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Post-partum Recovery: Getting back to physical activity!

Posted Jan 11th, 2019

This blog comes in response to a recent "mommy and baby" presentation Victoria Goodman, our in house Pelvic Physiotherapist, did in the Ottawa area.  It was a great time hanging out with the new moms, seeing so many cute infant smiles, and sharing some tips and tricks to ensure a safe and strong return to physical activity & life!

Here is a collection of exercises to help ensure a proper "foundation" to your pelvic floor & core's recovery and health:

1.  Diaphragmatic (Belly) Breathing– Place one hand on your stomach and the other on your chest. Practice taking deep breaths (3-5 at a time max), keeping your chest and shoulders down, and instead feeling the belly expand on the inhale, and flattening on the exhale. Don’t force/push as you practice, but instead visualize your lungs expanding outwards from the abdomen and back. Practice 3-5 times.

 

2.  Lateral Costal Breathing (Rib Breathing) – Place your hands on each side of your torso along the ribs. Practice taking deep breaths (3-5 at a time max), keeping your chest and shoulders down, and feeling your ribs expanding outward and slightly upward as you inhale (like the handles of a bucket). Visualize each rib creating space between it and the next one, while the sides of the lungs fill with air on the inhale and return back to resting position on the exhale. Practice 3-5 times.
 
 

3.  Transverse Abdominis Activation (deepest abdominal muscle) - Lie on your back with your knees bent and feet flat on the bed/floor. Place your hands just in and down from each of your front hip bones. Take a breath in, and on the EXHALE, practice bringing your hip bones together towards your midline, while your belly button slowly sinks downward. You can imagine your hip bones as the two covers of a book, and you are working to gently close the book on the exhale. You should feel a gentle muscle activation under your fingers as you do this; if you feel a sudden large push of muscle into your hand, then you are instead engaging the more superficial abdominal muscles and/or increasing intra-abdominal pressure (not effective for this exercise). Don’t push outward, which increases the pressure in the abdomen. Practice 5 repetitions, 2-3x/day
 
 


4.  Diastasis Recti Self-Assessment – Lie on your back with your knees bent and your feet flat on the floor. Place four fingers cross-wise (horizontally) at the level of your belly-button. Push your fingers inward until you meet firm resistance. Then, slowly curl your head up off the floor/mat, keeping your shoulders down (not a full sit-up). You should feel your abdominal muscles pressing into your fingers. Measure how many fingers you can place between the left and right abdominal muscles. If the width is greater than 2 fingers, you may have Diastasis Recti (separation of the Linea Alba – the connective tissue that runs vertically along the midline of the abdomen).
 


 
5.  Cat-Cow– Lean on all 4’s with hands and knees shoulder and hip width apart. Arch your back upward as you breathe out; then as you breathe in, drop your belly button towards the ground, creating an arch in your back (cow). Notice how your tailbone and pubic bone move away from each other slightly during the cow position, (lengthening the pelvic floor).
 


6.  Child’s Pose – Sit on a mat or carpet, with your legs tucked under you and your knees fully bent. Widen your knees, as you gently lean forward towards the floor. If you feel comfortable, stretch your arms out fully and place your forehead on the floor. If this is too difficult, then you can rest your head on your closed fists. Hold the position for 30 seconds to 1 minute, focusing on feeling your pelvic floor relaxing.
 


 
7.  Deep Squat - Squats are a great way to open up the pelvic floor. When we squat down, our pelvic floor lengthens, and our sitting bones widen. Begin with your feet slightly wider than shoulder width apart, toes pointed slightly outward. Place your hands on your thighs while you lower into a partial squat (not the image to the right). If this feels comfortable, then you can deepen your squat, placing your elbows inside your inner thighs and placing your hands together. To make this deep squat easier (as seen in the picture here on the right), you can place a rolled towel under your heels and/or place your low back against a wall to add stability. Hold the deep squat for 1-2 minutes, taking deep breaths and focusing on feeling your pelvic floor relaxing.
 

Photo resources:

  1. https://goo.gl/images/WZDEPj
  2. http://pilatesexerciseoftheday.blogspot.com/2012/08/day-32-rib-breath-bucket-handle.html
  3. https://www.medbridgeeducation.com/h/patient-education-low-back-pain
  4. https://nchesmummyandmemagazine.files.wordpress.com/2013/09/self-check.png
  5. Pelvic Health Solutions (written guidelines); photo https://fitness.stackexchange.com/questions/24295/cat-cow-stretch
  6. http://www.pocketyoga.com/Pose/child_wide
  7. https://www.yogamerge.com/blog/malasana-pose.php