Retraining Your Core Postpartum

 
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Pregnancy and postpartum causes changes in our bodies, sometimes big changes and sometimes small.  Delivering a child is truly the miracle of life and shows us a different side of our bodies, a side we didn’t think our bodies were capable of.   On the flip side, it is common to have a fear that our bodies will never be the same post-delivery, especially our abdomens. Everyone’s abdominal wall is unique and recovery from a vaginal birth or c-section can vary from person to person.  Some postpartum women have lingering laxity in the fascia and connective tissue making them more prone to diastasis recti (separation of the abdominal wall) or prone to having a distended abdomen. Others may have weakness in the abdominal muscles which causes difficulty coordinating and controlling these muscle groups.  

There is a solution in all these cases: strengthen and load the muscle gradually before you progress to anything more challenging. You want to build up weakened muscles from months of carrying your growing child and then focus on more advanced exercises later.  Taking it slow in your rehabilitation is key. Advanced barre, spin or Pilates classes are a progression for your abdominal wall postpartum, not a starting point.  You will eventually get there!

What do we mean by retraining our core? Retraining our core involves learning how to breathe properly again, activating our pelvic floor, and then engaging our transversus abdominal muscles.  These three items build up our inner foundation. When building our inner core, the exercises are simple and may require more mental capacity than physical.  As we master these basic foundational skills that we once had before pregnancy, we can then move on to the more strenuous core strengthening that you have been patiently waiting to begin.  

  1. Breathing: Using our breath is crucial during exercise to maintain proper abdominal pressure. Start paying attention to your breath in movement of everyday life.  Do you exhale or inhale when you lift your baby out of the crib? During exercise, try using your exhale during the hardest part of your movement and then inhaling on the recovery. Inhaling and exhaling through movement, such as getting up from the floor, decreases the load on our pelvic floor and abdominal muscles keeping our stomachs flatter without bulging.  As a bonus, when we use our exhale properly, the pelvic floor will be at its strongest – and this can make us less prone to leaking urine postpartum.

  2. Pelvic Floor: Know where your pelvic floor is again!  Try to master the three roles of the pelvic floor: contracting, relaxing, and bearing down.  Contract your pelvic floor by pulling the muscles up and in, the motion of “stopping urine midstream.” Then allow the pelvic floor to fully relax back down.  Once the muscles are relaxed, try to release the muscles further towards your feet by bearing down (without holding your breath of course!).  

  • Using the visual of a hotel helps: contract your pelvic floor up to the 10th floor of the hotel, then relax your pelvic floor to the lobby, and lastly bear down the pelvic floor to the basement of the hotel. Mastering the movements of the pelvic floor is the second part of using your entire core effectively.  

  1. Transversus Abdominals: Learning to contract your transverse abdominal (TA) muscles allows us to turn on our core. When you focus on the inner core, it will make you feel strong and stable again.  This lowermost region of the abdominal wall is the most loaded area during pregnancy due to the position of the baby when you are in an upright position (makes sense!). As a result, it tends to be weakened and stretched out postpartum. 

  • Finding these muscles can be hard but it is rewarding once you do: try exhaling while drawing your belly button towards your spine and bringing your pelvic floor upwards. Naturally, when your TA contracts, your pelvic floor moves and contracts simultaneously demonstrating a synergistic relationship.  Try engaging your pelvic floor, then pulling in your TA, and you will see the abdominal wall draw in even further.  

Why is building a foundation so effective for flattening our stomachs?  Once we master correct breathing techniques, strengthen our pelvic floor and activate our lower abdominal muscles, we can recruit the proper muscles to use our core in its entirety, not just the obliques and rectus abdominus.  When doing exercises such as a planks, side planks or any abdominal hollowing, having this particular body awareness makes the exercise more effective.   

* Exhaling, engaging our TA and our pelvic floors creates an optimal environment for abdominal strengthening while keeping our belly’s from bulging outward and creating the dreaded “mummy tummy.”  Once this is mastered, you can incorporate these three items during squatting, lunging, and harder work outs at the gym – you will feel a difference in your trunk stability! 

What to look out for when exercising your core postpartum?  

  • Making sure there is no doming or bulging in your abdominal wall when doing exercises. Increased intra-abdominal pressure is important in maintaining stability in our trunk but if there is too much pressure, it can cause the wall to bulge.  

  • Doming (or bulging) can be a sign that the exercise we are performing is too advanced for the time being. It could also mean that we are holding our breath when performing the exercise.  If you are experiencing this, take a step back and try an easier version of the exercise.  

  • Lastly, you want to keep in mind that the pelvic floor can change during pregnancy and post-delivery. If your pelvic floor is weakened postpartum, you may see evidence of urinary leakage or even painful vaginal penetration.  If these are signs and symptoms you are experiencing, consult with a pelvic floor physical therapist. You may need a more in-depth pelvic floor strengthening and awareness training.  

 Core and pelvic health work simultaneously together and both need to be mastered with the goal of living fully and happily postpartum.  Just like your body amazed you during pregnancy and childbirth, your body will continue to amaze you when taking the proper care. Don’t be afraid to challenge yourself and your body, but do so gradually!