Putting your body back together after pregnancy is a bit of challenge, but certainly not impossible by any means. If you realistically think about how much physical changes happened to your body while you were pregnant, you can begin to realize that the repair process is not an overnight fix. You probably gained anywhere from 20 to 50 pounds, expanded substantially through your abdomen, and carried all of that load through hips that shifted and settled. And then perhaps you’ve done this two, three or four times!
Give your body grace. It’s easy to be impatient and frustrated with your progress. But it’s important to treat it gently, especially in the first few months after childbirth. In all likelihood, you don’t have a date set to return to competition, so just calm down.
I definitely had to learn this after my first pregnancy. I had been extremely fit leading up to getting pregnant, stayed in remarkable shape for the whole 40 weeks, and then anticipated jumping right back into it at the first opportunity. It’s not so simple, though, is it? I had to progress a lot slower than I thought.
Healing. Obviously, first things first, you must let your pelvic floor heal. This will take several weeks, or longer depending on any delivery trauma, for the initial healing to take place. Treat this like a wound, and exercising with a major wound may cause more damage. Anything more strenuous than walking should be avoided for at least the first two weeks. If you are moving too much, you will probably notice more bleeding, which means you need to slow down. The same goes for a Cesarean delivery. Healing after a C-section will take even longer.
However, there are a few simple exercises that you can begin doing from the very beginning to turn on muscles and encourage some gentle tension. This will set you up for being able to do more when your body is ready.
Positional breathing is safe. You have to breathe anyway, right? So, you might as well learn how to do it properly using your diaphragm. Proper breathing technique will create good pressure on the inside of your abdomen, activating all the right muscles.
Do this more gently than I demonstrate in the video. Don’t brace hard at all--instead just think about “waking up” these muscles.
Postural work is safe as well. You can practice basic positioning with your pelvis as demonstrated in the video. Understanding good posture will be vital as you are now trying to heal your core while also carrying a baby. Practice a neutral pelvis position anytime you are standing. Wall angels are safe to do as well, and feel really good!
Focus on good posture with everything you do. Your goal right now is to encourage good positioning while you squat onto the couch, climb the stairs, carry your baby and carefully walk around. You may find that in the first two weeks you can go for some short walks outside. You will probably feel cabin fever setting in, so getting fresh air will do wonders. As you walk, be mindful of the placement of your pelvis, spine and shoulders.
At this point, you may even try to do some stretching. The pregnancy stretching routine is still a thorough stretching sequence that will be appropriate for your healing body.
Start Gentle Strength. When you are several weeks removed from delivery, you may begin to do some gentle strengthening. Around 3-4 weeks post-delivery is a good time to try these basic strength training exercises. Do about 8-15 reps of each exercise, one time through the list to begin with. Perform this on three separate occasions that week, then try it two sets through when you do it the next week.
Move very carefully and slowly through these exercises. Your goal is to not do a full “workout”, but to simply activate muscles that have been asleep for a few weeks. This should not feel hard, and if it does just stop and wait until your body is more ready.
Doing More. Typically, you will have a 6 week follow-up appointment with your doctor or midwife, at which point they may clear you to exercise again. If they give you the green light, then you can start to add a little more “umph” to your workout. I recommend trying the beginner bodyweight workout (2) and this beginner dumbbell routine, minus the plank at the end.
Abdominal Issues. Why no planking yet? Well, now we’re getting into the topic of separated abdominals, or diastasis recti abdominis. You may be aware of a split between your right and left abs, right down the center of your belly. There is a line of tendons called the linea alba (the big white band in the picture below) that connects your abs. This must stretch apart as your belly expands. This occurs in 100% of pregnancies. Wait, what?! Yes, with every pregnancy, the abdominals must separate to some degree to allow for this expansion.
The difference is that some women have a linea alba that expands more easily and then contracts more quickly following childbirth. They may never notice a separation. These women tend to go into pregnancy with strong and functional abs, but they have the bracing kind of strength—not the sit-up and crunching kind of strength. If you have a history of lots of sit-ups and crunches, you may be more at risk for diastasis recti problems. (One more reason to throw crunches and sit-ups out the window for good!)
What to do. To best heal separated abdominals, you must be very gentle at first. Positional breathing (as shown above) creates just the right amount of tension through your abs. This allows them to start finding their proper position and begin coming back together.
As you get good at positional breathing, really able to feel your low abdominals contract and relax, you may start adding some leg movement with these deep abdominal contractions. First try the posterior pelvic tilt with bent-leg lowering, and then try it with a straight leg as you get much stronger. When you feel confident with these motions, you can add the arms and attempt a dead bug.
Other good core exercises for healing your abdominals are farmer’s carries, anti-rotation presses and any upper or lower body exercise that offloads the weight, or positions the load on one side of your body (like offloaded squats). The gentle bracing and supporting nature of these exercises are perfect for your abs right now.
What to avoid. Until your abs have really come back together, avoid really hard core work where your abs have to exert a lot of force. DO NOT do crunches, sit-ups, V-ups, boat poses, or any other direct abdominal exercises. Planks and side planks should also be avoided until you feel like the divot between your abs is mostly gone.
Proper core work to heal your abdominals will also be beneficial for your pelvic floor. If you pay attention to your breathing technique, purposefully changing the pressure inside your core while you exercise, your pelvic floor muscles should heal well.
Doing even more. Once you are about three to four months out from delivery, you can try incorporating more intense activities into your workouts, like some light jumping and power exercises. The Beginner Metabolic Workout (2) is a great workout to try.
Above all, listen to your body and treat it gently. If you suspect that you have severe pelvic floor or diastasis recti issues, you may need to seek out a physical therapist that specializes in women’s health. You will regret pushing yourself too hard, potentially risking unnecessary damage.
Your body has endured a lot through pregnancy, labor and delivery, so be kind to it as you heal. No, you’re not fragile, you are still very strong—you just birthed a baby, for goodness sakes! You just need to rediscover your strength in a careful and gracious manner. Soon, you will be back to burpees and sprinting!
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