Pregnancy and the Core

Pregnancy brings about an exciting little bundle of joy, but it can also bring with it some new aches and pains. As the belly grows with the baby, the back muscles shorten, and the abdominal muscles excessively stretch. The increasing weight of the baby weakens the muscles of the pelvic floor. As pregnancy progresses, the ligaments surrounding the low back and pelvis loosen to accommodate delivery. Balancing the weight of the baby when lifting, carrying, and nursing can increase strain on already weakened muscles. Though things don’t snap back into place after delivery, proper stretching, exercise, and care will aid in getting the body back in proper balance.

WHAT TO AVOID

Starting too soon: the American College of Obstetricians and Gynecologists (ACOG) states a woman can resume exercise when she feels up to it. Most doctors will recommend 4-8 weeks for recovery. When exercise does resume, it should leave you feeling revitalized, not fatigued. Any bright red bleeding is a sign to slow down.

Poor form: your body won’t be ready to pick up where you left of before pregnancy. Pay careful attention to form when exercising and avoid having to compensate for pain or discomfort. Rest when needed.

Overworking abdominals: the linea alba (the ligament between the two large “six-pack” muscles) and abdominal muscles become significantly stretched while pregnant and can affect muscle and joint alignment. Strengthening the abdominals in a dysfunctional position can increase problems down the road.

WHERE TO START:  STRETCHING

  1. Single and double knee to chest
    1. Lying on your back, grab one knee with both hands and extend the other leg out straight. Pull your knee toward your chest until a stretch is felt in the lower back and hold for 30 seconds, repeat on the opposite leg. Perform 2-3 times on each side.
    2. Lying on your back, grab both knees with your hands and pull toward your chest until a stretch is felt in the lower back and hold for 30 seconds. Perform 2-3 times on each side.
  2. Seated hamstring stretch
    1. Sitting on the edge of a bed or chair, extend one leg in front of you with the knee straight and the heel on the floor with toes pointed up. Sit up straight, then gently hinge forward at the hips until you feel a gentle stretch on the back of your leg. Hold for 30 seconds, and repeat on the other side. Perform 2-3 times on each side.
  3. Gluteal stretch
    1. Lying on your back, hold one knee with both hands and extend the other leg out straight. Pull your knee across your chest to the opposite armpit until a stretch is felt through the gluteal muscles. Hold for 30 seconds, and repeat on the other side. Perform 2-3 times on each side.

STRENGHTHENING

  1. Basic breath:
    1. Lying on your back with knees bent, breathes in, and feel the pelvic floor (Kegels), rib cage and abs descend or open. When exhaling, lift the pelvic floor, pull the abdomen in and close the rib cage and hold for 5 seconds. Work up to 5 to 10 breaths with abdominal contractions several times per day. When you are able to contract and relax the abdominal muscles without moving the spine, progress to the next level.
  2. Heel slides:
    1. Lie on the floor with knees bent, spine neutral and arms at sides. Begin with the basic breath (exercise 1) to engage the abs. Slowly slide one leg out (inhaling) until it is parallel to the floor, and then exhale as you slides it back in to the starting position. Alternate sides, extending the other leg out and then back in to complete one rep. Back should remain neutral throughout this exercise. When you can comfortably perform 20 heel slides on each leg she can move to the next level.
  3. Leg extensions:
    1. Lie on the floor with knees bent, spine neutral and arms at sides. Begin with the basic breath (exercise 1) to engage the abs. Exhale to raise one leg to tabletop position (knee in line with hip, shin parallel to the floor). Inhale to slowly extend the lifted leg out as close to the floor as possible without arching your back. Exhale and return leg to tabletop position, then bring foot back down to the starting position. Switch sides. Progress until you can extend/hover the leg about 2 to 3 inches above the floor (without touching it). Work up to five repetitions on each side without stopping, building to 20 hovering repetitions on each side.

Whether it has been 5 months or 5 years since giving birth, these exercises can help restore functional balance in the core. Seeking treatment from a physical therapist can ensure proper progression throughout your program.

By: Jessica Parker, PTA

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