Basic Postpartum Recovery
By Holly Durney, DPT, OCS
You’re six weeks postpartum and have been cleared by your doctor to resume exercise. However, as a part of your rehabilitation there are basic exercises you should consider performing before jumping back into an exercise program particularly any impact activity (i.e. running, jumping, HITT, boot camp). These exercises are a vital part of your baseline recovery for your abdominals and pelvic floor after giving birth. Typically an evaluation from a pelvic floor physical therapist is recommended to ensure you are performing these exercises correctly and to screen for presence of diastasis recti. An evaluation would also personalize your postpartum recovery program. However, the exercises in this article are safe and effective for almost all postpartum women and are an excellent addition to your workout program as slow return is initiated.
1. Pelvic tilts (2 sets of 10) for pregnancy posture correction
Setup: Begin by lying on your back with your knees bent and feet resting on the floor.
Movement: Slowly bend your low back and tilt your pelvis backward into the floor while exhaling, then return to the starting position and repeat.
Tip: Make sure to only move your pelvis and low back and keep the rest of your body relaxed. Do not hold your breath. This exercise will also help you learn your own position of neutral spine (pelvic tilt and relax around 20% to find your neutral).
These exercises are a vital part of your baseline recovery for your abdominals and pelvic floor after giving birth. Typically an evaluation from a pelvic floor physical therapist is recommended to ensure you are performing these exercises correctly and to screen for presence of diastasis recti.
2. Transversus abdominal/Pelvic floor contraction (3 second hold, 1-2 sets of 10)
Setup: Begin lying on your back with your knees bent, feet resting on the floor, and your fingers resting on your stomach just above your hip bones.
Movement: Tighten your abdominals, pulling your navel in toward your spine while pulling your front two hip bones closer together. With your abdominals pulling in, pull your pelvic floor up and in as you could pull a straw internally with your vaginal muscles. You should feel your muscles contract under your fingers when you place them 2 fingers inside the hip bones. Hold this position as you exhale, then relax, inhale, and repeat.
Tip: Do not hold your breath as you tighten your muscles. Pay attention to your rectal muscles and relax your gluts. Gluts are NOT your pelvic floor. Isolate your vaginal muscles for a true Kegel.
*If #2 is difficult, the following two exercises activate your abdominals and pelvic floor with less concentration and precision.
3. Inner thigh squeeze (3 second hold, 1-2 sets of 10)
Setup: Begin lying on your back with your legs bent, feet resting on the floor, and a soft ball positioned between your knees.
Movement: Squeeze your knees together into the ball and exhale, then release and repeat.
Tip: Make sure to keep your back in neutral during the exercise without arching or tilting.
4. Outer thigh press with band (hip abduction) (2 sets of 10)
Setup: Begin by lying on your back with your knees bent, feet resting on the floor, and a resistance band or loop secured around your legs.
Movement: Move your knees away from each other, creating tension in the band, then slowly return to the starting position and repeat.
Tip: Make sure to not to arch your low back during the exercise.
The above exercises are also safe to perform throughout your pregnancy. Additionally, exercises 2-4 can be performed with your hips elevated on 2-3 pillows to improve gravity assistance when prolapse is present to assist in pelvic floor recovery. Proper technique and breathing are important so take your time with these. Perform once per day for 2-3 weeks before performing higher level impact activities. If you need additional assistance on your form, contact your local pelvic floor physical therapist.
Happy postpartum recovery!
Dr. Holly Durney is an APTA Orthopedic Certified Specialist and has pelvic floor rehabilitation training from the Herman and Wallace Pelvic Rehabilitation Institute. Her pelvic health training focuses on treating pelvic floor dysfunction and related issues in the pelvis, hip, and spine. Her pelvic floor treatments involve assessment including movement patterns, ligament structure, current activity level, and pregnancy history. She believes that treating the whole person is the key to complete health and wellness and to help her patients achieve their goals. Holly Durney is a women’s health physical therapist in Raleigh, North Carolina. If you have questions for Holly she can be reached at her email holly@smartathletept.com.
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