Post-Partum Recovery: It's So Much More Than Kegals
Pregnancy is a complex and dynamic shift in the human body that takes 9 months, with hormone shifts that impact the entire body. Relaxin changes connective tissue, bones shift to expand, rib cages flare, internal organs re-organize to allow for the expanding fetus.
When talking with clients about prepping for pregnancy, and how to return to training after, I emphasize it took 9 months to arrive in this post-partum body. Expect the transformation to arrive at another body in a similar manner; slow and steady, with daily practice, with at least 9 months to a year to see a similar return to sports performance.
But where exactly are we supposed to start? Many of my clients describe feeling alien in their own body after pregnancy, and overwhelmed at the idea of where to begin, and that's perfectly normal. It's okay to be overwhelmed, and it's one of the things that I love about working with post-partum folks, because I can be a guide to help re-buildinga foundation, and to feeling empowered and safe in your body again.
To be clear, this is not a guide to get a "pre-baby" body. This is a guide to help you reclaim your strength, reduce injuries, decrease your pain, and make you feel at home in your own skin again.
To start, I like the acronym K.I.S.S: Keep it Simple and Supported. It's not going to be a bunch of fancy instagram exercises, but they're going to be damn effective. There's also going to be a good bit of support from the environment so that you can't compensate using helper muscles.
1) Rebuild Your Core Strength
2) Address your breathing mechanics
3) Address your hip stability
4) Work on your posterior chain, especially in the upper back and shoulders.
5) Integrate and coordinate your pelvic floor
So, where do we start with that? I've included 5 basic exercises to address these 5 key principles that I find are relevant to post-partum bodies.
1) Rebuild Your Core Strength: Sidelying TA Lift
This is a foundational move to help you begin to rebuild your pressure management system in your abdomen. These deeper core muscles help prevent the development of a diastasis, and treat one if it's already present. Be sure to do both sides, because I guarantee it will be harder on one side versus the other.
2) Addressing breathing Mechanics: 360 Breathing with a Towel
Pregnancy often compresses the lungs as the uterus expands upwards to make space for the fetus, compressing the ribs an the diaphragm. This is why pregnant folks often feel like they huff and puff (among other reasons). Further more, this expansion can limit the rib's ability to expand and dynamically move with breathing. An important part of restoring normal core stability is making sure someone can expand their rib cage in all directions. This improved movement helps with deeper breathing, which reduces anxiety, and also promotes ideal positioning for the core muscles to contract, and also allows improved movement of the scapula for arm exercises.
With this drill, focus on expanding in all directions without arching your low back. As you breathe in, focus on breathing in through the nose, and expanding in all directions. Don't strain too much, and use the pillowcase/towel to assist with the exhale.
3) Address your Hip Stability: Clamshells + Reverse Jane Fonda
Clamshell: These seem easy, because they're all over instagram, but being able to control rotation is no joke, and I start folks here with a lot of support. Make sure your hips are flexed to 90 degrees, to avoid those strong and helper quads, and lift from the back of the hip, not the front. Remember to breathe as you lift. This strengthens your external rotators and hip stabilizers, which will help protect your knees and low back long term.
Reverse Jane Fonda: Internal rotation is incredibly important, especially for getting back to your deeper squats, stability for your hip, and addressing low back pain in a lot of my post partum folks. Internal rotation deeply relates to our lower core strength, and having good control of it is one of the key foundations for more complicated motions. For this drill, having something squishy but wide enough to separate your knees it key to help prevent cheating. If it feels too hard, move the band higher above your knees, and scoot slightly further away from the wall.
4) Address the Posterior Chain: Seated Rows with Thoracic Rotation
I absolutely love this drill because of how well it coordinates breathing, movement of the shoulder and rib cage, and core stability. It's a goodie. With this drill, make sure to exhale as you row and bring your elbow close to your side. The arm that it's front, be sure to "reach" and allow your shoulder to tip forward.
5) Integrate the Pelvic Floor: Pelvic Floor Contraction with Exhale
So many people think that the pelvic floor simply needs to be strong, but that isn't true. It needs to be strong, but it also needs to be coordinated with every other single core stabilizer.
With pregnancy and delivery, the pelvic floor needs to lengthen to accommodate the changing needs of the body. It can simultaneously be "tight" because of this lengthening, and weak. So we need to strengthen and shorten these muscles, without making them "hypertonic" or too tight.
With this drill, think about the way you coordinate your exhale with that TA engagement. It's the same principle, there's just another layer. If you're having a hard time feeling it, put a pillow between your knees and squeeze your knees together as you contract your pelvic floor. Additionally, I find it's helpful for a lot of patients to put their hand on their groin to actually feel that contraction happen. Here, we're working on shortening and strengthening the pelvic floor. If you fall in the "too tight" camp, it can be important to work on fully relaxing between contractions, and of course, consult a pelvic floor PT (like me!) if you feel challenged coordinating this.
With these, start with 1-3x sets, 5-15 reps each side, squeezing them in throughout the day. Drops in a bucket add up over time, and if you feel frustrated or want more support, email me at email@example.com to get the help you need!