Postpartum physical therapy essentials for the pelvic floor: 5 exercises to elevate your postpartum recovery
HEY NEW MAMAS! Are you ready to get moving again but don’t know where to start? Or, are you experiencing pelvic floor symptoms and not sure how to fix them without making them worse? You’re going to want to keep reading.
Maybe you’re experiencing:
Pelvic heaviness/ feeling like your vagina is falling out of your body
Hemorrhoids/ butt pain
Pain from perineal tearing
Leaking urine when you sneeze
Back pain when you lift your baby in his car seat on the way to the pediatrician
UGH! Postpartum can be rough.
I see you late night googling things like:
Why am I leaking postpartum?
How to heal prolapse?
Exercises for belly pooch / diastasis recti
When can I start exercising postpartum?
Whether you’re feeling great or dealing with pesky pelvic floor symptoms, starting postpartum physical therapy exercises can expedite your physical recovery, reduce symptoms, and get you back to the exercise that brings you joy (and not to mention, help you lift all that baby shit you now have to carry around everywhere. Forget Crossfit, I need to be able to get that Doona car seat in and out of my car without tweaking my back on the daily)
With all that said, Let’s get into my favorite postpartum physical therapy exercises!
First, let’s talk about postpartum recovery, return to exercise, and where postpartum physical therapy exercises fit in.
Ever wonder why your doctor or midwife told you to wait till you are “cleared” at 6 weeks postpartum to return to exercising?
This is because those first 6 weeks are an essential time where your body’s tissues are healing from birth - whether you had a vaginal delivery or cesarian section, this holds true.
During a vaginal delivery, your muscles and tissues of your pelvic floor stretch a CRAZY amount - so allowing them time to recover before introducing too much load can help you heal faster, while also reducing the risk of ongoing pelvic floor issues like prolapse, diastasis, leaking, and pelvic pain.
However, This advice can be construed such that new moms do NO form of exercise for 6 weeks, then are given the “all clear” to return to whatever exercise floats their boat.
The problem with the “All-Clear” to exercise at 6 weeks postpartum is two-fold:
1. At 6 weeks postpartum, your tissues ARE STILL HEALING. Jumping back into a high impact activity like running or cross fit without appropriate preparatory work, like postpartum physical therapy exercises, can set you up for injury and pelvic floor problems both in the immediate future and farther down the road.
2. Just as you would heal from an ankle sprain, you wouldn’t go back to running without first healing and strengthening your ankle.
All that to say, most new moms, barring an outstanding medical complication, actually DON’T have to wait 6 weeks to start moving!
In fact, as a pelvic floor PT specializing in postpartum recovery and return to exercise, I recommend starting pelvic floor physical therapy exercises EARLY.
Now, a few caveats before I share my favorite postpartum physical therapy exercises:
The FIRST part of postpartum recovery is REST. I highly recommend following the postpartum 5-5-5 rule, protecting those first 2 weeks (if not up to a month) as much as possible.
The best Postpartum physical therapy exercises for BEFORE 6 weeks are things like diaphragmatic breathing, gentle core activation, and mobility work.
The exercises I am going to share below MAY be started at 4-6 weeks postpartum, provided that they don’t cause any increase in pelvic floor symptoms or pain, and they feel GOOD.
I highly recommend consulting with a pelvic floor physical therapist to come up with an early postpartum recovery plan, and to screen you for any issues you may have doing these exercises.
Finally, if you aren’t ready to exercise yet - whether physically, or emotionally, or just logistically - I get it and I want you to know that there is NO RUSH to return to exercise. If it something you WANT to do now, then let’s help you get there!
Remember, this is not medical advice and these exercises are best done with the guidance of a pelvic floor therapist after assessing your postpartum pelvic floor healing.
As a pelvic floor therapist in New Orleans (offering virtual services everywhere), I love to help mamas come up with an individualized program to heal from birth in the early days of postpartum (0-6 weeks) so that once they reach that “all clear” appointment, they can continue their pelvic floor recovery with postpartum physical therapy exercises that really move the needle toward their exercise goals.
The following postpartum physical therapy exercises are meant to be started at approximately 6 weeks postpartum, and build on a gentle pelvic floor rehab foundation built from day 1 postpartum, starting with things as simple as BREATHING and mobility work. If you need help building this foundation prior to 6 weeks, please reach out!
At 6 weeks postpartum, I add in more challenging core, pelvic floor, and hip stability exercises to begin progressing to higher level strength training.
Alright - here are my favorite postpartum physical therapy exercises.
1. Quadruped hovers
This exercise helps incorporate your breath into core activation, and is a great precursor to planks . As a reminder, this particular exercise may not be appropriate for you if you have more intense symptoms of things like prolapse or diastasis recti. Check in with a Pelvic floor PT if you aren’t sure! Here’s how to do it:
Start on all fours.
Inhale to expand into your ribcage, back, and belly (I call this 360 degree breathing)
As you exhale, push into your hands, draw your ribs down, and lift your knees 1-2 inches off the ground.
Hold this for 5-10 seconds, then lower back down. Repeat 5-10 times for one set.
2. Bird dogs
Bird dogs are my favorite exercise for connecting breath to core with upper and lower body movement. PLUS there are so many variations you can do to add a challenge as you get stronger. Here’s how to do it.
Start on all fours
Inhale with your 360 degree breath
Exhale and lift your right arm while sliding your left leg back and lifting it off the ground.
Lower arm and leg back to the start position, and reset with a preparatory inhale..
Exhale and lift your LEFT arm while sliding your RIGHT leg back and lifting it off the ground
Repeat, alternating arms and legs. MOVE SLOWLY.
3. Fire hydrant
This one activates your core while getting into those juicy gluts for better pelvic stability
Start on all 4s (are we surprised?)
Lift one knee out to the side, and lower back down slowly.
You can use a mini band for an added challenge
Perform 10-15 on one side, then switch legs
4. Side plank clamshell
This is one of my all-time favorites for putting alllll the pieces together - breath, abdominals (transverse and obliques), gluteus medius and maximus (side and back butt muscles), and of course, your pelvic floor. This one takes regular clamshells up a notch while strengthening everything else 🔥
Start On your side with knees bent, and supporting yourself with your elbow
Inhale to prepare, then exhale to Push through your elbow and your knees and lift your butt up AND slightly forward (to straighten the line between your shoulders, hips, and knees
Lower down slowly with control, and repeat.
Add a low-resistance mini band if desired
Perform 10-15 and switch sides
5. Bridge
This is a staple for working your glut max- but did you know this is an extremely effective exercise to strengthen your pelvic floor? (you can ditch the kegels!)
Start laying down on your back with knees bent.
Push through your feet to lift your bottom up off the ground, then lower back down slowly
Make sure you are feeling it mostly in your butt - this should not cause back pain, although you will feel your back muscles working too!
There you go! Those are some of the best postpartum physical therapy exercises to elevate your pelvic floor recovery.
And by the way, you don’t HAVE to do any of these if you aren’t ready or just feel too overwhelmed to exercise. You’re already doing SO great mama!!
Need more help in your postpartum recovery?
In this blog, we’ve talked about some of the best postpartum physical therapy exercises you can try out on your own. They are a GREAT start to your postpartum recovery and return to exercise plan, but you may need more help to be able to do these exercises symptom free, especially if you are dealing with:
Postpartum pelvic pain
Prolapse
Urinary incontinence
Diastasis rectus abdominus (separation of the abs)
Low back pain
If any of the above sounds like you, and/or you just want a partner to guide you without the guesswork and cheer you on every step of the way, I encourage you to seek out support from a pelvic floor physical therapist. I want you to feel your absolute best during this postpartum season, and confidently get back to doing what you love most, all while being a badass strong mommy.
This is where pelvic floor physical therapy comes in. Pelvic floor physical therapists can help you diagnose the problem or problems you’re experiencing, and come up with an individualized exercise plan (that may include some of the above exercises) catered to your specific problems, needs, and lifestyle.
I am a pelvic floor physical therapist in New Orleans specializing in pregnancy, postpartum, and fertility. I currently provide home visits (yep!! You don’t even have to find a babysitter- I can come to you!) and virtual sessions to mamas everywhere.
I’d be happy to support you in this postpartum journey mama - please reach out!
Speaking of postpartum recovery, make sure you grab my free Postpartum Recovery Checklist with all the supplies you need to make a juicy transition into motherhood, care for your pelvic floor in those early postpartum days, and nourish your body for optimal healing.
Looking for more support in your postpartum recovery? Learn more about my virtual postpartum coaching and PT programs below:
BTW - Hi!!!
I’m Dr. Jackie Joy, a New Orleans Pelvic Floor Therapist and fertility coach. Think of me as your preconception to postpartum bestie. If you’re looking for more support on your fertility, pregnancy , or postpartum journey - whether that’s to understand your pelvic floor and how to keep it healthy during this season of new motherhood, fueling your body’s nutrition needs as you grow your family, how to exercise during and post-pregnancy, or preparing and recovering from birth, I’m your girl!
