Week 2 postpartum and the body starts the process of healing
So, before you know it, your baby is a week or 2 old and your days seem to pass as quick as the minutes themselves. During this time, the structures that were heavily stretched during the labour/birth process is in the process of healing, so it was important to keep activity light.
Hopefully however, you found the few minutes it takes/took to complete the first 3 simple exercises recommended in Week 1 of my Blog.
- Diaphragmatic Breathing
- (Transverse) Abdominal Compressions
- Pelvic Floor Activation / Kegel exercises
These 3 exercises were enough for me – not only in remembering to do them, but time-wise & physically too, for that first week or so at home.
Around Day 10 however, I was a bit more efficient about doing them, so I added in some extra exercises. If you have had an uncomplicated vaginal delivery, you may start around this time too. If you have had a C Section, and are recovering well, you could add them in around 3 weeks postpartum.
I typically did the following routine while the baby slept & my older toddler was kept amused by a dose of Dora the Explorer or Daddy!
Supine exercises are beneficial in these early days, because they help minimise the load which is bearing down on the Pelvic Floor (PF) muscles. It will also be easier to locate the PF muscles when lying supine, and prevent them fatiguing too soon. Begin with the lower Rep range and progress your reps over the next 2 weeks.
NB, begin each exercise above with a Diaphragmatic Inhale & PF activation of Exhale (wait for the end of the exhale to activate the PF using your 4 bony cues of ‘tailbone-pubic bone-sitz bone-sitz bone’).
Increases mobility in the lumbo-pelvic area, aiding circulation,
Activates the lower Transverse Abs &
mobilises the lumbar spine;
works the pelvic floor muscles
Lie in Basic relaxation position (with knees bent, feet hip distance apart, arms by sides), inhale…
Exhale and gently move the tailbone toward pubic bone, and pubic bone toward chest (tilting pelvis back)
Do not use buttocks muscles, and feel tension free in the movements
Inhale, tilt pelvis forward (ie to arch the lower back, thus stretching the pelvic floor);
Exhale, repeat the posterior tilt..
Hold the final Pelvic Tilt…and begin your Arm Circles (below)
Lying Arm Circles
Helps to relieve tightness in chest & back muscles (i.e. improves posture);
Better breathing (therefore, great for circulation & energy);
Mobilises the shoulders, helping ease upper back/neck tension
- Maintain the last (posterior) Pelvic Tilt from the last set of exercises;
- Inhale, reach arms to ceiling and back overhead (to the wall behind you), maintaining the contact of your mid-lower back with the floor;
- Exhale as you circle arms around to bring hands to rest beside your hips again;
- Inhale, repeat the first part of the next circle;
- On final exhale/circle, release pelvis from its tilt as you return arms to sides.
Lying Leg Slides
Stretches the iliopsoas muscle of the hip/low back area (improving low back flexibility); develops core abdominal control & pelvic stability.
- Supine position, pelvis titled posteriorly, inhale;
- Exhale as you slide your Right heel forward on floor, as far as you can maintain the posterior tilt;
- Inhale as you return the foot to you. Repeat on same leg for suggested repetitions & change to other leg.
Glute Bridge aka Shoulder Bridge
Strengthens the buttocks, hamstrings, core muscles of the low back & abdominals;
Opens front hips; builds pelvis & hip stability.
Have a sense of movement with this exercise, rather than overworking glutes.
- Lie supine, with spine / pelvis neutral, feet hip distance apart, inhale;
- Exhale, ‘bring tailbone to pubic-bone & pubic-bone to chest’, and peel spine from floor, to Bridge position;
- Inhale staying here;
- Exhale, roll back down ‘back of the throat to upper spine to mid spine to low spine to tailbone’;
Side Leg Series #1 – Side Leg Lifts
Strengthens the hip muscles (improving gait mechanics); improves hip & core stability; increases body awareness<
- Assume a side lying position, with bottom knee slightly bent, head rested on bottom arm, and in line with shoulders, tailbone and top heel;
- Inhale as you raise top leg to just above hip-height, emphasising a ‘push up’ action;
- Exhale as you lower the leg to bottom leg, emphasising a ‘pull down’ action;
- Repeat, keeping the underneath waistline lifted from floor & top waistline long; keep spine & pelvis stable throughout.
Swimming on All 4s
Strengthens the back, shoulders and hips;
Develops core strength & stability;
Improves balance; improves joint stability in hips & shoulders
- Kneel on all fours, knees below hips, hands beneath shoulders; keep head & neck in line with the back; pull navel to spine to support the lower back. Inhale…
- Exhale as you reach opposite arm & leg as pictured*, initiating with the abdominals. Do not allow alignment of the back to change.
- Inhale as you return hand and knee to start position simultaneously. Repeat same sides for a set, before changing sides. * if you are too unstable / unbalanced, modify to a single leg reach instead (pic 2).
Camel / Cat Stretch
Works & stretches the pelvic floor muscles; improves lumbo-pelvic mobility; reduces tightness in the spine & the lower back.
- In an all-fours position, inhale
- Exhale, press into your hands, rounding your back to the ceiling, curling tailbone to back of knees – shift 60%-70% of your weight toward your heels;
- Inhale as you release your back slowly, lifting eyes, chest & tailbone upward, creating length in your spine and keeping abdominals braced.
- Exhale repeat..
A truly functional exercise, strengthening & toning the leg, butt & back muscles; promotes good alignment awareness; improves ankle, knee, hip, and spine stability; they help the pumping of body fluids, thereby helping with swelling, fluid removal, waste removal, and circulation.
- Stand tall, with feet shoulder width apart and slightly turned out; Place hands to back of head as pictured (if this causes neck, shoulder or back tension, place them on your forehead); keep elbows wide and shoulders retracted.
- Inhale as you stick your butt back & down, keeping knees aligned over feet; keep range of movement small to moderate, to avoid stressing the PF.
- Exhale as you press into feet, standing up slowly, lifting abdominals in, and contracting hamstrings, quads and glutes.
P.S. A word on that 6 weeks Post Natal Check Up!
If there is one thing you can really do to help yourself return to pre-pregnancy strength & fitness, I would highly recommend you make an appointment with a qualified Pelvic Floor Physiotherapist, after you have attended your Doctor, for your general 6 week check-up. If your fitness goals include a return to running or other high impact activities, I could not stress the importance of such an appointment.
It is a hugely beneficial internal examination of your pelvic floor musculature, assessing PF function, checking for imbalances, such as Hypo-tonicity (weak pelvic floor), Hyper-tonicity (tight pelvic floor), as well as assessing the (re)alignment of the pelvic structures.
Contact any of the following for an appointment:
milltownphysiotherapy.com Tel: (01) 296 0603
physiofitwoman.ie Tel: (01) 293 2969
pelvicphysiotherapy.com – a fantastic, informative website, listing Pelvic Floor Manual Therapists in Dublin and countrywide.
Next Week, I will post the remaining exercises in this first 6 week-phase of your postpartum (home) rehabilitation programme..
I will also (gulp!) be revealing my 6 week postpartum Belly photos, and discuss how simple Goal Setting & Assessment Techniques, will help your progress and ensure your success in the ‘Restore & Reconfigure’ programme.