Exercising After Delivery

 

Most new moms are ready to shed those extra pounds and jump right back into their pre-pregnancy workouts right after giving birth. With all the changes that have happened to your body over the last 9 months doing what you did before getting pregnant might not be the smartest and safest thing for your body.  I’ve had clients come into my practice having created issues in their body from their post birth exercise routine.  I don’t want this for you.  Here are the top 3 issues that can occur if you aren’t careful and what you can do about it to protect yourself from developing them in the first place.  

3 Issues you want to Avoid when Resuming Exercise After Delivery

Low Back Strain/Pain

 

Two of the four main muscles of our core get stretched to the brink with pregnancy and labor.  The transverse abdominus muscles and the pelvic floor muscles are responsible for keeping our spine and pelvis stable while we move our limbs.  It’s important to make sure these muscles work appropriately prior to embarking on any exercise program so you don’t develop any low back pains.  

A good postpartum program should focus on rehabbing the reflexiveness of your core so the muscles work automatically without you having to think about it.  After birth though, you may have to retrain this automaticity in your core to turn on prior to movement.  

One way to see what is happening with your transverse muscle is to cough.  Place your hand on your lower belly and cough.  What does your lower belly do?  If it juts out then your TA is not working well.  

See if you can work on having your lower belly draw in with a cough.  

I have my clients work on shushing.  Do some SH’s with the lower belly drawing in.  Keep practicing this until it becomes automatic.  You also want to become aware of your lower belly drawing back in prior to any exertion with exercises.   

 

Prolapsing of your Pelvic Organs

When your pelvic organs fall down out of place in your vaginal canal it’s called a prolapse.  You can have your bladder, uterus, or bowel prolapse.  One organ or all three can come out of place.  There are different degrees of prolapse from mild to severe where your organs find their way outside of your vagina.  The most common symptom of a prolapse is a heaviness or pressure in the vagina, like a tampon is falling out, that tends to get worse by the end of the day.

Prolapse is a pressure and postural issue.  You first need to stop doing habits that put more downward pressures on your pelvic organs then you need to learn how to manage your intra abdominal pressures.  With everything you do, you are either supporting your pelvic organs or not.  You need to become aware of how you do anything and everything and learn how to do it with better support and less pressure down on your pelvic organs.   

Pregnancy can change your posture a lot.  If you allow yourself to let your belly lead you and fall into your expanded belly by tucking your bottom under you are setting yourself up for potential prolapse issues.  Especially if you don’t stop this habit after having the baby.  

Whenever you laugh, cough, sneeze, or exercise and your abdomen goes forward forcefully, downward pressure gets applied to the pelvic organs and potentially pushes them down thus stretching out supportive tissues. Any jumping, running or high impact exercises can create the same forces.  You must learn how to manage your intra abdominal pressures so the forces avoid going downward.  

Again making sure your core activates well and in a reflexive nature is key to preventing this issue.  In my Confidence in your Core, Pelvic Floor and More online course I teach you a progression of strengthening exercises that helps you to activate your core in a safe way and you can learn how to better manage your pressures.  

 

Diastasis Recti

A diastasis recti is a separation of the rectus abdominus muscle, otherwise known as the six-pack muscle. The rectus abdmonius muscle runs from the sternum down to the pubic bone and has two muscle bellies separated by a connective tissue called the linea alba. During pregnancy, as the uterus expands the two muscle bellies separate and the linea alba gets stretched thin. It is very important to allow this connective tissue to heal so the muscle bellies can come back together and stay.  Doing exercises that create a lot of doming or strain on the linea alba doesn’t allow it to heal. If you are constantly breathing into your belly and expanding it with your breath, the linea alba will never have time to heal.  You need to find the fine line of putting tension on the linea alba through exercises to help it to heal but not straining it too much to prevent healing.

One of the first things that can help this separation is releasing the oblique muscles.  These are the muscles on either side of your trunk that help you to twist.   They get tight being pregnant and that tightness pulls the recti muscles apart.  Stretching them out allows the muscles to come back to midline.  Doing a stretching twist of your trunk allows the muscles to lengthen.  In my Confidence in your Core, Pelvic Floor and More online course I teach you a very effective stretch and how you can massage your muscles to lengthen them and help your diastasis heal faster. 

 

So what’s a new mom to do?

It is so important to realize how weak your muscles are after delivery.  There are two exercises that you need to begin as soon as possible to help you on your road to recovery.  

 

Transverse Abdominus Muscle Strengthening

One exercise is contracting the transverse abdominus muscle and it’s best to do this in the sitting position with your back straight.   Sitting up against a wall is best initially until you get the feel for the exercise and then you can do it standing or sitting anywhere.    Think about bringing your belly button back, up and in like a hook motion.  Make sure your chest doesn’t move up as you do this, as the only thing moving should be your belly muscles.  Hold this position for 5 seconds and without it moving out away from your spine try and squeeze the muscle tighter than before for a little pulse.  Do 10 pulses and then relax the muscle. Ideally you are doing an isometric contraction of the transverse abdominis, taking this stretched out muscle to its end range and tightening it to help it to shorten again.  If you feel your pelvic floor muscles activating as well, that is great!  Allow that to happen.

It’s VERY IMPORTANT that you make sure you are not holding your breath while doing this.  If you count the pulses out loud you won’t be holding your breath.   Do as many pulses at one time as you can do well and do that 3-5 times throughout the day.  Try for a goal of 100 pulses at one time.  If you get sloppy or uncoordinated your muscle is fatigued and you need to stop.   

Pulling this muscle back into your spine as far as you can is good to do during any activity that may cause your belly to bulge outward, as in laughing, coughing, sneezing and exercising.

Pelvic Floor Muscle Strengthening

The other exercise you can also be doing within 24 hours of giving birth is contracting your pelvic floor muscles or doing a Kegel as they are called. Being able to hold a pelvic floor contraction, or kegel, for 10 seconds is considered normal.  If you tore these muscles during birth you may need to wait until it’s pain-free to contract them before beginning these exercises.  Initially you will be lucky to hold the contraction for a couple of seconds as these muscles get really stretched out in a vaginal birth.  With a c-section you can begin these exercises immediately.  Even though the baby didn’t come out through your vagina the pelvic floor muscles are still weak from carrying the weight of your baby for 9 months.  

To do this exercise you will want to make sure you are just contracting the pelvic floor muscles only.  Since they are so weak the gluteal, or your butt muscles, will want to help out.  When you are doing a Kegel contraction nobody should know you are doing anything as nothing should be moving outside of your body.  The best position to do a kegel in to make sure you don’t use any other muscle is either in child’s pose (down on your knees, butt on your heels and chest leaning forward on thighs and arms reaching out on the ground) or sitting on a chair with your legs spread wide apart.   Think about lifting your pelvic floor muscles up and inside of your or bringing your tailbone forward toward your pubic bone.  You want to hold this contraction for 10 seconds.  When you feel the muscle fading away just keep trying to re-engage the muscle.   Keep doing this for 10 seconds then relax.  You only want to do 3 sets of these 10-second contractions at one time as the muscles are small and will fatigue easily.  You can do them every hour though.

 

Note if you find your pelvic floor muscles are extremely difficult to contract and are not getting stronger no matter how many contractions you do, please go see a Birth Healing Specialist who has taken my Postpartum course.  They will be able to help you get your pelvic floor muscles working better with less effort on your part.  

 

These two exercises and walking are really the only things you should be thinking about doing for the first 6-8 weeks.  Honor your body and what it has been through and let it recover.  With a vaginal birth your pelvis has been stretched to its end limits of motion and needs time to solidify again.  The hormones are still in your system making your joints flexible and it takes about 3 months for your pelvis to regain the stability it once had before becoming pregnant.  That is why I recommend you wait for 3 months before you start jogging and doing any high impact aerobic activities.  Allow your joints to become stable again before imparting undue stress on it.  

As this is just a recommendation it is best to really pay attention to how your body feels in doing any activity postpartum.  Test it out and see how you feel with the activity.  If you feel your pelvis is still “mushy” and not really stable then that is a sign to wait a little bit longer before trying that activity.  Keeping in mind the principles discussed in this article you can slowly incorporate other exercises into your fitness routine and see how your body responds.

 

Best of luck to you on your recovery from birth!