Pregnancy-related pelvic girdle pain (PRPGP) has a prevalence of approximately 45% during pregnancy and 20 – 25 % in the early postpartum period. While most women are pain free after three months post-partum, up to 7% of women will continue to struggle with pain. Strengthening your core can be key to recovery, but there are some important things to keep in mind.
- Start pelvic floor strengthening in the immediate post partum stage
Continuing to strengthen your pelvic floor muscles like you did during pregnancy can help start the healing process. If you haven’t done pelvic floor strengthening, you can start with Kegel exercises (a good way to know if you are contracting the correct muscles is to imagine you are stopping the flow of urine) and inner thigh strengthening. Strengthening these muscles will also help to minimize your risk for urinary incontinence. Exercising these muscles with increase blood flow to the area and jumpstart your recovery.
- Listen to your body
Whether you had a vaginal or cesarean delivery, your body underwent a serious trauma. You need to listen to your body and watch for signs of over exertion. If you notice increased bleeding, or extreme abdominal discomfort, consult your physician. Taking your baby for a walk is a good place to start exercising. Limit yourself to 10 minutes to start and build up slowly. Also, do not forget to hydrate, especially if you are breast-feeding. If you have more questions, be sure to check with your doctor on a strengthening timeline.
- Hold the crunches
Start by strengthening your abs isometrically, especially if you have had a rectus abdominis diastasis. This is when you have a separation between your “six pack” muscles, or rectus abdominis muscles. This is a fairly common condition, and can be present in up to 66% of women during their third trimester of pregnancy. This happens as your abdominal wall stretches to accommodate the size of a growing baby. This disruption of the structure of your abdominal wall can be a serious hurdle in strengthening your core. One major consideration is that you want to work to draw these disrupted muscles closer together. Completing crunches will only further stress these muscles. Most women will see significant reduction in the midline separation of these muscles, but for those who still struggle with pain and separation one-year post partum, a surgical abdominoplasty may be recommended.
Try these exercises:
1. Lie on the floor or on your bed. Place a pillow under your head. Bend your knees by sliding your feet up towards your bottom.
2. Tighten your pelvic floor and pull in your lower tummy muscles, before squashing the small of your back down into the floor or bed. Hold this for a count to three and then arch your back away from the floor or bed. Repeat this 10 times. Try not to hold your breath!
- Give yourself time
We have all heard stories of women getting their bodies right back into “pre-baby” shape, but that is not the standard. It took nine months for your baby to grow and expand your stomach, so it is not going to bounce back over night. Be patient with yourself. Take your time, and do not give up!