Postpartum Exercises

Recommended Postpartum Exercises

The following exercises can typically be initiated within two days after a vaginal birth or five days following a cesarean section:

1. Deep Breathing with Abdominal Contraction
   
   

   • Sit comfortably and take deep breaths, drawing air from the diaphragm upward.
   • While inhaling, tighten and contract the abdominal muscles, holding the contraction briefly.
   • Relax the muscles as you exhale.
   • Gradually increase the duration of the contraction over time.
     
     

2. Kegel Exercises

   
   

   • Contract the pelvic floor muscles by mimicking the action of stopping the flow of urine or stool.
   • Hold the contraction for five seconds, then relax for five seconds. Repeat this cycle 10 times.
   • Follow this with a "pulsing" sequence: contract and hold for one second, then release for one second, repeating 10 times.
   • Complete a minimum of three sessions daily, ensuring normal breathing and relaxation of the legs, abdomen, and buttocks during the exercises.
     
     

3. Pelvic Tilt
   
   

   • Inhale deeply, then tilt the pelvis forward, lifting the pubic bone upward while avoiding tightening
     the gluteal muscles. Hold for three seconds and repeat 5–10 times.
   • This exercise can be performed lying down, sitting, or standing.
   • For a standing variation, position your feet slightly away from a wall with knees bent at approximately
     130–145 degrees.
     
     

4. Pelvic Tilt with Alternate Leg Movement
   
   

   • Lie on your back with knees bent and feet on the ground. Place one hand under your lower back.
   • Perform a pelvic tilt, maintaining constant pressure on your hand. Slowly slide one leg down, keeping the
     foot in contact with the surface, then return to the starting position.
   • Alternate legs, repeating the movement five times on each side.
   • If maintaining the pelvic tilt proves difficult, pause and revisit this exercise after building core
     strength. (A physiotherapist's guidance is recommended to ensure correct technique)
     
     

5. Abdominal Bracing
   
   

   • Lying Position: Lie on your side with bent knees. Relax fully, breathe in deeply, and as you
     exhale, draw your belly button towards your spine.
   • Standing Position: Gradually increase both the duration and strength of the contraction over
     time. Aim to hold for 5–10 seconds while breathing normally, then release. Repeat at least four times.
     
     

6. Walking
   
   Walking promotes activation and toning of the pelvic floor muscles, which connect to the thighs
   and lower spine. Regular walking supports the recovery of pelvic alignment and tonus.

Advanced Postpartum Exercises

For individuals ready to progress:

1. Head Lifts
   
   

   • Lie on your back with knees bent and feet flat on the floor. Keep the lower back flush against the floor.
   • Relax the abdomen while inhaling, then exhale and lift your head and neck. Lower slowly while inhaling. Perform 10 repetitions.
     
     

2. Shoulder Lifts
   
   

   • Follow the same starting position as above. Exhale and lift your shoulders and head, reaching towards your knees. If neck strain occurs, support the head with your hands. Perform 10 repetitions.
     
     

3. Curl-Ups
   
   

   • Progress from shoulder lifts by raising the torso halfway towards the knees, holding for 2–5 seconds. Exhale during the lift and inhale as you lower.

Postural and Diastasis Recti Rehabilitation

Regaining proper posture and addressing diastasis recti are vital components of postpartum recovery.

• During pregnancy, changes in weight distribution shift the center of gravity forward, necessitating compensation by other muscles. This, coupled with the reduced support from stretched abdominal muscles, affects posture.
• Postpartum, retraining the body to activate the deep core muscles for proper posture is essential, especially for individuals with multiple close pregnancies.
• Exercises aimed at restoring tonus in abdominal and pelvic muscles are critical for alleviating issues such as back pain and instability.

Understanding Abdominal Changes Postpartum

• The abdominal connective tissue, linea alba, stretches during pregnancy, leading to diastasis recti in 100% of women post-birth (defined as a separation of >3cm).
  
  
• Although spontaneous recovery occurs during the first eight weeks postpartum, targeted exercises are necessary beyond this period to rebuild core strength and elasticity.
  
  
  

Additional Resources and Recommendations

• Recommended Apps and Websites
  
  

  • MamaTummy App: Provides step-by-step guidance for postpartum exercises.
  • Kegel Trainer: Offers reminders and tracking for daily pelvic floor exercises.
    
    

• Notable References
  
  

  • Katarina Woxnerud's Mammamage (Swedish Osteopath): Offers postpartum exercise insights.
  • Holli Spicer-Clepper's Books: Extensive research on postpartum health and fitness.
    
    

• Useful Links
  
  

  • Diastasis Recti Information and Test Guide
  • Hormonal Changes in Pregnancy
    
    

For additional support, personalized consultations, or access to advanced classes (e.g., postpartum yoga or hypopressive techniques), please contact the instructor or visit the provided links.

References

1. https://www.uclh.nhs.uk/OURSERVICES/SERVICEA-Z/WH/MAT2/POSTNATALCARE/Pages/Postnatalphysiotherapy.aspx

2. https://www.webmd.com/parenting/baby/6-exercises-for-new-moms#1

3. https://www.webmd.com/baby/guide/abdominal-separation-diastasis-recti#1

4. http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=438&np=464&id=2825

5. Vine GS. Physiology of Pregnancy in: Obstetrics and Gynecology. Kaufman MS, Holmes JS, Schachel PP, Stead LG. Third edition 2011. McGraw-Hill Medical

6. Postpartum Care in: Obstetrics and Gynecology. Beckmann CRB, Ling FW, Herbert WNP, Laube DW, Smith RP, Casanova R, Chuang A, Goepfert AR, Hueppchen NA, Weiss PM. 7th edition 2014. Lippincott Williams & Wilkins

7. https://www.pregnancybirthbaby.org.au/physiotherapy-advice-after-pregnancy

8. R. Elaine Turner. Nutrition in pregnancy in: Modern Nutrition in Health and Disease. Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR. 11th Edition 2014. Lippincott Williams & Wilkins

9. Michalska et al.; Diastasis Recti Abdominis - A Review of Treatment Methods. Ginekologia Polska 2018 Vol 89, no.2, 97-101