Along with a healthy diet, exercise after childbirth can help you feel your best. In this article, Physiotherapy Manager Lee Heng Ho shares some post-natal exercise tips and techniques that will improve your strength and stamina after pregnancy.

After childbirth, it’s important to do light exercises to help you recover physically, regain your pre-baby figure and prevent further aches and pains. You will gradually feel better as you start moving about. At this stage, gentle lower belly exercises and pelvic floor exercises are all it takes to help your body to recover. Here, two groups of muscles need strengthening – the pelvic floor muscles and the abdominal muscles.

The pelvic floor muscles

These form a sling-like floor to the ‘basin’ of the pelvic and surround the exits of the vagina (birth canal), the urethra (the passage for urine from the bladder) and anus (back passage). Kegel exercise can strengthen the pelvic floor muscles, and there are many benefits to this exercise including:

  • Regaining the efficiency of bladder. (You may have noticed bladder weakness during pregnancy. This is probably due to hormone changes which affect the muscles.)
  • Providing good support to the organs around the pelvis, e.g. the bladder, bowel and uterus. (This is to prevent prolapse and stress incontinence.)
  • Improving enjoyment of sexual intercourse for both partners.

In recent years, due to several factors, there has been a marked improvement in the condition of pelvic floor after child birth. Perhaps the most important of these factors, are the antenatal and postnatal teaching and exercising of the muscles. The use of episiotomy (a small cut made during delivery to increase the outlet of the vagina where the alternative might be a bad tear or over stretching) and careful stitching have also helped to minimize the trauma to this area.

The abdominal muscles

These consist of layers of muscle fibres, some of them passing straight up and down the abdomen, some across and some in an oblique direction. The vertical fibres, called the rectus abdominis muscle form a double band which tends to separate during pregnancy. Together, these groups form a natural ‘corset’ supporting the abdominal organs and also the spine, and weakness of this ‘corset’ after childbirth is a common cause of backache.

During pregnancy, your abdominal muscles obviously became stretched. Your posture was altered and you probably noticed an increase in the natural hollow of your back. This will gradually correct itself during the postnatal period as the abdominal muscles are strengthened. In order to prevent or to treat backache due to pregnancy, strong abdominal muscles are needed.

Essential post-natal exercise

The following exercises will start to build up the strength of muscles of the abdomen and pelvic floor. Perhaps you have already practiced these exercises in your ante-natal classes. Even if you have had stitches and feeling sore, it is still a good idea to try and practice these moves as soon as possible – but go with them gently, of course. Some discomfort may arise due to swelling and this can be relieved by contracting and relaxing the muscles. Seek your healthcare provider’s advice if you are unsure.

Pelvic floor muscles (Kegel exercises)

Close up the ring of muscle around the back passage (as if you are stopping a motion while in the toilet) – now try to tighten the birth canal in the same way (as if you were trying to stop yourself passing water). Hold both muscles tight for as long as you can.

Try to do this important exercise regularly during the day – aim at holding the muscle tense while counting slowly to eight (eight seconds).

Do this 10 times after each visit to toilet. This guarantees frequent practice and you will soon feel the muscles getting stronger. (Check your improvement periodically by trying to stop the flow of urine in mid-stream)

Abdominal muscles exercise

Lie on your back with your knees bent. Put one hand under your back, flatten your back down onto your hand and at the same time tilt your pelvis towards your face. Hold for count of ten and relax. This is to strengthen the rectus abdominis.

Lie on your back with one knee bent and one knee straight. Rest one hand lightly on your abdomen just above the straight leg.

Lengthen the leg by stretching down with the heel. Now slide the heel up towards you while keeping the knee straight and shortening the leg at the waist.

At the same time, tighten the muscle under your hand. Do this a few times and change legs and repeat. (This is for the muscle fibres responsible for the side)

Lie on your back with your both knees bent. Flatten your back down onto the bed or floor (thus tightening the abdominal muscles). Keeping this position, roll both knees together over to one side as far as possible.

Now bring them upright and relax the abdomen. Repeat the whole series of movements to the other side. (This is for the muscle fibres which perform the twisting movements of the trunk)

Some mother will be ready to start these exercises within hours of delivery, while for others, rest will be far more important than exercises. See how you feel but do remember that many of your discomforts will be relieved by these gentle exercises.

Try to start the pelvic floor routine as early as possible and for abdominal exercises, it is recommended that you start by doing each posture five times twice daily.

Other post-natal exercises:

To flatten the abdomen and slim the hips:

  • Lie on your back with both knees bent. Pull in your abdominal muscles and keeping them firmly braced, lift your head and shoulders and stretch your hands towards your feet. You can lift higher each day until you actually sit up and then lower back slowly.
  • Kneel on all fours. Pull your abdominal muscles in and bend your right knee up to your chin; then stretch it out behind you before putting it down. Repeat with the left leg.
  • Sit on your left hip with your legs bent to the right. Kneel upright and change so that you are sitting on your right hip. Repeat several times.
  • Lie on your back with both knees bent up high and your toes tucked under something heavy. Tuck in your abdominal muscles and stretch your right hand across your chest and reach down towards your left ankle. Rest back again and relax your abdomen. Repeat on the other side.
  • Lie on your back with your arms stretched out sideways. Lift your right leg and take it over towards your left hand and twisting from the waist and keeping your arms flat on the floor. Put it down and repeat with your left leg.
  • Sit on the floor with your back straight and your arm stretched forward. Hold your abdomen in and then ‘shuffle’ forward and backward on your bottom.

To strengthen the pelvic floor

  • Lie on your back on the floor with your feet on a stool.
  • Lift your bottom up so that your body is in a straight line, pulling in your pelvic floor at the same time.

To shape up the breasts

  • Sitting, standing or kneeling, hold your arms horizontal in front of you with each hand gripping the opposite upper arm just above the elbow.
  • Grip each arm tightly, and push the arms together; hold it, and then relax. You will feel your breasts being lifted by the muscles which support them, and strengthening them may help to prevent the breasts from sagging.

Apart from these special exercises you will soon feel well enough to take long walks with the baby and this is very good general exercise. Swimming is another sport you may enjoy with your baby.

For activities such as badminton, yoga, aerobics class, or cycling, it is better not to start until you are certified fit during your post natal checkup. Always start gently and gradually. If you wish to do more, there may be a physiotherapist to guide you.