Postpartum Physical Therapy Exercises

By Dr April Mettler – CC’s Staff

Postpartum for so many can be the most rewarding and the most challenging time in a mom’s world. We are learning on the fly about our new little baby bundle while also navigating our changing and recovering body. Common medical protocol after a vaginal delivery is to be discharged in 24-48 hours from birth without physician follow up for 6 weeks. This is different depending on any complications or if the delivery was a cesarean section. In this case, a longer stay or earlier follow up is generally recommended. In either case, our main instruction is “pelvic rest” until the six week follow up. I find it mind blowing that we deliver a baby and go home with that one instruction for our own body. 

I am here to tell you that exercise in that 0-6 week window is not only safe, but it is also extremely beneficial to your overall health and well being. I’m not saying to go home and run a marathon. What I am saying, is that beginning to recruit key stabilizers and participate in activity that elevates your heart rate early can be a critical asset in your overall physical and mental health postpartum. Here are a few exercises you can begin immediately postpartum.

*All exercises to be performed without pain or residual discomfort, but soreness is a good thing!

• PFM Exercises
  • Draw the pelvic floor up and in towards the belly button. 
    • Avoid holding your breath as you perform activity
    • A horizontal position can be easiest due to the elimination of gravity with movement
  • The goal is to work towards 10 reps, each held for 10 seconds. Start with contractions without a hold and when able, increase the hold time. Make it about the quality…don’t count to 10 if your pelvic floor gave out in 4 seconds!
• Transverse Abdominal Recruitment
  • The corset muscle of the abdomen just got done with a 9 month workout and now it is unrecognizable to ourselves! To begin using your deep abdominal muscle group, use a towel or sheet wrapped around your body while laying on your back. As you begin to draw in your abdominal region, utilize the towel to increase feedback and recruitment. As a postural muscle, focus on performing repetitions for 3 minutes, not counting repetitions. 
• Walking Program
  • Start with small walks around the block (bonus points if you are able to get outside during your walks for some Vitamin D). 
  • As able, set a goal for various intensities in your walk. Start with an easy pace you could maintain for a long time and then add in bursts of increased speed. 
    • Example: walk for 3 blocks at normal pace and 1 block for increased pace and return to normal pace and repeat sequence. 
• Squats
  • It’s an oldie but a goodie. Give those hips some space and start to move through a functional squat! Place a chair behind you as a landmark to reach your bottom with every rep. If able, dig deeper, but take at your own pace. 
    • BONUS points if you are able to add the PFM exercise and TA recruitment with the exercise. 
    • Lift the pelvic floor, draw the navel in, squat, return to neutral and release. That’s 1!

Join us for more conversations on all things pregnancy, postpartum, and pelvic health with Core Conversations! To learn about how we at CC’s can help you, check out our pelvic health team or give our office a call today!