5 Ways to Help Your Postpartum Recovery

The body undergoes a significant amount of change during pregnancy and childbirth. Our bodies and bellies are stretched to the max and then often put through either a major surgery or a physically exhausting labor to bring our beautiful babies into the world. It can take weeks to months to fully heal and every woman’s recovery is different. But do not fear, there are several things you can do to help your immediate postpartum recovery. 

Without a doubt Baby #3 has been my best recovery. Between this being my third go around, plus my additional education on the postpartum body, I have discovered several things that have helped me feel better sooner. There are a number of things I have done differently but here are the five main things that have helped my body heal after baby.

1. Hydrate

postpartum recovery

Your body needs water! Depending on your specific labor and delivery experience your body likely lost some amount of blood and fluids. Water helps your body heal and function properly. It can aid in decreasing fatigue levels, improving muscle function, decreasing swelling, increasing milk production, and so much more. You should aim to have at least 64 oz of water a day. But an even better goal is to consume half your body weight in ounces of water daily. For example if you weigh 160lbs you should try to drink 80 oz of water a day. 

After Baby #3 was born I couldn’t get enough water. I brought my favorite water bottle to the hospital and went through a 32oz water bottle every few hours. Drinking a lot of water definitely helped reduce my swelling and my body fatigue. 

2. Eat Nutritious Foods

nutritious foods

Fruit, vegetables, and other high fiber foods can help quiet a bit with postpartum recovery. Eating nutritious foods can help with bowel function and offer important vitamins and minerals to aid in our bodies recovery. High protein foods can also be extremely helpful in healing postpartum. Foods high in collagen such as bone broth, chicken, fish, egg whites, and citrus fruits helps promote healing of the connective tissue in your body. Additionally, eating a healthy diet also helps with milk production if you’re a nursing mother.

During my hospital stay and the next couple weeks to follow I made sure to eat a good amount of fruit, vegetables, and protein. I know it can be really difficult to eat a healthy meal with a newborn, especially if there are older kids on the scene. My trick was to make sure my fridge was stocked with my favorite fruit, easy to eat vegetables, hummus, yogurt, and other grab and go items. Additionally, I had meal prepped several crockpot meals that were high in protein and other nutrient dense foods. Stay tuned for my Baby Meal Prep blog post. 

3. Breath Work 

postpartum breath work

To start your postpartum recovery, proper breathing is essential in retraining the activation of your deep core (abdominal) muscles. Breathing properly is very important for proper function of your core muscles, bladder, rectum, and pelvic floor. You can start with a simple diaphragmatic breathing exercise explained below. 

Diaphragmatic Breathing Exercise: 

  • Step 1: Lay on your back with knees flexed with one hand on  your stomach, and one on your chest. 
  • Step 2: Take a deep breath in through your nose. Chest should minimally move while your belly and lower ribs should expand out into your hand. 
  • Step 3: Slowly let the breath out through pursed lips (like you are blowing out a candle). As you blow out, feel your deep abdominal muscles activate and your belly tighten. 

Repeat for 5-10 breaths. Laying down is the best way to stay relaxed and tune into your breath and muscle activation. As you progress, perform this breathing exercise in sitting or standing

You also want to be sure to avoid the valsalva maneuver (or holding your breath) with bearing down or exerting yourself including bowel movements, sitting up, picking your baby up, or any other strenuous activities. This places excessive pressure on the pelvic floor and can cause hemorrhoids, prolapse, or other incontinence issues. 

Check out my blog post Are You Breathing The Right Way to learn more about how breath impacts our body. 

4. Tend To Your Pelvic Floor

physical therapy postpartum

After delivery, the tissues of your pelvic floor may be swollen and painful. Ice is your best friend! Place ice packs between your thighs as needed to help reduce pain and swelling. Twenty minute increments are recommended. 

Strengthening: After delivery, it is recommended to strengthen your pelvic floor muscles. This will help decrease incontinence (leakage of urine) and help return support to the organs that sit closest to your pelvic floor. Start pelvic floor contractions (Kegels) once pain and swelling have gone away. To do this, lay on your back, bend your hips and knees up with your feet supported and contract your pelvic floor by imagining bringing the tissues between your upper thighs up and in towards your abdomen. To feel the muscles activate, place a hand over your perineum and you should feel the tissues pull away from your hand. Do not hold your breath while performing these contractions.

I started doing kegels day three after delivery. I started with performing them in a seated position. Aim for 10 sec holds and doing a set of 10. I then moved on to performing them throughout the day in standing and during dynamic activity such as walking or squatting. Being able to contract and relax your pelvic floor muscles properly is imperative to your postpartum recovery. Check out more about the pelvic floor in “Is It Normal To Pee When You Sneeze?”.

5. Sleep & Rest 

Sleep Positions

Did you know your body heals itself while you are sleeping? Our bodies need sleep to recover. I know in those first couple weeks postpartum sleep and rest can be very hard to come by. What I have learned is to accept help and prioritize sleep. Let your partner take care of the baby, say no to visitors so you can nap when the baby naps, and let that pile of laundry sit another day. Sleep and rest is so important to our physical and emotional health. Try to get as much sleep and rest as possible those first couple weeks to allow your body to recover. 

Final Thoughts About Postpartum Recovery

This post is for informational purposes only. Talk to your doctor or medical professional if you have any questions about your postpartum recovery. I believe that all moms should have more education and help in their postpartum recovery. Please check out my post Bouncing Back After Baby (Why All Moms Should Have Physical Therapy After Pregnancy)

Your body went through many changes during pregnancy and delivery. Some of these changes may resolve on their own, but some may not. It is NOT normal to experience the following conditions after 6 weeks postpartum. Please let your doctor know at your follow up visit (or later) if you have:

  • Back pain
  • Pelvic pain
  • Pain with sex
  • Incontinence/ urinary leakage
  • Abdominal separation
  • Discomfort with C-section scar
  • Questions about safe return to exercise 

Pregnancy and childbirth is amazing but definitely hard on our bodies. The best thing you can do is be educated and proactive in your health, wellness, and recovery. Feel free to reach out if you have any questions about pregnancy or postpartum health and wellness.  You got this mama! 

Monica 

Postpartum recovery

4 of The Best Muscles to Strengthen During Pregnancy

Ahhh pregnancy, such a beautiful time. But boy oh boy, does it come with some challenges. And with nausea, fatigue, and an ever growing belly exercise, might seem like the last thing on your mind during pregnancy. But exercise throughout pregnancy has numerous benefits for mom and baby. You can read my previous post about Exercise & Pregnancy to learn why it is so important to stay physically active during pregnancy. With pregnancy comes a whole slew of physical changes. Between a growing uterus, increasing weight gain, loosening ligaments, and other physiological changes, pregnancy can be a lot on the body. A great way to manage these changes and to continue to stay active during pregnancy is to strengthen several main muscle groups. If you’re looking to feel better throughout your pregnancy and even help prepare your body for childbirth and postpartum you definitely want to incorporate strengthening or stabilization exercises into your routine. So what muscles are important to strengthen and why? 

Physical Changes During Pregnancy

important muscles for strengthening during pregnancy

When you stop and think about it, pregnancy is crazy. In a matter of 9-10 months a woman’s body grows another 6, 7, 8 (maybe even 10) pound human. That’s insane. During this time the body releases a hormone known as relaxin to loosen the ligaments and help the pelvis make room for a growing baby. Unfortunately this leads to joint laxity and instability which can cause discomfort and pain, especially in the back, hips, and pelvic region.

Speaking of this growing baby, a pregnant woman tends to gain a decent amount of weight in a short amount of time. Between the increase in fluid, blood volume, placenta, and the baby itself a pregnant woman gains on average 25-35 lbs. Most of this weight is in the midsection which can cause further stress and pressure on the abdomen, hips, pelvis, and pelvic floor.

Some of the common musculoskeletal related complaints experienced by pregnant women include:

  • Low Back Pain
  • Tailbone Pain
  • Hip Pain
  • Pelvic Pain
  • Sciatica
  • Pubic Symphysis pain
  • Core Weakness/Instability

Remember this post if for informational purposes only and should not substitute medical advice. If you are experiencing pain during pregnancy you should always speak with the appropriate health care provider. But a good place to start when experiencing muscle aches, pain, “tightness” sensations, or feelings of instability is to strengthen your muscles.

Why Muscle Strength Is So Important When Pregnant

Muscles are responsible for holding our body in place. The muscles do most of the work of keeping us upright and functional. When muscles are weak and not performing their particular responsibilities the body suffers. Weakness leads to tightness or over fatigue of other muscles, ligamentous strains, or joint inflammation. A particular pain is likely to persist if you don’t address what’s causing the problem in the first place. And most often there is some type of muscle weakness or imbalance occurring in the body.

the best muscles to strengthen during pregnancy

Pregnancy is a prefect opportunity for problem areas to reveal themselves. As ligaments become more lax the muscles have to work overtime. And with added weight, pressure, and lengthening of some muscle groups the muscles of the abdomen, hips, and pelvis really need to be carrying their weight (pun intended).

As the belly grows it can stretch out the muscles of the abdomen. This creates a problem with the length/tension relationship of the muscle making it have to work even harder to contract and relax appropriately. Likewise, a pregnant woman’s posture also changes. Her feet may turn out and she may began to lean backwards to counter balance the weight of the belly. Again this puts the muscles of the hips, core, and butt in an unfavorable position preventing them from working effectively. So let’s strengthen those muscle up to allow them to hold and support mama’s growing body.

4 Important Muscles To Strengthen In Pregnancy

 

Hip Flexors

hip flexors for pregnancy exerciseThe hip flexors are the muscles that lie on the front of the hip. They play important roles in both core stability and gait. These muscles help support the low back and hips. The hip flexors connect the low back to the legs and counterbalance muscles that run along your backside. They assist you in taking forward steps. Due to changing postures and core weakness these muscles often become tight and weak during pregnancy. This can lead to pain or compensations made by other muscles. One of the best ways to prevent these changes is to strengthen the hip flexors.

Gluteus Maximus

gluteus maximus for pregnancy exercise

The body is chain and all muscles groups are working together to keep the body balanced and functional. Along with the hip flexors you want to strengthen the opposing muscle group of the glutes, aka your butt. The gluteus maximus is a very large muscle that plays a big role in supporting your hips and low back. This muscle definitely needs to be strong and “turned on” to maintain good posture, movement, and stability. A strong gluteus maximus can aid in prevention of low back, hip, and knee pain.  

 

Gluteus Medius

pregnancy stabilization musclesThe gluteus medius is another glute muscle. This one is slightly smaller than the maximus and lies more on the side aspect of your butt. The gluteus medius is a very important muscle for lateral stability. It aids in stabilizing your pelvis, especially during any activities that require standing on one leg. Similar to the gluteus maximus this muscle can help prevent pain and discomfort in the low back, pelvis, and lower extremities. 

Core/Abdomen

abdominals during pregnancyThe core is one area of the body that will inevitably go through significant change before and after pregnancy. A diastasis recti, or separation of the abdominals, happens in most pregnancies. Nevertheless, continuing to strengthen the muscles of the core and work the abdominal muscles and fascia throughout pregnancy’s will keep these tissues healthy and strong. 

This is not an all inclusive list. There are numerous other muscles that should be strengthened for a strong healthy body. Muscles of the neck, shoulders, mid back, lower back, pelvic floor, legs, and feet are all important. These four areas are just a nice place to start for some global stabilization.  

Other Important Tips About Exercise During Pregnancy

You can read more about the benefits of exercise in my blog post Exercise and Pregnancy. As well as strengthening it can be helpful to incorporate cardiovascular exercise and stretching to maximize physical health benefits. Always check with your doctor prior to beginning an exercise program during pregnancy.
strengthening during pregnancy
 
If you are looking for more exercise ideas to strengthen muscle during and after pregnancy check out some of these workouts below: 
 
Try this Reistance Band Hip Stabilization Routine: 
 

Repeat for 3 sets

  • Shuffle with squat 
  • Straight leg raise with one knee bent
  • Straight leg raise with both knees straight
  • Fire hydrants
  • Donkey Kicks
  • Slow Sumo Squats 

Perform each exercise slow and with good quality movement. Ensure your core is braced and you’re breathing throughout the exercise. 

 

For glute or pelvic strengthening check out my posts:

For core strengthening you can check out my posts:
 
And a friendly reminder that your body goes through drastic changes during and after pregnancy. It may be necessary to see a Physical Therapist following pregnancy to ensure all your muscles are healing and functioning properly. Learn how a physical therapist can help with your recovery in Bouncing Back After Baby. 
 
Finally, ever body is different and every single pregnancy is different. What works for one woman may not work for you. Give yourself grace and remember what an amazing job your body is doing. 
 
Good luck and happy strengthening!
 
Monica 

Bouncing Back After Baby (Why All New Moms Should Have Physical Therapy After Pregnancy)

Hi ya’ll. Some of you may know that I recently began seeking further education in the area of women’s health. I especially have a strong interest in the pregnancy and postpartum population. Since having my two babies I have realized how much change women undergo physically. It’s actually quite amazing what our bodies are capable of. But unfortunately, our postpartum bodies are not perfect. Muscle weaknesses, posture changes, and healing tissues can lead to aches, pains, and impaired function. Luckily physical therapy is available to help women after pregnancy with many of these new and unanticipated challenges.

The need for physical therapy after pregnancy

physical therapy after pregnancy

In my recent postpartum course I discovered some staggering statistics on the number of women struggling with postpartum pain or issues who are not receiving any treatment. Some of the particularly noteworthy statistics include:

Pregnancy related lumbopelvic pain persists in 25-50% of women at 3 months postpartum. And if the pain is there at 3 months postpartum, then it will most likely still be there at one year postpartum. 

Sometimes this back pain can become chronic. So what exactly does this mean? This tells us that postpartum women suffering from low back pain need therapeutic intervention. Unfortunately the pain will not just magically go away. 

What’s more, only 32% of women who have PLBP (pregnancy low back pain)  or PGP (pelvic girdle pain)  report it to their care providers. And then of those who report pain to their providers only 25% of these women get a treatment recommendation. This means a huge number of women are not getting any treatment or professional help for their physical problems after having a baby.  

Postpartum Care in Other Countries

physical therapy postpartum

So why aren’t more women in the U.S. getting physical therapy after pregnancy? I mean their body just went through a huge change, they potentially had surgery, and their physical demands just grew exponentially with a new tiny human on the scene. 

Many other countries are leaps and bounds ahead of us in their postpartum care of mothers. In France, the Netherlands, and Australia every woman is automatically given several visits with a pelvic floor physical therapist to address healing issues,  muscle imbalances, or any other concerns.  Fox News published an article addressing the vast difference between France and the U.S in their care of the postpartum women. In fact, U.S. women are the least likely to get physical therapy treatment after pregnancy (only 24%) compared to Europeans.  

Yet, of these women who do get treatment in the U.S. up to 87% reported positive effect, meaning that therapy works. Obviously. Therapy can help your body heal effectively in order to prevent chronic pain symptoms, incontinence, pain with future pregnancies, and safe return to exercise and regular activities. 

postpartum care

Common Problems Postpartum 

Below are some of the common problems women might experience postpartum.

Abdominal Separation/ Diastasis Recti 

When we are pregnant our uterus and stomachs grow as the baby grows. This new growth can place extra pressure on the linea alba which is the tissue that runs down the middle of your 6 pack abs (also known as your rectus abdominis). The added pressure on your linea alba can lead to a separation of your abdominal muscles known as a diastasis recti. A diastasis recti is diagnosed postpartum if the distance between the abs is 2 finger widths or more when measured slightly above and below the belly button, or there is insufficient muscle tension.  Around 4 weeks postpartum this separation naturally starts to come back together.

However, about 60% of women still have a diastasis recti 6 weeks after childbirth. In fact, if a diastasis recti is present at 8 weeks postpartum it will likely still be present at 1 year (Coldron, 2008) An untreated diastasis recti can contribute to low back pain, pelvic pain, urinary incontinence, and other pressure system issues in our body. 

A physical therapist would be able to assess and provide proper treatment to help heal a diastasis recti. We do not have any specific exercise program supported in the scientific literature to heal a diastasis. What matters is the quality of your exercises and movement which would be assessed by a specially trained PT.

Incontinence

For many women pregnancy and postpartum is the starting point for urinary leakage and other bladder problems. There is no “normal” amount of leakage or pee with activity. A systematic review shows that 33% of women have urinary incontinence at 3 months postpartum. At 4 years postpartum about 29% women reported incontinence. Postpartum incontinence could be from weakness, poor coordination, pelvic floor muscle endurance or from overactivity and muscle trigger points. Again a pelvic floor therapist would be able to evaluate and determine to the best specific and individualized treatment for you. 

Therapy after having a baby

Cesarean Section Scar Healing  

One in three women have a cesarean section according to an article written by The Bump in 2017. A cesarean section is a major surgery in which several layers of the abdomen are cut open. Caesarean sections vary in the layers sutured or not suture as well as the depth and amount of scarring. There are several techniques for scar mobility and massage to help the healing process. A physical therapist can perform and educate a woman on these techniques to aid in optimal recovery. 

Perineal Tearing 

Tearing is the tissue damage that happens during labor and delivery. Greater than 85% of women have perineal trauma with vaginal birth (about 50% of women have episiotomy). Tissue healing of the pelvic floor is important for proper function and remaining pain free.

Low Back or Pelvic Pain

Pregnancy related low back pain or pelvic girdle pain is common during and after pregnancy. Due to changes in the body’s composition and posture during pregnancy many muscles and ligaments can become stressed out and irritable. And as previously mentioned, the core muscles are often quiet weak so there is a lack of stability which can further contribute to pain in the back and pelvis.

Upper Back and Neck Pain

Similarly upper back and neck pain is often present postpartum. Upper back pain is reported in about 43% of postpartum women. This again is due to muscle imbalances and forward posture preferences when holding baby, feeding baby, and more.

There are numerous other things a physical therapist can assist a new mom with after having a baby. Other impairments that often need to be addressed are posture, gait, breathing patterns, body mechanics, and potentially nerve pain. 

How Can Physical Therapy Help New Moms After Pregnancy

Physical Therapy after having a baby

No two women, pregnancies, or birth stories are the exact same so there is no one size fits all treatment for new moms. An individualized treatment session with a PT would allow a therapist to look at your specific impairments. There are numerous ways physical therapy could help a woman after pregnancy.

Examples include:

  • Help aid appropriate healing of perineal or C-section scars/incisions
  • Education on body mechanics and positioning techniques to improve function and prevent pain
  • Provide specific techniques and exercises to heal and strengthen the abdominal muscles (often through use of biofeedback, palpation, observation). They can help postpartum moms retrain the deep core muscles to work effectively and appropriately 
  • Provide specific exercises to heal and strengthen the pelvic floor muscles
  • Assess posture, breathing patterns, and gait mechanics for correctness and efficiency
  • Evaluate and treat low back pain and pelvic pain. Possible techniques include massage, taping, manipulations, and appropriate exercises.
  • Provide an individualized treatment plan for safe return to exercise

physical therapy after pregnancy

What’s Next?

Ok, ok I’ll get off my soap box now. I just recently realized how little education is available to American women regarding their postpartum bodies. To be honest with you there is so much I have learned already that I was not aware of when I had my children. Luckily, I was able to use some of my prior knowledge of the human body to heal and get rid of the little pain and discomfort I did experience after having my babies. But most women do not have a background or education base on body biomechanics and exercise science.

So what can you do? I would love love love if you could share this info with all the mamas or mamas to be out there. I do believe there is a movement happening in the U.S. for postpartum care to be more common place. Do not be afraid to ask your doctor for a referral to a pelvic floor therapist or woman’s health specialist. I think there is a bit of a stigma around woman needing therapy after pregnancy. But you wouldn’t be embarrassed if someone told you your leg muscles were weak. Weakness of the core and pelvic floor shouldn’t be any different.

Keep following along as I embark on this journey of education regarding health and wellness for the pregnancy and postpartum woman. And I do believe the saying, once postpartum, always postpartum. Our bodies are fricken amazing. Let’s give them the love and respect they deserve.

Monica

6 Pelvic Stability Exercises You Should Be Doing

I love my kids dearly.

But handing my two little dumplings off to their daddy so I can go out for a solo run is what gives me life some days. So after each of my respective pregnancies I was eager to get back to running. You can read my post about my return to running journey here.

Unfortunately, I was surprised by my ability to run and some other unexpected “experiences” which you can read about here. Pre pregnancy (and even at some points during pregnancy) I was able to run 5, 6, 7, miles no problem. However postpartum was a different story. Once I started getting up to that 3-4 mile range I really began to struggle. My hips would start to ache after just 3 miles. My knees would have little twinges of pain and my low back would hurt. 

Um, not ok. 

Why Pelvic Stability is Important

Running After Baby

 

The number one culprit for back pain, pelvic pain, hip pain and knee pain is often core weakness and pelvic instability, especially postpartum. In order to be successful with running it is imperative to have a strong core and sufficient strength in the muscles that stabilize your pelvis. These muscles include your abdominals, obliques, and especially your glutes. 

To be completely honest I have not always practiced what I preached and pelvic stability exercises weren’t high on my priority list in my workout repertoire. Butttt  I knew it was what I needed in order to improve my running endurance and to feel generally better. (And spoiler alert, stability strengthening has really grown on me). 

How To Improve Your Pelvic Stability

So below are 6 great, no equipment, strengthening exercises to improve core and pelvic stability. These exercises are good for anybody… especially postpartum, and especially if you plan on resuming regular exercise. I started with these exercises below and noticed an improvement after just a few weeks. 

Back pain, byeee.

Aint nobody got time for that.  

For each exercise focus on quality. Perform slow and with good form. Keep core tight. Perform 2-3 sets of each exercise. Plan on doing this exercises regularly for 4-6 weeks to notice an improvement in your pelvic stability strength.

  1. Clamshells

Lay on one side with your knees slightly bent. While keeping your feet together, slowly lift your top knee up. Keep your core tight and your trunk stable. Aim for 10-15 reps each side.

  1. Bridges

Lay on your back with your knees bent. Squeeze your glutes and press through your heels to lift your hips upward. Keep your pelvis even and your core braced. Aim for 10-15 reps.

  1. Plank

Support yourself on your elbows and the balls of your feet. Activate your core and squeeze your glutes to prevent your back from dipping down or hiking up. Hold for as long as you can maintain good form. Aim for 30-60 seconds

  1. Side plank

Lay on your side. Lift your hips off the ground so you’re supported on your elbow and your foot. Try to keep your body in a straight line with core activated. Hold for as long as you can maintain good form. Aim for 30-60 seconds each side.

  1. Bird dog

Start on your hands and knees. Extend one arm forward and raise the opposite leg backwards. Brace with your core. Aim for good form. Hold for 10 seconds and switch arms and legs. Perform 6 reps.

  1. Fire hydrants

Start on your hands and knees. Keeping your core braced raise one knee up to the side while the knee remains flexed at 90 degrees. (Like a dog using the bathroom on a fire hydrant…get it? hehe) Raise leg so that it becomes parallel to the ground. Slowly return to the starting position. Repeat for 10 reps each leg.

View the full routine below:

 

Have fun and happy stabilizing.

You can read more about the changes our body goes through during pregnancy in my post about the pelvic floor and the “Pop Can Core“. If you are looking for more core exercises be sure to check out these 5 great core moves.  And you can continue to work on pelvic stabilization with these 4 band exercises

-Monica

Pelvic Stability Exercise