As a fitness professional, you have the unique opportunity to empower new moms to take control of their recovery and overall wellness. Postpartum exercise has so many benefits – from decreasing stress levels, helping the body to heal, increasing self-esteem, decreasing the risk of postpartum depression, reducing aches and pains, and strengthening the body for the tasks of everyday life.
Every pregnancy and birth is different and both will affect how a woman resumes exercise after having a baby. Some factors include whether or not they exercised during pregnancy, whether they had a vaginal birth or a C-Section, whether they had birth complications or even a traumatic birth experience. Doctors typically recommend waiting 6 weeks before resuming a fitness program, but the truth is that doctors are not usually educated in exercise physiology and therefore are safe exercises you can encourage your clients to start doing before they even leave the hospital! These very early exercises should be focused on reconnecting to the core and pelvic floor, in order to help with simple functions that your clients will need to do on the very first day of postpartum, such as getting out of bed, picking up their newborn and putting them down in the bassinet.
Once the new mom is “cleared” for exercise by the doctor at their 6-week postpartum visit, this actually shouldn’t mean much to a qualified pre & postnatal corrective exercise specialist.
Yes, you heard that correctly.
See, on one hand, practically every single one of your postpartum clients should have begun some level of core & pelvic floor reconnection awareness in the days immediately following delivery. And on the other hand, a client who has been the recipient of a “class major” surgery, like a C-section, is not at all healed enough to jump back into her “normal exercise” at 6 weeks unless she has excelled in a valid pre & postnatal corrective exercise assessment.
Furthermore, regardless of whether your client has had a vaginal delivery or a C-section, her pelvic floor and abdominal muscles supported her baby throughout their entire pregnancy. Therefore, those muscles need to be assessed and reconditioned in order to restore the integrity and strength of the core before returning to traditional exercises.
And be VERY CAREFUL assuming that you can just keep teaching Kegel exercises – or suggesting any new variety of electronic devices and pessaries – because there is a reasonable chance that your postpartum client has a hypertonic pelvic floor, and actually needs to learn how to relax those muscles. Guiding your client through a verbal pelvic floor awareness assessment, like in the Pre & Postnatal Diastasis and Core Consultant certification, should be your starting spot, if not a woman’s physical therapist. PS. “Pelvic floor hypertonicity is not routinely evaluated by physicians and is therefore likely underdiagnosed,” as well as exacerbated by conventional treatments.
Below you will find safe and effective exercises to help engage and strengthen the muscles that worked so hard to help stabilize and support your client’s body during pregnancy. And the best part? These exercises can often be done as soon as your client feels like moving her body after birth, provided she has not had any serious complications post-delivery.
Try These 10 Postnatal Exercises with Your Clients
- Diaphragmatic breathing – The diaphragm is arguably the most important muscle in the body and is our primary breathing muscle – or at least it should be. Perhaps surprisingly, it is also one of the most underutilized muscles. From a very early age, most humans learn to breathe with secondary respiratory muscles, including various neck muscles and pec minor. If you pay attention to your own breathing, you may notice your chest rises and falls with each breath, but if you watch an infant breathe, you will notice it’s their belly that rises and falls. Practicing diaphragmatic breathing has many benefits including strengthening the core, reducing stress and promoting waste exchange.
- How to do it: laying down or on all fours, relax the belly, take a deep inhale and imagine filling the lower part of the ribcage and belly with breath, rather than filling the chest. Exhale naturally.
- Transverse Abdominal (TA) activation – There are four layers of abdominal muscles, and the TA is the deepest. Its primary job is to stabilize the body, specifically the spine, and it acts as a corset, keeping the organs of the body in place. During pregnancy, the TA is the primary abdominal muscle that supports the growing belly most posturally and also is forced into a dramatical stretch position for several months.. After mom has the baby, her abdomen will commonly continue to feel soft and loose for weeks (and even months if it is not rehabilitated), which can make it difficult for your client to feel reconnected and strong.
- How to do it: Laying down or on all fours, relax the belly and take a deep inhale. As you exhale, gentle “corset” your TA inwards toward the midline of the body. Continue imagining your hip bones, midsection and lower abs pulling towards each other. Inhale and release.
- Pelvic floor exercises – The pelvic floor is a layered set of interconnecting muscles that run from the coccyx to the pubic bone and sitz bone to sitz bone. They support the uterus, vagina, bladder and bowel. These muscles play a major role in pregnancy and childbirth, supporting the growing uterus and shifting organs, and then stretching to allow for the baby to pass through the pelvis. Many women feel disconnected from these muscles after having a baby and may experience pain or incontinence.
- How to do it: Laying on your back, take an inhale, and on the exhale, “close & lift” your pelvic floor muscles for a count of 10. On the inhale, coach your client to consciously relax her pelvic floor for a count of 5. Since it can be difficult for mom and trainer to know if they are doing this correctly, you may try different cues with them to help them mentally access the muscles. You can think about the muscles in 3 groups – the muscles that would stop the flow of urine, the muscles of the vaginal canal, and the muscles that would stop a bowel movement. Practice gently contracting and relaxing these muscles.
- Core Breathing Belly Pump® (CBBP) – This exercise was created by Fit For Birth, and has since been adopted by other fitness training companies. It is a way to tie the previous 3 exercises together to encourage the diaphragm, TA and pelvic floor muscles to sync up and work together.
- How to do it: Laying down or on all fours, take a deep diaphragmatic breath, filling the lower ribcage and belly with breath. On the exhale, contract the pelvic floor and activate the TA simultaneously, “corseting” it inwards toward the midline of the body. Then, inhale as you relax the pelvic floor and the TA while simultaneously filling the lower ribs and belly with breath.
- Pelvic Tilt – Pelvic tilting is important for a postpartum person to reconnect to the middle of her body, by allowing for a range of motion contractions and relaxations to occur.
- How to do it: Try pelvic tilting in these positions, and remember to coach your client to use her Core Breathing Belly Pump in conjunction with each repetition, inhaling for anterior tilt and exhaling on posterior tilt. Try the following progression order:
- Lying supine with knees bent.
- Lying supine with knees partially straightened, and then fully straightened.
- Standing
- How to do it: Try pelvic tilting in these positions, and remember to coach your client to use her Core Breathing Belly Pump in conjunction with each repetition, inhaling for anterior tilt and exhaling on posterior tilt. Try the following progression order:
- Cat-Cow – This exercise can be wonderful for gently reconnecting the tiny spinal muscles immediately postpartum.
- How to do it: In this classic perinatal exercise, remember that how you do it is most important. Instruct your clients to coordinate the Cat-Cow with their CBBP. On all fours, ask your client to inhale as she arches her spine while relaxing the pelvic floor and TA. Make sure to emphasize the extension of her thoracic spine here, more than lumbar. On the exhale, ask her to round her spine while contracting the pelvic floor and TA. Make sure to emphasize the portion of her lumbar spine here, more than thoracic.
- Bird-dog – This subtle exercise can be incredible for core stabilization, particularly those anterior and posterior oblique patterns.
- How to do it: Start your client on hands & knees. Coach her to lift just one limb (leg or arm) barely from the floor, while maintaining CBBP. She should already feel some level of core engagement. After practicing single limb pick ups, progress her to opposite limb lifts, again just barely from the floor. (Lifting barely from the floor commonly helps the client feel her core stabilization, since her focus is more likely to remain centered, rather than in the periphery of what her raised arms and feet would be doing. Future progressions can include limbs lifting high, to horizontal, but try to keep this for after you’re sure that she has learned how to feel her core initially.
- Glute bridge – Activating glutes is one of the most important muscular objectives in nearly any chair-sitting population.
- How to do it: Ask your client to lay supine, hook lying with knees bent, and lift her glutes from the floor. Hold here, and make sure that she can actually feel her glutes, not her lumbar back or quads or hamstrings. Once your client is confident that she knows how to activate her glutes, and is progressing along in her postpartum recovery, there are many progressions for this exercise, including: feet wide, feet narrow, shifting weight to one side, 1 foot completely raised from the floor, pulses, and more.
- Deadlifting-Squats – Whether the doctor has “cleared” her or not, your client will be squatting to get up and down from chairs, couches and toilets, and very likely bending over to pick up her little one from the bed, crib, etc. Therefore, it’s important for Pregnancy Safe Coaches to teach their clients HOW to do these better, rather than pretending that she won’t be doing them for 6 weeks.
- How to do it: Either a squat or a deadlift could be appropriate at this stage, but here we are simplifying it into one blended continuum, from deadlift to squats. Ask your client to stand comfortably, and to hinge her hips (keeping enough bend in the knees to ensure she feels the burn/fatigue in her glutes and not in her lower back nor quads). At some stage, remind her to connect her CBBP as well. As she gets better at feeling her glutes during the hip hinge, suggest her to progress more and more towards squatting, by letting her torso remain upright with hips now dropping “back & down” rather than just “back” as she may have been doing during the deadlift phase. No matter what this looks like, the key element is that you’re training your client to confidently feel her glutes and core engage, so that she can confidently and strongly pick up and put down her newborn.
- Walking – “Nature’s first exercise” is a great one to remember at this stage. Walking can be a natural and gentle re-connector of muscles all the way up and down the kinetic chain. In addition, it can be particularly healing if it is done with the intention of reconnecting your mind-body.
- How to do it: Just help your client find joyful times to take walks. In today’s busy world, it’s often most important to help your clients to start somewhere, and just help her build upon successes in a direction that keeps her moving in a great direction.
Looking for more exercises? Check out our full library of pre & postnatal online courses here.