Step 1 – Pelvic Floor Exercises are the best place to start
The pelvic floor muscles form a sling between the tailbone (coccyx) and the pubic bone, and support the pelvic organs including your bladder, bowel, uterus and vagina.
Pregnancy and childbirth can damage and weaken these muscles, and this can contribute to incontinence and pelvic organ prolapse. Returning to other exercise without a well-functioning pelvic floor can further exacerbate these issues.
To exercise the pelvic floor muscles, you need to start by tuning in to them. There are lots of complicated explanations for how to do this but to keep it simple – the pelvic floor muscles are the ones you use to stop you weeing and farting, so simply practicing these two functions will suffice.
These pelvic floor exercises can be performed lying down, sitting or standing but are probably best done in all three positions. Whatever position you’re in, try to relax your yummy and don’t hold your breath.
- Gradually squeeze the pelvic floor to about 75% maximal tension. Hold for 5-10 seconds and release gradually. Repeat 10 times.
- Perform shorter, stronger squeezes – aim for 100% tension for just a split second. Repeat 10 times.
- Squeeze to about 75% maximal tension and then cough lightly. Repeat 3 times.
Aim to do 5-6 sets per day – the easiest way to remember this is to do a set after each visit to the loo.
Step 2 – Abdominal Exercises
You can start to exercise your abdominal muscles as soon as you feel reasonably comfortable to. If you feel any significant pain just stop, give yourself a few more days to recover and then try again.
Strengthening the muscles of your abdomen will promote recovery and aid return of full spinal mobility and strength. It will also help return your posture and gait to something more akin to your pre-pregnancy state.
Avoid sit ups, crunches and abdominal curls initially, these can put too much pressure on the abdomen and pelvic floor. Start with simple static contractions before adding any loaded movements of the trunk or lifting any heavy weights.
- Lie on your side your knees bent up.
- Relax your abdominal muscles and breathe in gently.
- As you breathe out, gently tense both your abdominal and pelvic floor muscles.
- Hold this for 10 seconds and gently release.
- Repeat 10 times.
Aim to do 3 sets per day.
Step 3 – Returning to your pre-pregnancy exercise
Getting out of the house and walking as much as you feel you can is a great start to getting your body back in shape, but returning to any more vigorous exercise is probably best left until you’ve had your 6-8 week postnatal check with your GP or obstetrician.
Once you’ve been given the all clear to get started, plan to build back up to your previous exercise levels gradually over a 3-6 months. It is usually best to start with low-impact exercises, such as swimming, pilates, yoga, cycling and a low load weights program. Aim to build some condition doing these things consistently for at least a couple of months before moving on to high-impact and higher load exercises, such as aerobics, running and heavier weight training.