Postpartum Exercise: Where Do I Even Start?!

The early postpartum period, the fourth trimester,  is filled with so many feelings. What to do, and how to heal, during this time can be confusing. The needs of a postpartum person’s body are different than when they were pregnant, but also different from their typical “normal”. Their exercise needs are no different.

The body’s recovery from birth is often glossed over by society and doctors, leaving people to figure it out on their own. Do I need to exercise if I don’t ever plan on going to the gym? When do I start exercising? Can I just go back to what I used to do? When can I get back to the gym, yoga, running? The truth is-it is different for every person, but developing the foundations of reconnecting to your core and pelvic floor in the early postpartum period, as well as helping with posture and stretching, can save a lifetime of symptoms-for everyone! 

The focus of early postpartum exercise are two-fold:

1. Reconnecting to the parts of the body that change so much during pregnancy- breathing (diaphragm), the core muscles, the pelvic floor muscles and hip stabilizers
2. Managing the new movements and postures of being a new parent

Why Focus on the Core and Pelvic Floor?

The weight of the growing baby, hormonal changes, and the physical act of birth can all affect the muscles that support the spine, pelvis and abdominal organs. For some people, this can lead to pelvic floor dysfunction, diastasis recti (separation of the abdominal muscles), or incontinence. Therefore, taking time to reconnect with and gently activate these muscles is an essential part of postpartum recovery. Establishing the subtle control of these muscles is the foundation to all other movement and exercise in the future.

Understanding the Core and Pelvic Floor

Before diving into how to reconnect with these muscles, it’s helpful to understand their roles:

1. Core Muscles: The core consists of more than just your abdominal muscles. It includes the diaphragm, pelvic floor, transverse abdominis, obliques and erector spinae (muscles along your spine). These muscles work together to provide stability and support to your torso and pelvis. They play a critical role in posture, balance and movement.

2. Pelvic Floor Muscles: The pelvic floor is a group of muscles that form the base of your pelvis. They support organs such as the bladder, uterus and rectum. The pelvic floor also helps control bladder and bowel movements and is vital for sexual health. During pregnancy and childbirth, these muscles can stretch, weaken or become overactive, leading to challenges like incontinence or pelvic organ prolapse.

Why Focus on your Upper body and Postural muscles?

Feeding, carrying and lifting the baby (and all the equipment that goes along with them) causes a lot of tension and stress on a healing body and can cause pain, discomfort and stiffness. The exercise plan should address the movement, flexibility and strength to support the body throughout the day. There should be elements of upper back stretching and motion, shoulder and chest stretches, wrist and hand exercises, and awareness of the neck posture.

Mindfulness and Posture Awareness

Good posture is essential for supporting your body. It also helps you engage your core and pelvic floor, especially as you care for your newborn. Many new parents find themselves hunching forward or leaning over during feeding or holding their baby. This can lead to unnecessary strain on the back, shoulders and core muscles.

It’s hard, but it’s good to be mindful of your posture throughout the day. Try to sit and stand with your shoulders back, chest open and hips aligned. Sit against a towel roll or pillow when feeding so that your chest can stay lifted and shoulder blades back. Engaging your core while holding your baby or lifting objects can help reduce strain and promote healing.

Knowing all of these things can be helpful but are easier said than done. The exercise program you follow should include exercises that focus on helping you improve your posture and help you feel stronger in your everyday movement.

The Importance of Help, Patience, and Consistency

Although the tasks and exercises for this phase of recovery are simple, they are not easy. Guidance from a trained professional will ensure that you are performing exercises accurately and gaining the improvements you need. Similarly to recovering after a hip or knee surgery, physical therapy is crucial in the first phase of healing to set you up for success in the rest of the process. Finding a pelvic floor physical therapist to teach and guide you will save you months, potentially years, of frustration.

The early postpartum period is about honoring your body’s need for rest and gentle recovery. As tempting as it might be to rush back into a fitness routine, it’s crucial to listen to your body and progress at a pace that feels right for you. Reconnecting to your core and pelvic floor is a process, and every woman’s recovery timeline will be different.

Consistency is key. A few minutes of breath work and gentle exercises each day can go a long way in restoring strength, function and confidence. And if you experience pain or discomfort, don’t hesitate to consult a physical therapist or healthcare provider who specializes in postpartum recovery.

Final Thoughts

Reconnecting to your core and pelvic floor in the early postpartum phase is a powerful way to support your body’s recovery and well-being. By starting with gentle, mindful movements and exercises, you can rebuild strength, enhance stability and promote overall health. Remember, every step forward—no matter how small—is a victory, and your body is capable of incredible healing. Be patient with yourself and celebrate the progress you make along the way.

Chelsea Anjeski, PT, DPT, OCS is co-owner of Level Up Wellness + Physical Therapy. She really enjoys working with people during pregnancy to help with general aches and pains, pelvic floor dysfunction and for birth preparation. She also specializes in working with people having issues from side effects from breast cancer and its associated treatments-particularly pelvic floor problems.