  exercise altogether. Instead, it may be time to stop and take a look at the bigger picture, particularly the previous hours. Sometimes, we simply may progress too much, too soon, without giving the body enough time to adapt to a new challenge. In this situation, modifying the duration of the activity may be one way to better match the exercise to your current capacity.

Questions that you can ask yourself when experiencing symptoms: What had you been doing before your session? How was your night’s sleep and overall recovery? What other physical activity have you done? How has your exercise progression been planned?

If you are experiencing new, persistent, worsening, or concerning symptoms, or you’re simply unsure about how to progress, get in touch with a registered naprapath or physiotherapist with continuing education in pelvic health, who can assess your individual situation and help guide your return to exercise.

Shorter sessions can be a useful way to reintroduce activity postpartum and gradually build your capacity before increasing how long you exercise. But remember, a shorter session isn’t necessarily an easier session! This brings us to our next variable: Intensity.

3. Intensity

How hard are you exercising? Intensity refers to how demanding the exercise is and the perception of HOW demanding an exercise is, is very individual! 

This includes both strength training and endurance (cardiovascular). You can manipulate intensity in many ways: walking faster, walking or running uphill, jogging or running instead of walking, lifting a heavier weight, changing type of equipment, or body position. 

Early in your return to exercise, the goal is to find an appropriate starting point and gradually increase the challenge as your capacity improves.

4. Type of exercise

The type of exercise or activity you want to return to is another important consideration, as different activities place different demands on the body. However, many exercises can be modified to better match your current capacity. This may include changing the mode of exercise, such as cycling instead of running. In strength training, for example, changing an exercise from standing to a supine or prone position may alter or reduce the demand placed on the pelvic floor while still allowing you to continue training. By understanding the different variables modifications can be made to promote progression. 

Take CrossFit, for example. Not only can the intensity of a workout be adjusted, but individual exercises can also be modified. Box jumps might initially become step-ups onto a low box. From there, you could progress to a higher box before gradually reintroducing jumping onto a lower box. 

Strength exercises can be modified in countless ways by changing the load, range of motion, position, exercise selection, volume, or resistance. If your goal is to return to running or another higher-impact activity, strength training can help progressively build the capacity needed to tolerate those demands through increased strength and neuromuscular adaptations. 

Running introduces repetitive impact and requires the body to repeatedly absorb and transfer forces with every step. Ground reaction forces during running can reach approximately three times body weight, making strength, load tolerance, and recovery important considerations when preparing to return to running.

However, running itself can also be modified. This might mean running at a slower pace (intensity), completing a shorter run (time), or reducing the number of running sessions per week (frequency). Other modifications, such as changing the incline or terrain, can alter running biomechanics and how loads are distributed throughout the lower limb.

Cycling or crosstrainer may also be a useful lower-impact option during this process, allowing you to work on cardiovascular fitness and endurance while gradually preparing for higher-impact activities such as running. 

So, ask yourself: What type of exercise or sport do I want to return to? Considering frequency, duration, intensity, and the specific demands of that activity, is there anything I need to modify or gradually build towards? 

Why consider all four?

Frequency, time (duration), intensity, and type of exercise don’t exist independently.

If you increase how often you exercise, how long you exercise, and how hard you exercise all at the same time, you’re making a significant jump in overall training load.

Instead, think about progressing these variables gradually.

For example, you might first increase the time of your walks while keeping the frequency and intensity relatively consistent. Later, you could introduce a small increase in intensity and observe how your body responds. As you start running, you may want to work on progressing time first then gradually add intensity.

One practical approach is to keep the overall structure of your exercise relatively consistent, including frequency, time, intensity, and type of exercise, for a period of time before progressing further. This gives you an opportunity to observe how your body responds both during exercise and in the hours and days that follow.

If things are going well, consider changing ONE variable at a time. You might increase time/duration. Again, repeat and stick with the same structure for a period of time ( 2weeks = 4-6 sessions). The most important is to maintain a structure and these variables will help you with that structure and hopefully progression.

Why one at a time? Because the body needs time to adapt to new demands. Gradually progressing these variables gives your body an opportunity to build capacity while also making it easier for YOU to recognise how you are responding to each change. 

The goal is to build a level of exercise your body can tolerate, recover from, and gradually progress. Think of it like building a house: a strong foundation is essential for long-term stability and you don’t want to build on shortcuts!

There is no single timeline that will work for everyone. Your starting point and progression will depend on your individual recovery, symptoms, previous activity level, goals, and the type of exercise or sport you want to return to.

Finally… How do we start, and how do we progress postpartum?

A general progression might look something like this:

1. Start with everyday activity
   Begin with manageable amounts of daily movement, such as short bouts of walking, and gradually build from there. 
2. Gradually work towards physical activity recommendations
   Over time, aim to work towards the recommended 150 minutes of moderate-intensity physical activity per week, alongside muscle-strengthening activities on two or more days per week. Strength training doesn’t necessarily mean going straight back to the gym—it might begin at home using body weight, resistance bands, or other appropriate exercises.
3. Introduce more structured exercise
   As your capacity increases, you may begin introducing more structured training, whether that’s at the gym, at home, or through another form of exercise you enjoy.
4. Progress towards your individual goals
   If your goal is to return to a particular activity or sport, training can gradually become more specific to the demands of that activity. This is where frequency, duration, and intensity become particularly useful variables to manipulate as you progress.

And a gentle reminder: there is no race to get back. Returning to your previous level of exercise or sport may take many months and, for some, the process may continue throughout the first year postpartum or beyond. 

In summary, we should move away from simply telling new mothers that particular exercises are inherently “safe” or “dangerous.” Physical activity should be encouraged and, most importantly, applied on an individual basis. Rather than categorising an exercise as dangerous, it may be more useful to consider whether that exercise presents an appropriate level of challenge for the individual at that point in their recovery.

Join the movement!

Mary-Lou – leg naprapat, advanced practitioner pelvic health 

References:

American College of Obstetricians & Gynecologist (2020) no: 804. Accessed: September 6, 2026. Available at: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period

Komici, K., Bianco, A., Cuomo, A., Bianco, R., Illario, M., Guerra, G., Paoli, A., Schena, F. and Iaccarino, G. (2026) ‘Practical guidelines for exercise prescription in different clinical populations’, Frontiers in Sports and Active Living, 8, 1649549. doi: 10.3389/fspor.2026.1649549.

Schoenfeld, B.J., Ogborn, D. and Krieger, J.W. (2016) ‘Effects of resistance training frequency on measures of muscle hypertrophy: A systematic review and meta-analysis’, Sports Medicine, 46(11), pp. 1689–1697. doi: 10.1007/s40279-016-0543-8

Schulz, J.M., Marmura, H., Hewitt, C.M., Parkinson, L.J. and Thornton, J.S. (2023) ‘Navigating the “new normal”: What guidelines exist for postpartum return to physical activity and sport? A scoping review’, British Journal of Sports Medicine, 57(24), pp. 1573–1578. doi: 10.1136/bjsports-2023-107166

Selman, R., Early, K., Battles, B., Seidenburg, M., Wendel, E. and Westerlund, S. (2022) ‘Maximizing recovery in the postpartum period: A timeline for rehabilitation from pregnancy through return to sport’, International Journal of Sports Physical Therapy, 17(6), pp. 1170–1183. doi: 10.26603/001c.37863.

Stavrinou, P.S., Astorino, T.A., Giannaki, C.D., Aphamis, G. and Bogdanis, G.C. (2025) ‘Customizing intense interval exercise training prescription using the “frequency, intensity, time, and type of exercise” (FITT) principle’, Frontiers in Physiology, 16, 1553846. doi: 10.3389/fphys.2025.1553846This section provides an overview of the blog, showcasing a variety of articles, insights, and resources to inform and inspire readers.