By Dr. Ashley Wozniak, PT, DPT
It’s true that during pregnancy, there are certain physical changes that happen to every woman’s body. In my Physical Therapy practice working with prenatal and postpartum women, I’ve found that the impact of these changes always look a little bit different for each new mother and their unique body.
In pregnancy, your ribs expand 10-15 centimeters to make room for the growing baby. As the baby gets larger, changes are happening in your abdominal muscles. Prenatal and post-birth, your pelvic floor is also impacted in certain ways – whether you had a vaginal birth or Cesearean birth.
The postpartum period is the right time to address and heal muscle changes from pregnancy within your deep core and pelvic floor. These muscles provide the foundation for your entire body – involving all your daily movements, not to mention any exercise you hope to do.
The 3 essentials
Due to these major changes in the body, I’ve found that there are three main essentials to learn in order to jumpstart your postpartum healing journey.
1. 360 breathing.
This breathing exercise is where I always start with my postpartum Physical Therapy clients – because your breath is the foundation of everything. As I mentioned above, the ribs expand during pregnancy about 10-15 cm. As the baby grows during pregnancy, the diaphragm muscle loses its range of motion and becomes stiffer during inhalation.
During postpartum, it’s key to relearn what a “360 breath” looks and feels like inside your body in order to regain range of motion in the diaphragm muscle. In pregnancy, the oblique muscles often become lengthened out. During postpartum, it’s key to address this muscle group- whether strengthening and healing them to resolve any pregnancy-related abdominal separation, such as diastasis recti.
2. Core coordination.
This postpartum essential is related to all four of the abdominal muscle groups: the transverse abdominus, internal obliques, external obliques, and rectus abdominus. As the baby grows during pregnancy, muscles and tissues in the abdominal area become lengthened. The task at hand during postpartum is to learn how to re-coordinate all four of the abdominal muscle groups together with your breath, along with the pelvic floor muscles. We have several other muscles that many do not think of as core muscles- serratus, our pectoralis muscles, psoas, our back muscles that also need to be assessed as they impact our healing and core stability.
The muscles that were lengthened need to relearn how to coordinate and contract. Determining where your body is currently at involves an individualized assessment by a Physical Therapist. Your therapist can then help you determine which muscles are already contracting appropriately and which need more work to re-coordinate – and put together an individualized plan for your healing.
3. Pelvic floor healing and re-coordination.
After a vaginal birth, the pelvic floor muscles have incurred tissue damage – they’ve been lengthened, and perhaps vaginal tearing or an episiotomy were part of the birth process. These muscles have several different layers and require re-coordination work to heal and strengthen.
Also, during pregnancy a growing baby changes our posture and puts increasing amounts of pressure on the bladder, so urinary urgency and lack of control can lead to additional pelvic floor issues that often linger during postpartum. During pregnancy, women also usually are more short of breath because the diaphragm can’t expand all the way (as I mentioned in essential #1) which can create a pressure management issue in that area, making it more difficult to control intra-abdominal pressure and coordinate contracting your core and pelvic floor together.
Try this breathing exercise
Learning how to coordinate your breathing sets the foundation for good abdominal pressure management. Try this: When you inhale, relax your core muscles and pelvic floor muscles completely. On your exhale, re-coordinate the contraction of your core and pelvic floor muscles at the same time. I find that about 95% of postpartum women initially have that breathing pattern reversed of what’s most optimal for their healing.
A Physical Therapist who specializes and is educated in women’s healing and wellness is able to look at the bigger picture of physical changes that happen prenatally and postpartum. They go beyond simply teaching how to do a kegel or draw in ab muscles. They consider how specific areas of your unique body were impacted by your pregnancy and birth process – and help guide you on the path to healing.
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The postpartum fitness and wellness classes offered by our studio are intimately sized in order to provide individualized direction and guidance to each woman, as well as personalized exercise progressions that can be done at home between class sessions.
Talk about your pregnancy or postpartum goals for healing with our Physical Therapist, Dr. Ashley Wozniak. Learn more about our studio, wellness programs and Physical Therapy offerings at www.inspiredmaternity.com.
Inspired Maternity is a one of a kind Pregnancy and Postnatal Health, Wellness and Fitness Studio located in Peoria, Ill. We offer in-studio prenatal and postpartum fitness programs and Physical Therapy assessments throughout the calendar year, as well as virtual options and telehealth visits