Restoring Your Core After Pregnancy
Pregnancy can be described in many ways, such as beautiful or a miracle, while at the same time less sugar-coated adjectives include laborious, intense and painful. It can also be traumatic for the woman‘s body resulting in soft tissue tears and adhesions requiring progressive and possibly long rehabilitation. Your doctor may advise a return to activity anywhere from 4 to 8 weeks after birth, however this is all dependent on the amount of trauma experienced during and after labor such as a Cesarean incision, Diastasis Recti, postpartum bleeding, painful intercourse, and/or urinary or bowel incontinence all which will require being monitored by professionals before entering a general exercise program. But how do you go about getting properly educated to do things progressively and with correct form? The safest way to reintegrate an exercise program following pregnancy is to seek the advice of a specialized pelvic floor, postpartum, or women’s health physical therapist who can help you address your individual needs safely and efficiently, however, you can find some beginner exercises below to follow in the meantime.
How is the musculoskeletal system affected during pregnancy and why is important to stabilize the core?
Pregnancy results in weight gain and changes in center of gravity for the mother as the stomach expand resulting in stretched abdominal muscles, decreased rib expansion and increased lumbar lordosis or low back curving. This can cause countering muscles to shorten, stretch and weaken leading to muscular inefficiency. When preparing for birth, the body’s ligaments and joints become more unstable due to hormonal changes to allow for the baby to pass through easier, but it is important to remember that following birth the body does not just bounce back. Additionally, the weakened, tight muscles and inflamed body then needs to carry, lift, and nurse the new life which can result in postural aches and pains for the mother. You can surely appreciate why it is necessary to learn appropriate and functional strengthening exercises that begin from the inside out.
Whether the pregnancy was 8 weeks ago or 8 years ago, the first or fourth child, it is essential to improve core engagement and stabilization strength, but also to not create a more severe problem by doing an exercise that may be too difficult, too soon. Postpartum core exercises should also not necessarily be for only those want to just lose weight or increase muscle tone, but more importantly, for all woman following a pregnancy to assist in proper and pain-free daily function. This is especially important for those who would like to return to higher impact sports like running. Thus, we have created some exercise guidelines you can try, prior to working with a specialist, to help re-engage the core stabilizers which include the pelvic floor musculature, Transversus Abdominis, Multifidus, and Diaphragm.
Breathing sounds simple enough but due to rib cage changes and shortened Diaphragm, it may be the simplest thing we forget how to incorporate. This exercise can be performed by laying down, sitting or even standing. Begin with a neutral spine (not too extended or too flexed) and one hand on chest and the other on the belly. Begin with an inhalation that is slow and deep, allowing for the ribs to expand. Exhale slowly while focusing on pulling the abdominals in towards the ribs, engaging the abs. Work your way up to 5 to 10 breaths and try to repeat several times throughout the day.
Begin by lying on your back with hands on the ground by your sides, the knees bent and feet hip-width apart on the floor. Engage the abdominals as if someone were to lightly punch your stomach while continuing to breathe. Begin to press the low back into the floor by tilting your pelvis upward. Hold for 5 seconds while not forgetting to breathe. Repeat for 5 to 10 repetitions for 1 to 3 sets in a day.
Start by lying on back with knees bent and feet hip-width apart on the floor. Engage the abs and maintain a neutral pelvis. Begin to slowly extend one leg straight away from the body by sliding the heel along the floor until the knee is practically straight. Keeping the abs engaged, slide the heel back towards your bottom and back to a bent knee position. Alternate sides and repeat for 5 to 10 repetitions on each leg working up to 1 to 3 sets in a day.
Begin by lying on the floor with knees bent and feet hip-width apart. Find your neutral spine. Engage the abs while marching one knee up in line with the hip and the foot parallel to the floor. Slowly straighten the elevated leg and hover a few inches from the floor. Return to hovering bent knee position then place the foot on the floor. Alternate sides. Repeat for 5 to 10 repetitions on each leg working up to 1 to 3 sets in a day.
Lie on the floor with the knees bent and feet hip-width apart with a neutral spine. Engage the abs and slowly lift one or both legs up at a time to bring both knees over hips and feet parallel with the floor. This is called a tabletop position. Keeping both knees bent to 90 degrees, slowly start to lower one foot to the floor while keeping the other leg in the air and not allowing the low back to arch. Return the leg to tabletop and alternate sides. Repeat for 5 to 10 repetitions on each leg working up to 1 to 3 sets in a day.
Start by lying on your back. From there, bend your knees and place your feet on the surface, hip-width apart. Engage the abs, tilt the pelvis to flatten the low back to the floor and slowly lift hips off the floor towards the sky. Slowly lower the back to the floor. Repeat for 5 to 10 repetitions working up to 1 to 3 sets in a day.
Lay on one side with both knees bent and the heels together. Engage the abs while slowly rotating the top knee towards the sky while keeping the knees bent, hips stacked on top of one another and heels together. Repeat for 5 to 10 repetitions then repeat on the other side. Work your way up from 1 to 3 sets in a day.
Alternating Opposite Arm & Leg Lift
Begin on all fours with hands under the shoulders and knees under the hips. Engage the abs and focus on keeping a flat back where the pelvis does not tilt to one side or the other as you lift one arm and the opposite leg to be in line with the trunk of the body. Lower and alternate sides. Repeat for 5 to 10 repetitions working up to 1 to 3 sets in a day.
Always remember: never push through pain & form is more important than repetitions. This routine is meant to be used as a guideline to help restore core function and strength, but it is always advised to work with a specialized professional.