Postpartum exercise: Creating a healthy body post-baby
Most mothers will agree that exercise after delivery can be challenging; your body has been tested to its limits, you’re getting little to no sleep, and you have a new life to care for 24 hours a day. But after their bodies have been through such stress and weight fluctuation, exercise can help new mothers lose excess weight and feel better.
As Ann Cowlin, an expert on women’s health points out, not only does postpartum exercise help women lose weight and regain fitness, but it has also been shown to reduce postpartum depression. (Ann is the creator of Dancing thru Pregnancy, one of Physiquality’s partner programs.)
Pregnancy is hard on the body, and it can take time to recuperate and rebuild strength. Our experts’ number one recommendation is that women be aware of diastasis recti, or a separation of the abdominal wall. Cherie Hamelin, a physical therapist at Orthopaedics Plus (a Physiquality network clinic with two locations in Massachusetts), recommends testing yourself for diastasis recti using the following method:
Lie on your back with your knees bent.
Place three fingers of one hand at your belly button pointing towards the floor, while the other hand remains straight by your side.
Raise your head and shoulders off the floor (keeping your shoulder blades on the floor) and reach the hand that is straight by your side toward your knee.
Look at your stomach — Is there a vertical separation of the stomach muscles causing a gap or a bulge to appear?
If so, measure the gap with the three fingers you placed on your belly. Measure above and below the belly button as well. Placing one to two fingers in the gap is considered normal; anything greater may be diastasis recti.
Kelly Whitsel, a physical therapist at Allegheny Chesapeake Physical Therapy, a Physiquality network member with 11 locations throughout Pennsylvania, advises avoiding abdominal crunches that would place stress on the abdominal walls, especially if you suspect diastasis recti. Ann suggests starting off with working the transverse abdominis, which is the deepest layer of abdominal muscle, in a resting position (otherwise known as Constructive Rest Position, or CRP, seen below). Simply exhale, making a hissing sound, and suck in your abdomen.
Once you’ve mastered that, Kelly suggests advancing to the following exercise:
Lie on your back with your knees bent and your feet flat on the floor. Pull your belly button toward your spine using only your abdominal muscles, not your buttocks. Slide your heel out until your leg is straight, then drag your heel back to its starting position, maintaining your abdominal contraction the entire time. Alternately, try lifting your head to look toward your knees and reaching your arms forward.
|Note: If the abdomen pops up when the head is lifted, return to working with the head on the ground until it no longer happens.
Other strengthening exercises recommended by Bev Baumgardner (a physical therapist at Clinton Physical Therapy Center, a Physiquality network member in Tennessee) include Kegels or Kegel exercises, a familiar exercise that strengthens the pelvic floor muscles. Bev notes that these can prevent bladder leaks, can generally be started immediately after birth, and are one of the most important exercises to start early.
And the easiest exercise Bev recommends is walking. Kelly agrees, stating, “If you had an uncomplicated vaginal delivery, you generally can start light walking for exercise at any time.” This includes putting your new baby in a stroller and walking around your neighborhood for some fresh air (although try to keep your back upright, rather than hunching over the stroller). If you can make time in your busy schedule for a class, she recommends starting with low-impact activities as the ligaments and joints have loosened during pregnancy. Cherie also points out that it may take 4 – 6 weeks for your heart rate to return to a normal resting rate, so be moderate — you may still tire rather quickly.
Please note that every woman reacts to delivery differently. Kelly states that if you had a C-section or were not maintaining a level of exercise during pregnancy, it is best to be cleared by your doctor or nurse midwife prior to starting exercise. Other medical issues, like infection or extensive bleeding, could also delay your recovery and would require release from your doctor before exercise. Ann also recommends caution about tenderness in the pubic area; if it is painful, avoid lateral movements for the first 3 – 4 weeks.
Once a baby arrives in a household, new parents are often overwhelmed and focus all of their energy on the baby, but new mothers should try to keep in mind the importance of exercise after birth. Bev’s recommendations are simple: Start slowly. Avoid excessive fatigue. And try to remember that daily exercise will help you feel more energetic, improve your posture, and shed leftover weight. After all, a healthy mom is a happy one.
Bev Baumgardner, PT, is a physical therapist at Clinton Physical Therapy Center, a Physiquality network clinic in Clinton, Tennessee. Bev is the director of the Women’s Health Program at CPTC and manages the Before the Stork program for pregnant women with back pain.
Ann Cowlin, MA, CSM, CCE, is the creator of Dancing thru Pregnancy, one of Physiquality’s partner programs. Ann is the author of Women’s Fitness Program Development, a guide to creating girls’ and women’s health and fitness programming, and is the expert consultant for the U.S. Army’s Pregnancy and Postpartum Train the Trainer Program.
Cherie Hamelin, PT, DPT, FAAOMPT, is a physical therapist at Orthopaedics Plus, a Physiquality network clinic with locations in Burlington and Beverly, Massachusetts. Cherie completed certifications in pregnancy and obstetrics with the APTA in 2010 and a fellowship in orthopedic manual physical therapy in 2011.
Kelly Whitsel, PT, DPT, is a physical therapist at Allegheny Chesapeake Physical Therapy, a Physiquality network member with 11 locations throughout Pennsylvania. Kelly specializes in women’s health and treatment of problems with the pelvic floor.
For further information, look through our selection of articles on postnatal women’s health, in addition to the below links:
Harms, Roger W. Diastasis recti: How does pregnancy affect stomach muscles? Mayo Clinic, August 30, 2011.
Postpartum exercise tips. Dancing thru Pregnancy.
Diastasis rectus abdominus and lumbo-pelvic pain and dysfunction: Are they related? Renew Physical Therapy, December 16, 2010.
Deardorff, Julie. Flat abs for new moms. Chicago Tribune, November 2, 2010.
Kegel exercises: A how-to guide for women. Mayo Clinic, July 10, 2010.
Redzic, April. The workout every new mom should be doing. The Examiner, January 27, 2010.
Cowlin, Ann. Postpartum exercise: What’s safe? What’s effective? Dancing thru Pregnancy, 2009.
Daley, Amanda J., Christine MacArthur, and Heather Winter. The role of exercise in treating postpartum depression: A review of the literature. Journal of Midwifery and Women’s Health, January/February 2007.