Postpartum Core Recovery

After you give birth, it’s normal for your entire midsection to seem quite foreign. Perhaps it seems like you have no abdominal muscles at all.  If you had a C-section, you may have even lost feeling in some areas.  Don’t panic, but also PLEASE don’t act on any urge to do thousands of sit-ups or planks in an attempt to “get your abs back.”  This will have the opposite effect.  You can absolutely have a strong core again, perhaps even stronger than it was prior to pregnancy, but it does require a methodical approach to recovery, focusing on gradually rebuilding your core from the inside out.  Here are a few tips to get you started.

Your Postpartum Core

Before we tell you what to do, it’s important to understand a bit about your core anatomy and what happens during pregnancy.  Let’s first take a (simplified) look at your deep core muscles.  The image below shows the critical muscles we refer to as the Core Canister: The diaphragm (DF), the transverse abdominis (TVA), and the 14 different muscles of the pelvic floor (PF).

Think of the TVA as your body’s “inner girdle” (wrapping around your entire midsection) and your pelvic floor muscles as the “floor of your core.” A growing belly during pregnancy places excessive pressure outward and downward (AKA “loosening that girdle” and “weakening the floor”).  Childbirth further traumatizes these muscles (especially if you use the traditional pushing technique of holding your breath, as many doctors cue).  So, typically women have some degree of diastasis recti (abdominal separation) and pelvic floor dysfunction in the early postpartum period.  If you jump into doing traditional ab exercises without properly rebuilding the walls and floor of your core, it’s like trying to add an addition onto your house when the foundation is weak. We don’t want to deal with those repercussions, so let’s focus on rebuilding that foundation first.

6 Steps to Rebuilding Your Core

Follow the steps below in numerical order, moving on only with mastery of the previous. You can (and should) begin doing all of these immediately following delivery.  In fact, the sooner the better.  For movements #2 – 6, master them first in a seated position.  Then, you can move to other positions like standing, lying on your back, and all 4s.

  1. Get in Neutral: The first step is to remove any added stress to your core muscles.  When your body is out of neutral alignment, this places added stress on your core muscles, and will slow your healing process.  Focus on neutral alignment when seated (especially when feeding your baby) and during all of your movements. Learn how to GET IN NEUTRAL
  2. 360° Breathing: This is the first and most fundamental technique to master, as proper breathing gets all the critical Core Canister muscles to function properly as a unit and regulate intra-abdominal pressure.  If you can master 360° Breathing, and make it become natural, that’s like doing over 20,000 reps per day of the most beneficial core exercise there is. It is the first, and most fundamental, technique we teach ALL clients. WATCH VIDEO
  3. 360° 2-Step Exhales: This is a progression on 360° Breathing that increases emphasis on the exhale to increase TVA activation (AKA tighten the girdle more). WATCH VIDEO
  4. PFAs-Slow and Fast: Now, we want to increase activation of the traumatized pelvic floor muscles with PFAs (Pelvic Floor Activations). No, this does not mean doing “Kegels” as they’re traditionally known (squeezing the muscles used to stop the flow of urine). Watch this video to learn how to target ALL your pelvic floor attachment points, and work them through a full range of motion. PFAs can be tricky to learn, especially in the beginning when your PF muscles are weak, but keep practicing and it will get easier.  WATCH VIDEO
  5. Core Canister Pump: This movement is essentially a PFA-Slow with a stronger TVA contraction on the exhale. So, if we think of that Core Canister, it’s a stronger contraction of both the walls and floor on the exhale (followed by full relaxation on the inhale).  WATCH VIDEO
  6. Core Canister Hold: This movement begins the same as the Core Canister Pump, but after you exhale and contract the TVA and PF, you then hold that contraction in the muscles as you continue to breathe (light inhale, strong exhale). Do only 2 breath cycles at first, then gradually increase to 3, 4, and so on (up to about 30 seconds). You may not be able to hold the PF contraction as long as the TVA, which is fine.  WATCH VIDEO

Practice these techniques as much as you can throughout your day.  You can make up your own routines and perform 6-10 repetitions of each.  Again, once you master them seated, you can do them in other positions (standing, lying on your back, all 4s).  If you had a C-section, follow these other C-section Recovery Tips as well.

What to Avoid

While going through the recovery process, it’s important to avoid all traditional abdominal work (sit-ups, planks, leg lifts, dead bugs, V-sits, etc) until deep core strength has been restored.  One easy way to tell if a movement is not appropriate is to watch for a vertical, torpedo-like protrusion down the center of the abdomen, like the image below.

Diastasis Recti

This is a sign of diastasis recti You are seeing the abdominal contents protrude through the separation.  Don’t panic. Just stop the movement, and regress it.

It’s also important to avoid heavy lifting and impact exercise. Look out for another sign that a movement or activity is not inappropriate: accidental urine leakage.  This is a sign of pelvic floor dysfunction.

Finally, while you might be tempted to “suck in” your belly to make it appear flatter, or walk around with your core constantly “engaged,” AVOID the temptation.  These activities create excess intra-abdominal pressure in your core, which can actually worsen DR, and end up having the exact opposite effect of a flatter tummy.

Want More Support?

The above is just a small excerpt of our full Core Recovery Protocol that we take women through after pregnancy. Want to work with an expert on your postpartum recovery (no matter how many months or years postpartum you are)? Consider working with a PROnatal Personal Trainer.  Want to earn your specialization to work with postpartum women?  Consider getting your Pre/Postnatal Performance Training Specialization.