Pregnancy & Post-natal Physiotherapy
Do I need to exercise in the first few weeks?
Yes. It’s fine for you to take some exercise, as long as it’s gentle, in the first few weeks after having your baby. Gentle lower abdominal exercises and pelvic floor exercises are all it takes to help your body to recover at this stage.
Although exercise may feel like the last thing you want to do while adjusting to life as a mum, it does have benefits. It can:
- Boost your mood by increasing the levels of feel-good chemicals (endorphins) in your brain.
- Help you to lose weight and regain your pre-baby figure, if you eat sensibly.
- Protect you from aches and pains.
- Give you more energy, if you are feeling tired.
- Improve your strength and stamina, which will make looking after your newborn easier.
The most important exercises in the first few days after birth are your pelvic floor exercises. Start doing them as soon as you can. Strengthening your pelvic floor will help to protect you against having accidental urine leaks.
Pelvic floor exercises will also help your perineum and vagina to heal more quickly. That’s because the exercises improve circulation to the area, helping to reduce swelling and bruising. If you have stitches, exercising your pelvic floor won’t put any strain on them.
You may find for the first few days or weeks that you can’t feel your pelvic floor muscles working or that nothing is happening. Keep going, as the feeling in your pelvic floor will return after a few days and it will be working even if you can’t feel it.
As soon as you feel up to it, try to get out and about, ideally walking while pushing your baby in his pram. Make sure that the pram handles are the right size for you so that you don’t have to bend forwards or reach upwards.
In the first few days, your perineum or pelvic floor may feel uncomfortable, swollen or very heavy. Start with short walks of about 10 minutes, building to 20 minutes. Try to make a walk with your baby part of your daily routine, so that you’re more likely to do it.
If your lochia becomes redder or heavier, this may be a sign that you are overdoing things, so take things easy. In fact, the key to exercising healthily is to listen to your body.
You may feel on a high for the first few days. Then you may come down to earth with a crash when the baby blues kick in or you run out of energy. Try to pace yourself with a little bit of exercise followed by a well-earned rest.
If you are unsure about what you should be doing, talk to your doctor or midwife.
It’s safe to exercise while you are establishing breastfeeding. Exercise won’t affect the quality or quantity of your breastmilk.
The jury is out as to whether taking regular exercise when you’re a new mum reduces symptoms of postnatal depression. But one small study showed that joining in with regular exercise sessions helped new mums to feel better after their baby’s birth.
You’ll be adjusting to all sorts of new routines now. It’ll help you to keep up the exercise habit if you make gentle exercise one of your routines.
What about exercise after a caesarean?
The gentle exercises in this article are safe for you if have had either a vaginal birth or a caesarean section.
Gentle exercise of your tummy muscles can help them to recover from the operation. You may feel a pulling sensation when you tighten your muscles, but you should not feel any pain.
Be guided by how you feel. If you have had a caesarean you may find that you become tired easily.
Are there exercises I shouldn’t do in the first six weeks?
Don’t go swimming until you have had seven days without any bleeding or discharge from your vagina (lochia). If you have had stitches or a caesarean section, wait until after you have had your postnatal check. Talk to your doctor about exercise regimes that go beyond gentle tummy-tightening.
Don’t exercise in a hands-and-knees position for the first six weeks. There is a small risk that a little clot of air can form at the site where your placenta was attached.
How do I exercise my lower abdominal muscles?
Your lower abdominal muscle is the most important one to exercise after you have had a baby. It works with your pelvic floor muscles to support your back and pelvis. Exercising your lower tummy muscle may help you to lose your post-pregnancy belly.
Try this exercise, either lying on your side or on your back with your knees bent up. If you have had a caesarean section, you may find it uncomfortable to lie on your side for the first few days, so lie on your back.
1. Breathe in and as you breathe out, tighten your pelvic floor muscles. The feeling is one of squeeze and lift. Imagine that you are stopping yourself from passing wind and doing a wee mid-stream at the same time. Once you’ve tightened your pelvic floor, gently pull your belly button in and up. You should feel your lower tummy muscles tighten.
2. Hold this while you count to 10 without holding your breath (this is the hard bit!). Then slowly relax your muscles. Wait at least five seconds and then repeat. Try to avoid moving your back or over-tightening the tummy muscles above your waist.
You may find that you can only hold a squeeze for a second or two in the early days. Try not to worry – you’re doing fine. Aim to hold your tummy muscles in for 10 seconds by the time your baby is about six weeks old.
You can try lower tummy muscle exercises sitting on an exercise ball once you can do them lying on your back or side:
1. Sit on an exercise ball with both feet on the floor, preferably on a carpet to ensure the ball does not slide away from you.
2. Squeeze your pelvic floor and lower tummy muscles and then gently lift one leg off the floor. Remember to breathe! Hold this for up to five seconds, slowly lower your foot and relax your muscles. Repeat between five and 10 times on both legs.
How can I strengthen my pelvis and back?
Pelvic tilts are useful exercises that gently move and stretch your back and exercise your tummy muscles. They can also help to alleviate back pain. You can do pelvic tilts lying down, sitting or while balancing on an exercise ball.
Here’s how to do pelvic tilts while lying down:
1. Lie on the floor or on your bed. Place a pillow under your head. Bend your knees by sliding your feet up towards your bottom.
2. Tighten your pelvic floor and pull in your lower tummy muscles, before squashing the small of your back down into the floor or bed. Hold this for a count to three and then arch your back away from the floor or bed. Repeat this 10 times. Try not to hold your breath!
Here’s how to do pelvic tilts while sitting:
1. Sit on a chair or stool with your feet on the floor.
2. Tighten your pelvic floor muscles and pull in your lower tummy muscles. Slump your back and then arch it so you stick your chest and bottom out. Keep the exercise flowing smoothly so you stretch your back one way and then the other.
Here’s how to do pelvic tilts while using an exercise ball:
1. Sit on an exercise ball with both feet on the floor, preferably on a carpet to ensure the ball does not slide around.
2. Move the ball backwards and forwards with your bottom, allowing your pelvis to move with it. Try to keep your shoulders still. You can also move the ball from side to side to exercise your waist muscles.
How do I strengthen my upper back?
It is easy to spend a lot of time sitting in a slumped position when you’re a new mum, especially while breastfeeding. Try these exercises to stretch and move your upper back and neck.
1. Sit up straight with your arms crossed over your chest. Twist to the left and then to the right. Repeat 10 times each way.
2. Sit and link your hands behind your neck. Twist to the left and then to the right. Repeat 10 times each way.
3. Sit and link both hands together in front of you. Take your arms up in front of you and above your head as far as you can. Hold for two or three seconds and then slowly lower your arms down again.
This exercise will strengthen your neck:
1. Sit and slowly turn your head to the left and then to the right.
2. Slowly, tilt your head so you move your right ear down to the right shoulder and then your left ear down to your left shoulder.
3. Slowly bring your head back to the middle and then bend your neck forwards to your chest and backwards to the ceiling. If you start feeling dizzy, do the exercises more slowly.
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