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Rebuilding a Safe Foundation for Exercise Postpartum

hi, i'm dr. kayla!

DPT & mama of three who is passionate about proactive, root-case women’s health care.

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Congratulations! You’re a new mama. And now you’re wondering how and when you can begin a safe return to exercise. You have likely heard that formal clearance to “return to exercise” comes from your OB-GYN or Midwife at your 6 week follow up visit. However, that does not mean that you need to be sedentary until your 6 weeks postpartum visit. This also does not mean when you get the “green light” at 6 weeks, that you should go directly into your prior activity levels. In fact, a slow and steady progression is best to help rebuild your foundation. The below exercises are gentle and meant to help you reconnect with your body.

Always consult your personal physical therapist or healthcare provider if you are unsure if this is right for you. I’m happy to help you through this on a 1:1 basis as well, where we will tailor the program to you and your needs. Check out my offerings here if this applies to you.

Benefits of Early Activity Integration

  • Reduce muscle and joint tension/stiffness
  • Improve muscle activation
  • Improve posture
  • Assist lifting mechanics
  • Decrease injury risk
  • Reduce leakage
  • Improve blood sugar levels
  • Increase mood

These exercises are even helpful to understand prior to birthing, so you can easily implement them from home after your child is born. By developing this foundation postpartum, you will be able to return to your prior activity levels with greater ease once formally cleared to do so.

Let’s reconnect with those muscles, shall we?

Diaphragmatic Breathing – Envision a canister with your diaphragm on the top, pelvic floor on the bottom, abdominals in the front and backside muscles completing the canister that is your core. As you breathe, this system should work together to expand on your inhale and recoil on your exhale. Diaphragmatic breathing is not just belly breathing, it’s 360 degree breathing through this full core canister. A balloon is a great image to use when doing breath work to ensure you are expanding in all areas, and not just through the front abdominals or upper chest. Perform focused breath work for 1-2 minutes, multiple times throughout your day. 

Pelvic Floor Activation A gentle tightening and relaxation of your pelvic floor muscles. Imagine picking up a marble with your vagina (the area that you birthed your baby from). Sounds funny, but these muscles were stretched out during delivery and over the course of pregnancy (so C-Section mamas – this still applies to you!). It’s important to learn to re-activate these muscles postpartum to prevent leakage and back or hip pain. Be sure to relax fully between contractions, as over-activation of the pelvic floor is not good either! These can be done alone, or with movement. For instance, exhale and lift the pelvic floor as you go from sitting to standing. This will help to support and strengthen your pelvic floor, while also retraining your brain to muscle connection. That way, the muscles begin to activate automatically during daily activities such as squatting, transfers, getting in and out of the car, etc.! Perform 10 quick contractions followed by 5 repetitions of 5-10 second holds, multiple times throughout your day.

Deep Core Activation A gentle tightening of the lower abdominal muscles that form a corset around your torso. Place your fingertips just inside of your front pelvic bones. To activate the deep core, exhale as though you are fogging up a mirror. As you do this, you should feel a slight tightening of the muscle beneath your fingertips. This is your Transverse Abdominis muscle, a deep core muscle also stretched out during pregnancy. It’s important to learn to re-activate this muscle so that you can better support your abdominal organs and your backside to help prevent onset of back pain. Perform with movement throughout your day – such as when lifting your baby, transferring to stand, or when picking up the car seat.

Postural Muscle ActivationGently strengthening your backside muscles helps to combat the extra tension from holding your baby in a forward position. This has the added bonus of lengthening your frontside muscles as you move the arms in the opposing direction. Lie on your belly (as shown in video) or complete the same motions in standing. Squeeze your shoulder blades down and back towards your tailbone, then lift the arms. Be careful not to overuse the muscles around the neck, but focus on using the muscles between your shoulder blades to perform this movement. Perform 10-15 repetitions of each motion, up to 3 sets every other day. 

Time to GET MOVING!

Holding, nursing or bottle feeding your child all bring you into a forward rounded mid-spine position. This causes your mid-spine to get very tight and stiff, which can lead to back or neck pain and headaches from this added tension. To help alleviate this, move into the opposite direction by utilizing these exercises:

Thoracic Extension – seated against backrest, or on floor against foam roller. Perform 10 repetitions at varying levels along the mid-spine. 3 sets of 10 up to 3 times a day is recommended.

Cat/Cow – seated or on all 4’s. Match your movement with your breath, inhaling as you look up/extend your spine and exhaling as you look down/round your spine. Perform 10-15 repetitions up to 3 times per day.

Keep it Simple: Walk!

Choose a comfortable pace in which you can hold a conversation. Start with a short duration, 5-10 minutes. If that feels good with no strain to your pelvic floor or abdominal region, then you can increase the duration by 5-10 minutes each day until reaching your desired duration. A 20-30 minute walk, 5-6 days per week is a great goal to move towards for overall cardiovascular health. Walking is a great way for you and your baby to get some fresh air if it’s nice enough to push your baby in the stroller. Baby wearing is also a great option here! A note of caution: if you notice an increase in bleeding or discharge, slow your pace and reduce your duration.

You’ve got this, mama!

We just scratched the surface on recommendations for reconnecting with your body postpartum. Understanding the specific muscles and joints to address in order to reduce or prevent the onset of pain or discomfort during those first few months with your baby is a game-changer. I hope these moves help you feel your best, so that you can show up as your best self for your family. 

Need more specifics? I’d love to help tailor this to your needs – reach out here for 1:1 work (spoiler alert: FREE initial consult, scroll to bottom of scheduling to book).  Follow along on my Instagram and YouTube for more movement recommendations!

you deserve to be supported

before, during and after pregnancy.

Looking to feel empowered and inspired along your perinatal journey? All things movement, nourishment and holistic lifestyle wellness – delivered to your inbox every Tuesday. Sent directly from an Orthopedic & Pelvic Health Doctor of Physical Therapy.

I'm Dr. Kayla Borchers!

A Holistic Orthopedic and Pelvic Health Physical Therapist, Prenatal and Postpartum Corrective Exercise Specialist, Certified Yoga Teacher and mama of three who is passionate about proactive, root-case women’s health care.