Post Natal Physiotherapy

It’s a good idea to start gentle physiotherapy exercises after the second day of your baby’s birth.

Most hospitals offer physiotherapy services or classes before you go home — it’s a good idea to take up the offer, as you’ll be able to find out if you’re doing the exercises correctly.

Sometimes mothers are given lots of handouts from their hospital, some even advising that physio classes are available.

However, when you’re so busy coming to terms with being a mother and learning about childbirth and breastfeeding, it’s understandable that your interest may wane when it comes to taking care of your body. Until you find out that pelvic floor exercises are responsible for good bladder and bowel control!

What Exercise Should I Be Doing?

Walking is a great and gentle exercise, particularly for the first six weeks while your body is recovering. It’s very easy, gets you and baby into the fresh air, and is excellent for stress. Start your walks slowly, and increase the speed, time and distance of your walks as you feel comfortable. If you experience any pain or discomfort, stop, and see your doctor.

Swimming is another great exercise following birth; however you can only do this as long as your blood loss has stopped. Bike riding is okay, as soon as you are comfortable. Exercise classes or sport are best to hold off until your 6 week check up, so you can get the all clear from your care provider.

Below are some physiotherapy exercises that are great for your after-birth recovery. To make the exercises more enjoyable, set aside some quiet time and put on some music. You could also put your favourite aromatherapy oil in a burner and breathe in the gorgeous smells, helping you to relax as you exercise.

Pelvic Floor Exercises

The pelvic floor muscles are made up of layers of both muscle and other elastic tissues, which stretches from the pubic bone to the tail bone. It supports the uterus, bladder, bowel, vagina, anus and urethra. The pelvic floor muscles are some of the most important muscles a woman has, yet because they are not visible, they are often neglected. Pregnancy and childbirth can weaken these muscles. Try the exercises below to strengthen your pelvic floor, but don’t overdo them — you can end up sore. If you do get sore, stop doing the exercises for one or two days before starting again.

While lying down, tighten the muscles around the urethra, vagina and anus, drawing the muscles inside. When doing pelvic floor exercises, remember not to hold your breath or squeeze your legs and buttocks together. If you can feel your abdominal muscles tighten, this is normal and absolutely okay.

If you are unsure of what muscles you should be feeling, when you are on the toilet, stop your stream of urine when midstream and you should be able to identify the muscles. Another method of checking that you are doing the exercises correctly is by using a mirror. Hold the mirror so you can see the vaginal area and when you squeeze your pelvic floor muscles, you should be able to see the area tighten. Hold the squeeze for three seconds, then rest. Repeat three times.

Do three quick, hard squeezes in a row hold, then rest between each one.

As you progress, try the exercises in sitting and standing positions. When you cough, lift, sneeze or blow your nose, try squeezing your pelvic floor muscles at the same time. Aim to be doing 3-4 holds for five seconds each and 3-4 faster squeezes by the time you are six weeks post-natal. Continue to increase up to ten if you can do so.

Pelvic floor exercises are very beneficial for women – you should try to make it a lifelong habit. Do the exercises at traffic lights, the doctor’s waiting rooms, even right now! No-one will notice that you are exercising your pelvic floor muscles. If you can get yourself into a good routine, you will be less prone to problems which result due to poor pelvic floor muscles later, for example, poor bladder control.

At approximately 12 weeks post-natal, you can test your pelvic floor strength. If you want to return to playing high impact sports, you will need to pass this test. A couple of hours after going to the toilet, jump a few times, then star jump. This exercise requires very good muscle strength, so if you did not have bladder control, then you still need to work on your pelvic floor exercises. It would also be a good idea to speak to your physiotherapist or doctor.

In the early days after the birth, it is good for your pelvic floor, back and wellbeing to lie down flat whenever you can. Take phone calls lying down, feed baby lying down and anything else you can think of. Avoid heavy lifting and straining on the toilet, which can weaken the pelvic floor muscles.

Back exercises

These exercises should be performed slowly and should not cause pain. If you do feel any pain or unusual discomfort, please stop doing the exercises and consult your doctor or physiotherapist.

Pelvic Rocking

Helps with good posture and relieves wind pains.

Lie flat on the floor with a pillow underneath your head. Put your knees up. Roll your pelvis off the floor, to flatten the small of your back. Tighten your pelvic floor muscles at the same time. Repeat 10 times.

Pelvic Rolling

Roll your knees over to one side. Keep your feet flat on the floor and look to the opposite side. A gentle stretch should be felt in your back. Repeat 5 times on each side.

Abdominal exercises

It is important to exercise the abdominal muscles after having your baby, as they play a very important role in supporting your back and abdominal organs. It will help you regain your figure as well as strengthen back support by doing the below exercises. Please note that following research, sit-ups are no longer recommended as a safe or appropriate way to strengthen your abdominal muscles post-natally.

Abdominal Stretch

This exercise will help with good support and posture for your back and tummy.

You will need to be on your hands and knees. Ensure that your back is flat, and let your tummy drop. Inhale, and as you exhale, draw the lower part of your stomach up as if you are bringing your belly button towards your back. Hold for a few seconds, then relax. Repeat 5 times. Slowly build yourself up to 10 holds for 10 seconds. This exercise can be done whenever you can during the day. Remember not to tilt your pelvis or hold your breath!

Upright Abdominal Stretch

When you have mastered exercise number 1, try this! Kneeling upright, place your hands on your hips, and make sure your back is flat. Inhale, and as you exhale, draw your belly button towards your back, and you will feel the muscles tightening underneath your fingers. Imagine you are doing up your belt one more notch! Build up to 10 holds for 10 seconds each.

The next progression is to do the above exercise in a sitting or standing position. Aim to always have these abdominals working, particularly if you are carrying or lifting.

Tips for taking care of your back

Following the birth of your baby, you are suddenly faced with tasks that you and your body are not used to, for example, carrying baby in a capsule and bathing baby. Below are some tips on how you can avoid injuring your back.

Baby capsules are heavy and awkward, so avoid carrying them. Opt for leaving the capsule in the car, and choose either a pram or a sling for moving baby.

When purchasing a pram, select one that either has an adjustable handle height, or one that is approximately at your waist height.

When bathing your baby, try to have the bath at waist height. Some laundry sinks are at the right height for doing this, and you can even use the washing machine as a change table afterwards! Do make sure you have one hand on baby at all times and that it is safe. If you prefer to use the baby bath, don’t carry a full bath of water — it is likely you will hurt your back, or could cause a terrible accident if you spill water and slip. Try and have the bath filled where you plan to bathe baby, even if you have to fill the bath with jugs of water.

When changing baby, again, you should have the table at waist height.

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