Congratulations on the arrival of your baby! The transition into the postnatal period can be challenging, balancing bonding with your new addition, and taking care of yourself.
As a new mother, your body is undergoing significant changes, and it’s important to give it the care and attention it deserves during this phase of recovery. One of the most important aspects to focus on during this time is core and pelvic floor strength, to have functional strength for recovery, looking after your baby, and progressively returning to exercise. This can begin in the first six weeks postnatally, before your pelvic floor check up at 6 weeks with pelvic physiotherapist.
What to do in the first 6 weeks:
- Pelvic Floor Activation
- Gentle Mobility
- Core strength
- Increase exercise capacity
- Breastfeeding care
Pelvic Floor
Whether you have had a vaginal or caesarean delivery, the pelvic floor has undergone changes during pregnancy, as well as managing increased load, supporting the growing uterus. As a result, it requires strengthening postnatally, to prevent prolapse in future years, and have the capacity to support pelvic organs in return to sport, as well as in daily activities being a busy mum.
In the early stages of your recovery (first 2 weeks), you can start exercising your pelvic floor muscles. Begin with what you are capable of doing and increase as strength and endurance improves. The starting point may vary between person to person, from a flicker to a 10 second hold. If you experience pain, try a very gentle squeeze, and if it persists, try again the next day.
To contract your pelvic floor muscles, imaging you are tightening around the anus, vagina and urethra. You should feel a closing / squeezing sensation around the urethra, vagina and anus and a lift up internally. They may feel strange and different initially but should improve with practice and time.
Position: Any – Lying, sitting, standing.
Hold: Try to hold for 1-2 secs
Repetitions: 5-10
Gentle Mobility
The tension on your body during pregnancy, throughout delivery, and the adaptation to carrying and feeding your baby can increase stiffness and general musculoskeletal discomfort. Below are some gentle mobility exercises you can begin in your first few weeks.
Cat/Camel
Setup: on hands and knees
Action:
- Arch back up and tuck tailbone underneath, while dropping head between arms and breathing out.
- Lift chin up, breathing out as letting chest lower down and bottom moves upward.
- Keep elbows straight throughout
Repetitions: 10
Thread the Needle
Setup: On hands and knees
Action:
- Rotating through the upper body, lift one hand up towards the ceiling while breathing in
- Rotate chest back and thread the arm between the opposite arm and leg, while breathing out.
Repetitions: 8 each side
Chest Stretch
Setup: sitting or standing, hands behind head
Action:
- Push elbows apart and chest forward
GREAT to complete after feeding!
Repetitions: 3x10sec hold
Core Strength
During your pregnancy, your abdominal muscles need to stretch to let your baby grow inside you. A rectus abdominus diastasis is a widening of the connective tissue between the six pack muscles. It can occur anywhere along the midline.
In the first 6-12 weeks of your postnatal period, the diastasis can recover naturally as the hormones and stretching forces decrease. New collagen fibres are created during this time frame to increase tension in the diastasis. However, the tissue can still feel thinner and weaker for up to one year. The use of tubigrip, or compression leggings, such as SRC shorts, can provide added support and can be worn for months postnatally. Exercises will help increase the tension and improve strength long term.
Tabletop Marches
Setup: Lying on your back with knees bent and hands on lower abdomen.
Action:
- Activate lower abdomen by gently pulling your stomach away from hands. If you have had a caesarean, gently pull the incision down.
- Maintain the contraction while breathing.
- Lift one leg up into tabletop (90deg bend at hip and knee) and lower down, alternating legs.
Repetitions: 2×8 each side
Bridges
Setup: Lying on back, knees bent, feet flat hip width apart
Action:
- Tuck tailbone under and slowly roll the hips up, holding briefly at the top, and slowly lowering back down
- Breathe in when lifting, and out as lowering
Repetitions: 2×10
Resisted Obliques
Setup: Lying on back, knees bent
Action:
- Bring one knee up towards chest
- Press into the thigh with the opposite hand.
- Hold for a count of 5, continuing to breathe normally
Repetitions: 5x5sec holds each side
Increase Exercise Capacity
You can begin walking in your first/second week postnatal, allowing time initially for recovery. Walking every 2nd day, build up duration and distance as tolerated, as well as frequency.
Return to running/high impact exercise is recommended at 3 months, to allow adequate recovery and pelvic floor, core and strength training. At your initial postnatal assessment, a pelvic floor and strength training plan will be developed, specific to your goals.
Running pushing a stroller typically begins 6-9 months postnatally, depending on baby’s development.
Breastfeeding care
Initially breastfeeding can take time to adjust. Your nipples may be sore and crack, and may may experience blocked milk ducts, which can progress into mastitis. Low-level laser therapy aids in promoting healing for cracked nipples, and therapeutic ultrasound can assist in reducing blocked milk ducts.
SUMMARY
Pelvic floor, core and exercise can begin in your first few weeks postnatally, as you feel comfortable. This is the starting point of your recovery, to be progressed at your postnatal assessment. If you would like additional advice, or are experiencing any pain or discomfort, you can check in with your pelvic physiotherapist prior to the 6 week assessment, either in clinic or via telehealth.
To book online, click HERE.