Hello.
A common question women ask after pregnancy and birth is
when can I return to my pre- pregnancy exercise routine?
Physical therapists agree that it's best to return to exercise
slowly and listen to your body in the process.
Listening to your body means monitoring yourself for
symptoms and modifying your activity, if you
have any signs of exercise intolerance.
These signs may include new or worsening pain anywhere in
your body, increased vaginal bleeding,
urinary or fecal leaking, heaviness in your
vaginal region, bulging or a ridge along the midline
of your abdomen, or C-section scar soreness that lasts longer
than 2 weeks after birth.
In general, exercise in the first several weeks after
delivery can include short walks and
gentle core exercises, such as Kegels and the
drawing in maneuver.
I will show you these 2 exercises first.
At 6 to 8 weeks postpartum, gentle,
low-impact strengthening, such as the bridge
or clam exercise, may be added.
I will demonstrate these exercises a little later
in the video.
Low-intensity water exercise is also safe at this time, as long
as you are no longer experiencing
postpartum vaginal bleeding.
At 8 to 12 weeks, you can begin to gradually increase
exercise intensity, such as incorporating
light weight training.
It's highly recommended to wait 4 to 6 months before returning
to running, jumping or more advanced core exercises,
such as planks and sit-ups.
This is because the pelvic floor muscles and abdominals
have been stretched during pregnancy and delivery.
Adding too much load to these muscles too quickly can
limit their healing.
If you are experiencing any signs of exercise intolerance,
or are having other difficulty with your exercise routine
after pregnancy and birth, contact your OBGYN for guidance
or for a referral to pelvic physical therapy.
The first exercise I'll demonstrate is
the Kegel exercise.
The Kegel exercise activates the pelvic floor.
The pelvic floor is the group of muscles at the base
of the pelvis.
These muscles help to support your pelvic organs,
maintain urinary and fecal continence, and help
with sexual function.
It's important to retrain these muscles,
whether you've had a vaginal delivery or a C-section.
You can begin Kegel exercises right after the baby is born,
as long as they don't cause pain or make your
vaginal bleeding worse.
Lie on your back with your knees bent and feet flat.
Align your lower back in a neutral position — not pressing
down onto the surface beneath you or overarching away
from it.
Maintain that neutral position throughout the exercise.
Take a few deep breaths, focusing on relaxing your
abdominals and pelvic floor.
Now, start by tightening the muscles around your anus, as if
you're trying to stop yourself from passing gas.
Then move forward to tighten the muscles around your vagina
and your urethra, as if you're trying to stop urine.
Make sure you're not gripping with your abdominals,
glutes or thighs.
Then, completely relax your abdominals and pelvic floor.
Do 10 of these contractions, 3 times per day,
gradually working up to a 10-second hold
for each contraction.
These are slow, or endurance, Kegels and can help with pelvic
organ support, pelvic and lower back stability, and can even
enhance sexual sensation.
You can also perform quick contractions,
which help with maintaining your ability to hold urine and
bowels when you cough or sneeze.
Take 2 seconds to contract and 2 seconds to relax.
You can think of it as engage, relax.
Engage, relax.
Do 10 contractions, 3 times per day.
If you experience any difficulty or pain while doing
Kegel exercises, you may benefit from
pelvic physical therapy.
Contact your OBGYN for a referral.
Next is the drawing in maneuver.
The drawing in maneuver activates your deepest core
muscle: the transverse abdominus.
This muscle stretches during pregnancy and will take up to 2
years to restore its proper length and tension.
So it's important to progress core strengthening slowly.
The drawing in maneuver is a great exercise to start with.
You can begin this exercise immediately after a vaginal
birth and about 2 weeks after a C-section, or after the
initial scar soreness has resolved.
Lie on your back with your knees bent and your feet flat.
Align your lower back in a neutral position — not pressing
down on the surface beneath you or overarching away from it.
Maintain that neutral position throughout the exercise.
Breathe in, allowing your belly to rise and relax.
Then exhale and imagine you are blowing out birthday candles,
gently engaging your abs, and moving your bellybutton
toward your spine.
You can perform this drawing in maneuver along with a
pelvic floor contraction.
Perform 10 contractions, 3 times per day.
Other common abdominal exercises,
such as planks and sit-ups, are not recommended soon
after giving birth.
They can be started 4 to 6 months after delivery,
possibly even longer if you have a persistent separation in
your abdominal muscles or pelvic floor weakness.
If you notice pain or bulging in your abs, or heaviness in
your pelvic floor region, contact your OBGYN for guidance
or a referral to pelvic physical therapy.
After practicing Kegels and the drawing in maneuver for a
few weeks, the bridge exercise is a great core exercise.
Typically, this exercise is appropriate 6 weeks after a
vaginal delivery or 8 weeks after a C-section.
Lie on your back with your knees bent and your feet flat.
Engage the pelvic floor as described earlier in
the Kegel section.
Then gently engage your core so that your navel moves toward
your spine as described in the drawing in maneuver.
Engage your glutes — the muscles of your butt — and
slowly lift your pelvis and spine off the floor.
Hold for a moment, and then slowly lower your
pelvis back down.
Perform 10, repetitions 2 times per day.
If this exercise causes any discomfort, heaviness in
the vaginal region, or abdominal bulging,
contact your OBGYN for guidance or a referral to
pelvic physical therapy.
Now we'll show you the clams.
The clam exercise helps to strengthen your hip muscles,
which may have become weak during pregnancy.
This is a good exercise, whether you have had a vaginal
birth or a C-section.
You may begin this exercise around 6 weeks postpartum after
a vaginal delivery or 8 weeks after a C-section.
Lie on your side with your knees bent, feet flat, and hips
stacked on top of each other.
Gently activate your deep core by performing the Kegel and the
drawing in maneuver as described earlier.
Keep your feet together and gently lift your top knee
toward the ceiling.
Be sure not to roll your pelvis back.
You should feel the muscles tighten on the outside
of your hip.
Perform 10 repetitions, 2 times per day.
If this exercise causes any discomfort,
vaginal heaviness, or abdominal bulging,
contact your OBGYN for guidance or a referral to
pelvic physical therapy.
So, when you are ready to restore your core, get started
with these excellent exercises: Kegels,
the drawing in maneuver, bridges and clams.
Remember, listen to your body.
Thank you for watching.
Good luck and good health.