Dr.HarpreetKaur

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Exercise After Delivery

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Fitness and Exercise After Pregnancy: Abdominal Reconditioning After Pregnancy.

So you’ve had your baby and now it’s time to do crunches, lots and lots of crunches, to get your abs back in shape again. Right? Well, actually no. Fitness and exercise after pregnancy is a lot more complicated than that. In fact, exercises like crunches may actually do more harm than good in the initial postpartum period.
To appreciate the subtleties of exercise after pregnancy and particularly postpartum abdominal reconditioning, it’s helpful have a basic understanding of the structure and functions of your abdominal wall.
Fitness and Exercise After Pregnancy: Abdominal Wall Structure and Functions
The abdominal wall is comprised of four main pairs of muscle tissue, each with right and left sides, which cover and support the abdominal cavity.

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Services Provided

 Muscle Layers of the Abdomen:
1. Rectus abdominis
2. External oblique
3. Internal oblique
4.  Transverse abdominis

Post Natal Abdominal Reconditioning

Two main concepts must be understood and utilized to quickly, safely, and effectively strengthen and flatten your abdominal wall after pregnancy.
First, a critical component for restoring your abs and the development of core strength is learning to control the shape of your abdominal wall during exercise. To do this, you need to train your abs to pull back in toward your spine during exertion. The quickest and safest way to develop a flat abdominal wall after pregnancy is to perform special postpartum exercises that specifically develop this essential skill.
Second, dynamic stability is the other key component of postpartum reconditioning and exercise after pregnancy. This term may sound like a contradiction. However, it refers to the ability to maintain proper position during exercise. Because you have both loose joints and weakened abs after pregnancy, it is particularly easy for the weight and force of your limbs to pull your pelvis, spine, or shoulder girdle out of good alignment. When your bones are out of proper positioning, muscle functioning is impaired, which greatly reduces the effectiveness of exercise. After pregnancy, you must

learn to recognize and eliminate undesired movement during exercise. dynamic stability is an essential skill that enables you to develop core strength, promotes healthy spinal function, and prevents injury.

For more on how pregnancy affects muscles and joints please consult the Physiological Adaptations During Pregnancy and Pregnancy and Postpartum Discomforts pages of this web site.

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Caesarian Delivery Delays Postpartum Abdominal Reconditioning A caesarian delivery is major abdominal surgery and postpartum reconditioning must be delayed until you have made a complete medical recovery. Generally it takes about 4 to 6 weeks for your stitches to heal and if you’ve experienced no other complications, your doctor will give you the “green-light” for exercise after this time. If you’ve had a “C”, consult with your doctor before starting postpartum exercise.
All new mothers should resume walking as soon as possible after a caesarian delivery. Walking increases blood flow circulation, which helps to speed healing. In the initial days after a “C”, try to walk for a short time—start with 15 to 20 minutes—every day. Slowly increase the amount of time walked by 5 minutes every session or so, building up to where you can walk for 30 minutes without undo fatigue. After this point, try to walk for 30 minutes on most days of the week. When walking with your baby, use a stroller rather than a front pack or sling, which can stress your abdomen or incision.

1.Delay abdominal reconditioning until 4 to 6 weeks postpartum.

2 Avoid lifting and carrying heavy objects.
3. When rising from the supine position, first roll over onto your side and then use your arms to help push your self up to a sitting position.
4. Gentle massage along your scar will help to reduce adhesions and ease discomfort.

5.You develop a cough and /or sneezing from allergies or a respiratory illness in the few months after a caesarian delivery, place a large pillow across your belly and gently press it into » your abdomen to provide support for your scar and to help ease discomfort.
6. Scar tissue is very strong and after your stitches have healed you may begin postnatal abdominal conditioning exercises without fear of injury to your incision site or to your abdominal wall.

The real secret to flat Abs

The real secret to flattening the abdominal wall after pregnancy is to recondition from the inside out. This is done by first building strength, and then functional control, in the deepest abdominal muscle, the transverse abdominis or TvA. You want to avoid starting reconditioning with traditional exercises like crunches and oblique curls, which strengthen the external layers, the rectus abdominis and the external oblique. After pregnancy it’s all too easy for these external layers to overpower relatively weaker TvA. This causes the abdominal wall to bulge outward during exertion.


Notice the difference in the shape of the abdomen. The model here is almost 7 mos. postpartum, and her abdominal wall has already shortened and firmed up quite a bit. The ballooning of the abdomen is much more pronounced for those with more abdominal laxity.

In sports and fitness training, what you practice is what you get, i.e., muscle specificity theory. If you allow the abs to balloon during exercise, that is what you are unintentionally training your abs to do. (Yikes!) More importantly, expansion of the abdominal wall worsens abdominal separation and

 

contributes to many postpartum problems, such as lower back pain, pelvic instability, postural problems, and urinary stress incontinence.
Lack of strength and functional control in the TvA is the most common pitfall for all new moms. Most women, who have tried to recondition their abs the traditional way, with lots of crunches, end up with unsatisfactory results. Their abs grow stronger, but never flatten. Their bellies, particularly below the waist, protrude and stay round.


Functional Imbalances from Improper Exercise After Pregnancy


Routinely exercising the external muscles while neglecting the deepest layer results in a functional imbalance within the abdominal wall. Poor neuromuscular patterning results, which inhibits the development of dynamic stability and core strength. This sets the stage for many types of back problems, and is a clear example of how form follows function in the body.

Impacts on Spinal Alignment and Postnatal Posture

As you now know, reliance on supine (on the back) abdominal exercises that flex the upper spine, including most traditional abdominal exercises, many Pilates mat exercises, and some yoga poses, should be avoided immediately after pregnancy. In postpartum women, the curve of the upper back has increased significantly; a kyphotic posture, (see the Physiological Adaptation During Pregnancy page of this web site) . This is why so many new moms feel “hunched over” after childbirth. Habitually performing exercises that flex the upper spine aggravates the problem. It is far better for new moms to focus on lower spine flexion, which improves pelvic alignment, and to perform abdominal exercises where the upper spine is stabilized in the neutral neutral position.

Impacts on Spinal Alignment and Postnatal Posture

The safest, fastest, and most effective way for you to whittle your waist and develop a nice hour-glass shape into your torso, is to start postpartum exercises and abdominal reconditioning with exercises that isolate and strengthen your TvA. After this muscle has become strong again, you can then progressively add in exercises that work external layers, all the while maintaining a flat abdominal profile. Using this method, you will not only flatten and re-tone your abs, but just as importantly, you will train all four layers of the abdominal wall to function synergistically.


Even if You’re Post Postpartum, It’s Never too Late to Correct a Problem
Don’t panic if you’ve had a baby in the last year (or even longer) and have been consistently “crunching” your external abdominals. It’s never too late to retrain your abs from the inside out. With the right exercises in the right order, you can teach yourself this important skill and make significant improvements in the shape of your abdomen that will take inches off your waistline.