It's tempting to hit the gym when your doctor gives you the all-clear to start exercising postpartum. And if only it were that easy. During pregnancy, the body undergoes massive changes as it makes room to carry a baby, causing muscles, ligaments, and tendons to stretch and loosen. This physical change can be difficult to experience as you can feel weakness where there has been strength and instability where there has been strong stabilization.
The good news is that you can take important steps during the fourth trimester to strengthen your pelvic floor and restore your core strength and health. And with a little patience, knowledge, and the help of a pelvic floor physiotherapist, not only will you regain your core strength postpartum, you may return to your exercise routine stronger than before thanks to building a strong pelvic floor.
From separation & pelvic floor explained:
Diastasis recti – the dreaded abdominal muscle separation in front of the torso is feared by many expectant mothers. Luckily, "diastasis recti is normal and doesn't mean your abs are ruined," says Rachel Trotta, NASM-certified personal trainer specializing in women's fitness, prenatal and postnatal nutrition, and therapeutic exercise.
During pregnancy, the core tends to become stretched and separated. As the pregnancy progresses and the baby grows, the abdominal muscles are in a habitually elongated and weakened position. "Similarly, the pelvic floor (that's the muscular base of the abdomen that connects to the pelvis) gets stressed," says Trotta. "Carrying on extra weight for months — not to mention the labor itself — puts pressure on the hammock-like muscles of the pelvic floor," she explains.
Because the core and pelvic floor are responsible for everything from balance to holding urine, things will feel a little "fancy" when a new mom returns to exercise. "Something as small as sneezing or as unexpected as stepping off a curb can trigger urinary leakage, and either end of the spectrum — overdoing it or not exercising at all — can promote symptoms like pelvic pressure or lower back pain," says Trotta.
More good news: With the right attention during the postpartum period, you can not only make a full recovery, but come back stronger, faster, and fitter than ever!
The best exercise after childbirth: single-leg exercises
Single-leg movements, also called unilateral exercises, are movements in which you either balance on one leg or have one leg pulling most of the load. Trotta loves the one-legged work for women after childbirth for three reasons:
- Using only one leg at a time, mimic common, functional movements—like kneeling to pick up your baby, climbing stairs, or even tripping and catching. They need balance and coordination for real life.
- We tend to have a "favorite side," and this habit is only emphasized in the postpartum period when you find yourself holding your baby to one side more often. Single-leg exercises help correct muscular imbalances and prevent resulting discomfort (such as back pain).
- Single-leg exercises present your body with a unique challenge that helps strengthen your abdominal and pelvic muscles after childbirth. Using only one side of your body demands more balance and stability from your core muscles, which means your core and pelvic floor recover faster and smarter. more leaks!
5 postpartum exercises to avoid
Although all women are unique in their recovery journey, it's generally recommended to avoid the following exercises and other similar exercises until at least six weeks after childbirth—sometimes even later:
- sit ups
- Leg Raises (from the back)
"These movements create high so-called 'intra-abdominal pressure', which can impair diastasis recti recovery, pelvic floor coordination and wound healing in the early postpartum period," says Trotta.
Although many women have been technically cleared by their obstetrician to resume exercise at 6 weeks, Trotta encourages postpartum mothers to treat this as a time to rebuild and not pick up where they left off before pregnancy.
Instead of jumping into a vigorous exercise routine (even jogging) to lose weight, Trotta likes to frame the "fourth trimester" as a time to strengthen the pelvic floor, rebuild the core, and prevent urine leakage.
Photo by Bruce Mars on Unsplash
Incorporate postpartum exercise into your lifestyle and workout:
(Remember, if you had a cesarean section, you must get official approval from your doctor before doing any type of exercise.)
Trotta strongly recommends that new moms avoid formal exercise for the first two weeks and just focus on resting, going for short walks, and getting to know their new baby. "Use floor time with your baby for abdominal breathing exercises, light stretching exercises and mobility exercises," says Trotta.
This time is also a fantastic time to develop a relationship with a Pelvic Floor Physiotherapist who can give you personalized exercises to promote pelvic floor regeneration. Here, Trotta shares a quote from veteran pelvic floor physiotherapist Kim Breslin.
“Whether a woman is delivering a baby vaginally or via cesarean section, she will absolutely benefit from seeing a pelvic floor physiotherapist. The body goes through major physical changes during pregnancy, labor and childbirth and deserves special attention when healing after childbirth. There's no one-size-fits-all exercise to heal the pelvic floor (Kegels aren't the answer!), but seeing a specialist can help resolve difficult symptoms like bladder weakness, prolapse, abdominal separation, or pelvic pain that can be a barrier to resuming exercise.”
Before you're officially approved for exercise, you can begin to rebuild your muscles and aid your recovery by continuing your breathing exercises and adding in plenty of stroller walking and gentle stair climbing (in real life situations, not the gym). You can also train your one-leg strength with:
- Four-legged leg extensions
- Standing from half kneeling
- Stroller walking uphill
At this point, many women are cleared for formal exercise.
"Rather than jumping right back into a running or HIIT class routine, incorporate single-leg exercises like these into moderate workouts to gradually rehabilitate your core and pelvic floor," says Trotta.
For each movement, start with 8 reps per side and increase to 20 reps per side.
- One-legged stand-up aid
- Single leg bridges
- Bodyweight split squats
- Side leg raises
Practice these exercises with proper breathing and allow the pelvic floor to relax between each repetition. "Even if you feel the urge to 'shape' or 'flatten' your postpartum core, I would still advise against direct ab training, running, and high-intensity exercise." Trotta recommends.
Once you are past the "fourth trimester" you will be significantly recovered and will most likely be able to resume your regular training and incorporate plenty of abdominal exercises with good breathing and control. "But keep an eye out for worrisome symptoms like leaking urine, pelvic heaviness, or abdominal doming when you sit up — gradually increasing the intensity can help prevent pelvic floor dysfunction, even if you're itching to get right back to your regular workout." return to routine." warns Trotta.
More advanced postpartum single-leg exercises that Trotta recommends at this point include:
- Single leg weighted deadlift
- pistol squats
- Reverse lunge to single leg jump
The postpartum period is not a time to be inactive, but it is also wise to adopt the “practice slow to go fast” mentality. It's not time to push yourself, but instead to lay a foundation of solid fitness, breathing coordination, and core strength that will both tone your abs and increase your athleticism for years to come.
Photo by Juan Encalada on Unsplash
Postpartum training for a stronger core
(This is an example bodyweight workout, short and sweet for a mother with a 6-12 week old baby.)
Instructions: Perform 8 reps of each of the following exercises (8 per side for the single-leg exercises), rest 60 seconds, and then repeat as many times as possible within 12 minutes. Perform slowly and carefully with good breathing.