Recommended Exercise:

Below are recommended exercises and timelines for when to progress. The most important exercise you can do is to stay consistent! I often tell my patients to pick 2–4 exercises and focus on them 3–5 days a week. In the early postpartum period, exercise may look different as we focus on activating the trunk and pelvic muscles, improving flexibility, and enhancing motor control.

Many women tell me that exercise helps with their mental health—great! Let’s find something that doesn’t cause pain or discomfort. I recommend walking as a great starting point, especially if you can get outside.

My recommended guidelines for knowing if you’re ready to progress with exercise are based on the '3 P’s':

  1. No Peeing: This means no leakage when standing, lifting your baby, transitioning between positions, or during exercise.

  2. No Pain: If you experience back pain, pelvic pain, or any sharp, achy, or dull pains, the exercise may not be right for you, or your body may be signaling that something is off.

  3. No Pressure: This refers to no pressure at the vaginal opening or in the abdominal wall.

Recommended Exercises: 2-6 weeks

  • Piston Breathing

    Set up: Begin lying on your back with your hands resting your belly, knees can be bent

    Movement: Inhale gentle through your nose expanding your belly; Exhale like you are blowing through a skinny straw

    Tip: Use this technique each time you get out of bed, picking up or putting your baby down or picking up a car seat.

  • Bridge with Kegel

    Set up: Begin lying on your back with your knees bent and feet hip width apart.

    Movement: Slightly tuck your tailbone (like a dog in trouble) and lift your butt muscle to up towards the ceiling. Exhale out, blowing through a skinny straw and contract your kegel muscle. Return to the starting position and repeat.

    Tip: Make sure to keep your feet (toes and heels) planted into the ground when you lift.

  • Modified Bird Dog

    Setup: Begin on all fours with your arms under your shoulders and knees under your hips.

    Movement: Extend your leg straight back so that it is parallel with the ground and your toes are pointing toward the floor. Exhale out while moving your leg and pull your stomach away from the ground. Hold briefly, then return to the starting position and repeat with the opposite leg.

    Tip: Avoid rotating your trunk (abdominal wall) while moving your leg

  • Squat

    Setup: Begin standing upright with your feet slightly wider than shoulder width apart.

    Movement: Bending at your knees and hips, squat down; exhale with pushing feet into the ground while straighten your legs and repeat.

    Tip: You can hold your baby in a front carrier or in your arms when performing. You can also add weight that equates to the weight of your baby.

  • Child's Pose with Side-bending

    Setup: Begin on all hands and knees.

    Movement: Sit your hips back as you reach your hands forward and to the side, then continue to sink further into the stretch. Hold, then repeat to the other side.

    Tip: Relax tailbone as your sit back into the pose to help open up pelvic floor

  • Open Book

    Setup: Begin lying on your side with your legs bent and your arms together straight in front of you, palms facing each other.

    Movement: Slide your top hand over your bottom rotating your shoulders. Then, lift your top arm straight up and over to the floor on your other side.

    Tip: Make sure to keep your knees together and only rotate your back and upper arm. Your hips should stay facing forward.

  • Figure Four Stretch

    Setup: Begin lying on your back with one leg bent and your other ankle resting on your knee.

    Movement: Grab underneath one leg, pushing your elbow into the lower thigh of the opposite leg. Gently pull your leg toward your body until you feel a stretch in your buttock and hold.

    Tip: Try to keep low back on the ground and make sure this doesn’t pinch on the front of the hip.

  • Shoulder Blade Squeeze

    Setup: Begin in an upright position.

    Movement: Gently squeeze your shoulder blades together, relax, and then repeat.

    Tip: Perform this each time you place your baby down or change your baby.

Recommended Exercises: 6 -12 weeks

  • Core Marching

    Setup: Begin lying on your back with your arms resting at your sides, or on your lower abdominal wall; Keep your knees bent and your feet flat on the ground.

    Movement: Exhale out through a skinny straw to engage abdominal wall and slowly raise one of your legs off the floor, keeping your knee bent. Then return to the starting position and repeat with your other leg.

    Tip: Make sure to keep your trunk steady during the exercise and do not let your low back arch.

  • Bridge with Resistance Band

    Set up: Begin lying on your back with your knees bent and feet hip width apart with a resistance band secured around your legs.

    Movement: Maintaining tension in the resistance band, slightly tuck your tailbone (like a dog in trouble) and lift your butt muscle to up towards the ceiling. Exhale out, blowing through a skinny straw and contract your kegel muscle. Return to the starting position and repeat.

    Tip: Make sure to keep your feet (toes and heels) planted into the ground when you lift.

  • Bird Dog

    Setup: Begin on all fours with your arms under your shoulders and knees under your hips.

    Movement: Exhale out and contract your pelvic floor muscles, lift one arm and your opposite leg, keeping both parallel with the ground. Bring them ack to the ground and repeat with opposite arm and leg.

    Tip: Avoid rotating your trunk (abdominal wall) while moving your arm and leg

  • Core with Shoulder Pull with Band

    Setup: Begin lying on your back; you can placed a ball or yoga block in between your knees; Hold the ends of a resistance band that is anchored overhead.

    Movement: Exhale out to engage your abdominal wall as you pull down your arms toward your hips, pulling against the resistance band.

    Tip: Make sure to keep your back flat from your mid back to low back when pulling on the band.

  • Squat

    Setup: Begin standing upright with your feet slightly wider than shoulder width apart.

    Movement: Bending at your knees and hips, squat down; exhale with pushing feet into the ground while straighten your legs and repeat.

    Tip: You can hold your baby in a front carrier or in your arms when performing. You can also add weight that equates to the weight of your baby.

  • Deadlift

    Setup: Begin standing upright with your feet slightly wider than shoulder width apart and a kettlebell or weight in front of you.

    Movement: Bend at your hips to reach down and grasp the kettlebell or weight. Lift it off the floor, with pushing your heels into the ground to engage the back side of your legs. Exhale out when lifting.

    Tip: Make sure to breathe throughout the exercise and keep your pelvic floor muscles engaged. Do not let your knees bend forward as you lower the kettlebell.

  • Half Kneeling Shoulder Press

    Setup: Begin in a half kneeling position holding a Kettlebell.

    Movement: With your elbow bent, hold the Kettlebell so the bottom is up close to your shoulder, then press your arm straight up overhead.

    Tip: Make sure to keep your trunk upright. Do not side bend or shrug your shoulder as you lift the Kettlebell overhead. Avoid pushing your hip out to one side when lifting.

  • Half Kneel to March

    Setup: Begin in a half kneeling position holding a Kettlebell in front of your chest.

    Movement: Exhale out and press your front heel into the ground as you lift up. Bring your back leg up to a 90 deg and pause before repeating.

    Tip: You can tap your toe of your back foot down as your stand for balance before lifting to 90 degrees.

Recommended Exercises: 12 weeks and beyond

  • Dead Bug

    Setup: Begin lying on your back with your knees bent and feet flat on the floor.

    Movement: Exhale out lifting one leg at a time to a 90 deg angle and your arms up toward the ceiling. Slowly lower one arm overhead and you straighten your opposite leg at the same time. Return to the starting position and repeat with your other arm and leg.

    Tip: Make sure to keep your mid and low back flat to the floor and exhale out to help engage your abdominal wall.

  • Bridge with Alt Leg Extension

    Setup: Begin lying on your back with your knees bent, feet on the floor, and your elbows resting on the ground with your hands in fists on your hips

    Movement: Tighten your abdominals and slowly lift your hips off the floor into a bridge position. Hold this position and straighten one leg, then bring it back down and repeat with your other leg.

    Tip: Make sure to maintain your balance during the exercise and do not let your hips rotate to either side as you lift your legs. Use your thumbs to monitor the movement of your hips.

  • Plank

    Setup: Begin lying on your front, propped up on your elbows.

    Movement: Exhale out and move into a plank position with keeping your elbow under your shoulder.

    Tip: Breath through this exercise, look about 6” in front of you with keeping a gentle chin tuck; You can start on your knees and build up to a full plank.

  • Core with Shoulder Pull with Band

    Setup: Begin lying on your back and bring your knees up to 90 degrees. Hold the ends of a resistance band that is anchored overhead.

    Movement: Exhale out to engage your abdominal wall as you extend one leg out, return and repeat on opposite side.

    Tip: Make sure to keep your back flat from your mid back to low back when kicking your leg out. You can pull the band or weights towards your hips as you kick a leg out to make the exercise more challenging.

  • Squat with Overhead Press

    Setup: Begin standing with feet slightly wider than shoulder width apart; Hold weights just above your shoulders.

    Movement: Squat down with weights in the starting position; As you stand up, press the weights above your head. Repeat.

    Tip: Exhale out as you press the weight above your head; Make sure you do not arch your upper back as you lift above your head.

  • Single Leg Deadlift

    Setup: Start in a standing upright position with holding a weight in one hand.

    Movement: Lift one leg off the ground and bend forward at your hips, lowering the kettlebell toward the ground. Then return to an upright position and repeat.

    Tip: If unsteady, you can keep the back leg down with a toe touch until you improve on your balance.

  • Diagonal Chops with Weight

    Setup: Begin in a standing upright position, holding a weight in both hands up to one side of your body.

    Movement: Slowly pull the weight down and across your body in a diagonal movement, rotating your trunk, then return to starting position and repeat.

    Tip: At the top of the movement, make sure to have your arms straight, and activate your trunk muscles as you rotate.

  • Lunge with Rotation

    Setup: Begin in a standing upright position holding a weight in front of your chest.

    Movement: Take a long step forward into a lunge position with your knees bent at 90 degree angles, then rotate your trunk toward your forward leg. Rotate back to forward position and move back into the starting position.

    Tip: Avoid moving your knee over your front toes and do not let the knee fall inward. You can perform this as a reverse lunge vs. forward if this feels easier on your knees.

Things that are “not normal”

…but can happen – if you experience any of these, please consider seeing a pelvic physical therapist sooner rather than later.  It is easier to fix these problems now!

Pain

Pain with intercourse, bowel movements, urination, sitting, walking, moving in bed, picking up your baby, etc.

Abdominal pain, hip pain, low back pain, pubic pain, pelvic pain, tailbone pain, thoracic pain, shoulder pain, neck pain.

Anything falling out of your vagina or a feeling of heaviness in your vagina.

Burning or itching around your vaginal opening or in your pelvis.

Sensitive scars.

Urine leakage – even a little bit! – Should return to normal within 6 weeks.

Fecal leaking/Constipation.

A split in your rectus muscles, or a pooch when you move.

Something just doesn’t “feel right”.