Pregnancy is like running a marathon for 40 weeks straight. Research shows that a pregnant person operates at 2.2 times their resting metabolic rate—and that’s just during pregnancy. Yet, how often do we hear about people training for pregnancy in the same way an average person trains for a marathon? What about the recovery process after pregnancy? Do we talk about this in a similar way we may talk about the aftermath of a marathon?
Typically, the answer is no.
Going to a pelvic floor physical therapist during pregnancy is recommended, but it can be even more important after giving birth. Your postpartum body is incredibly resilient and adaptive, but it takes time to heal and regain its strength and coordination. If you try to exercise too intensely too early, you may not only hinder your recovery, you’re more likely to cause physical injuries that could negatively impact you for months or years to come.
Just as you see the doctor at six weeks postpartum, I highly recommend you also make an appointment with a pelvic floor physical therapist (PT) around that same time. During pregnancy, the pelvic floor muscles have worked hard to support you, your growing baby, and your widening pelvis for up to nine months. After birth, some people might have pelvic floor muscle tension, whereas others might have weakness (or possibly a combination of both). A pelvic floor therapist can accurately assess what your muscles need to heal, strengthen, and recover.
Here are some safe, targeted exercises that I recommend for new moms to help reactivate the abdominal muscles and pelvic floor, encourage healing, and set a perfect foundation for recovery and a return to exercise once cleared to do so by an OBGYN.
This is a continuation of the exercise above, but we turn a relaxing breath/exercise into a powerful, functional exercise.
- Begin in the same starting position as in the exercise above.
- Inhale through your nose, feeling your belly rise and your pelvic floor lengthen and let go.
- Exhale like you are blowing through a straw, tightening and contracting your pelvic floor muscles and engaging your deep core as the abdomen moves belly to spine. (This can take some practice.)
- If it is too challenging to coordinate both your pelvic floor and core, start by focusing on engaging just the pelvic floor on the exhale. When that gets easier, add in the core. These muscles work together and work better with our breath, so the practice is worth it!
- Try five to eight repetitions, and rest.
- Do two to three sets, depending on fatigue levels.
This is a less complicated exercise but still an important one after birth.
- Begin by lying on the floor with your knees bent and feet flat on the floor. (As this exercise gets easier, you can progress to trying it in a sitting position and eventually in a standing position.)
- Imagine there is a marble outside the vaginal opening at the bottom of your pelvis. Use the pelvic floor muscles to tighten and pull the marble up into your pelvis. Bring that marble as deep into the pelvis as you can without using any other muscles in the body.
- After completely tightening your pelvic floor, release the muscles and bring the marble back down. (You must relax the muscles after you tighten them, just as with any other exercise.)
Pro tip: Do not hold your breath, and try to only use the pelvic floor muscles. No one should be able to tell you are doing this exercise.
- Try to do 10 repetitions, and see if the muscle fatigues before you finish. Work up to three sets of 10 reps.
When you are ready to try a more coordinated exercise, you can pair the pelvic floor with a movement like a bridge.
- Start by lying on your back with knees bent, feet flat on the floor, and heels close to your glutes.
- Take a big inhale, and let the belly rise and pelvic floor relax (just like in the second exercise).
- Exhale like you are blowing through a straw as you engage your pelvic floor muscles and pull your abdomen muscles in, lifting the glutes up towards the ceiling. When you lift the glutes, think about driving the hips up and knees forward to really engage your posterior chain.
- On the inhale, relax your muscles, and come back down.
- This exercise takes practice and coordination, but it helps prepare you for more strenuous exercises.
- Try 10 repetitions, and work up to three sets of 10 reps.
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