This can be a tough topic. The answer? Well, there is no quick and easy answer; this is dependent upon where you are at in your journey to healing. Unfortunately, I have seen recommendations by physicians or fitness instructors that planks and crunches will get you back to where you need to be.
If you know how to activate your core and can do so without excessive pressure to the pelvic floor and abdomen, then maybe those movements are right for you!
The problem is, if you do not know how to appropriately neutralize your pressure system, meaning that you do not know how to activate your core 4 (diaphragm, pelvic floor, TA, multifidi) with exercise movements, we should try to avoid those movements until that muscle is trained.
The good news? With proper instruction, muscle memory begins to take over and the TA can be trained within a few sessions and continue to create neural connections for muscle recruitment within a span of 1-3 months.
As I said, I don't like to give a "list" of cans/can'ts. I will typically assess to see what a person should avoid for a period of time. But generally, exercises that cause significant pressure to the core 4 include:
Improper lifting techniques
Any heavy/maximal effort lifts in which you are breath holding without an exhale
COMPARISON CAN BE YOUR ENEMY
You are the best judge of your own limitations. Feel the core doming? Try to modify the movement. Peeing your pants with that activity? You may not be ready for it yet. Comparison to others can often lead us in the wrong direction towards healing.
I have seen women performing exercises 2 weeks postpartum. Typically I recommend we let our bodies heal for AT LEAST 6 weeks, however it is not my position to judge or give advice unless someone comes to me to do so.
For that individual and her mental state, exercise that early might have saved her from postpartum depression. However, if she is having pelvic floor and core troubles and comes to see me, then I may educate to change her movements to more gentle healing techniques for those first 6 weeks.
That person also may have a very well trained core and pelvic floor.
Do not let comparison to others determine your path. Prior to having my son, I exercised 3-5 days/wk on average and have, realistically, my entire life. This is the first time in my life that I have not been consistently working out.
While I see others running and biking postpartum, I know that my path to healing my own pelvic floor looks different than others. I started out by a walk around the block. My mom and I laugh because we went on walks the first week my son was born, and I had to listen to my body! I could only get to the stop sign by our house, and that was not far! But I could tell that it was enough.
Now I am doing gentle yoga and finally able to add some higher impact, push ups, and planks, but I am 6 months postpartum! AND I had a very strong and trained core before and during pregnancy.
TRUST YOUR INSTINCTS
Our mind and body often tell us when we need to stop. We often choose not to listen or to ignore the signs and symptoms along the way. Some signs and symptoms that you are doing too much include:
Excessive vaginal bleeding (lochia is normal postpartum for the first 3-4 weeks, but if it is more than normal)
Doming or bulging of the belly and/or pelvic floor
Feeling pressure at the vaginal entrance (this can be common for the first couple of months postpartum, which shows us how vulnerable these tissues are!)
Excessive fatigue with activities
Inability to recover from the activity
When we start to pay attention to the needs and demands of our body and serve our body in that way, healing can be a more gentle experience. I have spoken with many women who pushed too hard in the beginning of their journey and they have told me they feel like they hindered their recovery.
MEET YOU WHERE YOU ARE AT
So, have I confused you at all? The point of all of this is that each person and journey looks different. If you have a well-trained core 4, you may progress to some activities quicker than others. I like to meet my patients where they are at, meaning I KNOW that some things are unavoidable.
You have to pick up your child. You have to reach over the crib. You have to feed them. I want to teach you the foundation principles initially so that you can retrain your muscles to activate during isolated events, but I also train you to do it during activities that you cannot avoid.
There is never a bad time to start pelvic floor recovery. See my local resources here to find someone near you!
This content is created in order for individuals to learn more about the pelvic floor. I am in no way giving medical advice or medically assessing the pelvic floor through this blog. If you ever have any health questions or concerns, please consult with your physician or midwife. If you are ever unsure if you are performing exercises correctly, it may be beneficial for you to get a referral from your physician to a pelvic floor therapist for further evaluation. My blog posts are for educational purposes only!I am not liable or responsible for any damages resulting from or related to your use of this information.