Postnatal Care

Postnatal exercises are important for you. They help you regain the strength of your abdominal muscles and help prevent lower back injury and other complications like abdominal organs from “drooping forward” due to lack of support. They also help you regain a flat stomach.

Always consult your doctor before starting these exercises and start your postnatal exercises only after 8 weeks. It is important to make sure your abdominal muscles have healed before you do any vigorous exercises such as crunches.

BREATHING EXERCISES

Breathing is an important technique to ease pain and stress. It is best to inhale through the nose and exhale through the mouth. There are three types of breathing:

  • Diaphragmatic breathing, which utilises not only your chest, but your abdomen as well. It promotes relaxation by decreasing the effects of the sympathetic nervous system.
  • Apical breathing, which utilises only the upper chest, or the apex (the pointed extreme) of the lungs. – Lateral breathing, in which air is directed into the sides and back of the ribcage. The ribs expand outward and upward, like the handle of a bucket. Proper breathing is the easiest way to achieve relaxation. It is important also to breathe while we exercise since holding our breath diminishes the oxygen supply to muscles and causes blood pressure to increase.

ANKLE AND FOOT EXERCISE

This exercise helps improve circulation and can be performed while seated on a chair or on the floor. If seated on the floor, extend one leg out and away from your body.

With your back straight and arms at your sides, extend your toes forward and away from your body as far as you can. From this position, bend your foot back, pointing your toes up to the sky and your heel away from your body.

STATIC BACK OR PELVIC TILT EXERCISE

Lie down on the floor with your knees up / feet flat. In this position, tilt the pelvis so that the curve of the lower back flattens. Hold it in this position for a slow count of 3 and then allow the pelvis to return to it starting position.

Pelvic tilts are often recommended for developing support for the lower back, abdominals, sacroiliac joint, and the adjacent structures. They are great for lower back problems due to poor posture and muscle atrophy, and provide a starting point for spinal stabilisation exercise programs.

KEGEL EXERCISES

Exercise 1 (for strength)

  • Step 1: Sit, stand tall or lie on you back with your knees bent and legs comfortably apart.
  • Step 2: Close your eyes, imagine what muscles you would tighten to stop yourself from passing urine. If you can’t feel a distrinct tightening of these muscles, ask for some help from a physiotherapist. She will help you to get started.
  • Step 3: Now that you can feel your pelvic floor muscles working, tighten them around your front passage, vagina and back passage astrongly as possible and hold for three to five seconds doing this. You should feel your pelvic floor muscles up inside you and feel a definite let go as the muscles relax. If you can hold longer (but no more than eight seconds), then do so. Remember squeeze must stay strong and you should feel a defrinite let go. Repeat up to ten times or until you feel your pelvic floor musicles fatigue. Rest for a few seconds in between each squeeze. Steps on to three, count as one exercise set. If you can do three sets per day in different positions.

Exercise 2 (quick squeeze for power)

Squeeze and lift your pelvic floor muscles as strongly and as quickly as possible. Do not try to hold on contraction, just squeeze and let go. Rest for a few seconds in between each squeeze. Repeat this 10 times or until you feel your pelvic floor muscles fatigue.

You can do these exercises set one to three times per day.

UPPER LIMB STRETCHES

Usually due to frequent feeding periods, the mother’s posture starts to droop. This causes neck aches and shoulder pain. In order to avoid this, you could do the following stretches.

    • While stretching left side of the neck, place right hand over the side of head and pull the neck towards the same side. Neck stretch can be felt on the left side. Make sure that the side of stretch i.e., left side shoulder is not lifted. Hold for 10 seconds, repeat 10 times. Repeat on the right side as well.

    • To stretch the back of the neck, look down towards your chest so that your chin touches your upper chest. Hold for 10 seconds, repeat 10 times. To stretch the front of the neck, look towards the ceiling. Hold for 10 seconds, repeat 10 times.

    • Clasp your hands behind the back with the fingers interlaced. Breathe in and while breathing out lift the hands up as shown in the figure. Stretch and hold for 10 seconds, repeat 5 to 15 times.

  • Place one arm across the chest and use the other arm to pull the shoulder towards body from the elbow joint. Hold for 10 to 15 seconds and repeat 5 to 10 times on each arm.

BREASTFEEDING POSTURES

  • Sit upright on a straight back chair. Use a pillow to support your lower back.
  • Put your feet up as shown below. Being comfortable ensures efficient breastfeeding to the baby and prevention of backache in mother.

CORE EXERCISES

Core contraction – In a seated position, place both hands on abdominal muscles. Take small controlled breaths. Slowly contract the abdominal muscles, pulling them straight back towards the spine. Hold the contraction for 30 seconds, while maintaining the controlled breathing. Complete 10 repetitions.

Pelvic bridging – Though the pelvic bridging is an easy to do exercise, it is highly useful in maintaining strength in the lower back and useful in a lower backache prevention programme. Pelvic bridging is also a great exercise that strengthens the paraspinal muscles, the quadriceps muscles at the top of your thighs, the hamstring muscles in the back of the thighs, the abdominals and the gluteal (butt) muscles.

    • Lie on a flat surface. Bend your knees and place your feet flat on the floor with your feet apart. Your palms should be flat on the floor alongside your body.

  • Relax your upper body and back while you draw in your abdominals and squeeze your pelvic floor muscles (as if you were stopping the flow of urine) and slowly push your pelvis up towards the ceiling. Hold in an up position for a slow count of three and lower your body back to start position.

COBRA POSE

Lie on the belly, with the hands placed right below or slightly forward on either side of the shoulder joint. Breathe in and then slowly use your hands to come a little upward and look straight while breathing out. Hold for 10 seconds and relax. Repeat 10 times.

FLUTTER KICKS

Start by lying flat on your back on a mat with your arms by your sides and your palms down. Extend your legs fully out with a slight bend in your knees. Lift your heels about 6 inches off the floor. Make small, rapid up and down scissor-like motions with your legs.

The key is to focus on having your midsection do all the work and to keep your abs constantly contracted throughout the exercise. If you have a lower backache, keep the hands tugged at the low of your back. Perform 10-15 repititions per set. Do 3 sets.

SIDE PLANKS

Lie on one side of the body. Breathe in and then lift your body off the ground and balance on one forearm and the side of your foot. Contract your abdominals and relax your shoulders. And breathe out. Hold that position for 10 seconds. Repeat thrice on each side.

HEAD LIFT

 

In a lying down position, knees bent at 90° angle, feet flat, slowly lift the head, chin toward your chest, (concentrate on isolation of the abdominals to prevent hip-flexors from being engaged), slowly contract abdominals toward floor, hold for two seconds, lower head to starting position for 2 seconds. Complete 10 repetitions.

ABDOMINAL CRUNCH

 

Place your hands behind your neck or head, keep in mind not to pull head or neck up during the exercise, which can place extra strain on the spine. Your head and neck should be resting on your hands. Breathe in and lift your shoulders towards the ceiling using your abdominal muscles and pause at the peak. It is very important not to lift your entire back off the floor, as this can cause back strain. Ease back down slowly as you inhale. Relax your abs before doing another crunch. Repeat 10 times per set, do 3 sets. You can slowly progress to 20 per set.

SIBE ABDOMINALS

Lie flat on the ground with the knees bent. Cross one leg and place the ankle on the opposite thigh/ knee. Clasp the hands behind the head, twist the trunk and crunch. While crunching try to touch the opposite elbow to the folded knee, i.e., left elbow trying to touch the right folded knee (as seen in the figure below). Repeat 10 times on each side per set. Do 3 sets.

PLANK

Position yourself face-down on the floor, resting on your hands and knees. Place your elbow at 90 ̊ and flex your foot so that you can feel the toes on the floor evenly. Brace your abs, and push your knees off the floor so your weight is distributed evenly between your toes and hands. Lower your hips so your body forms a straight line, like a plank. Hold this position for 10 to 20 seconds. Repeat this 5 times. The seconds can be progressed to a minute (60 seconds).

PUSH UPS

Come onto crawl position, cross the legs and place the hands right under the shoulder. Keep the body in a straight line and bring the body down. Make sure that the elbows are near the body. Start with 5 repetitions per set, do 3 sets and slowly progress to 20 repetitions per set.

UPRIGHT PUSH UPS

Place hands flat against the wall. Contract abdominal muscles towards the spine, and lean the body towards the wall, with elbows bent downward close to body. Pull abdominal muscles in further, with controlled breathing. Release muscles as you push back to starting position. Complete 20 repetitions per set and do 3 sets.

BIRD DOG

 

Get down on your hands and knees with your palms flat on the floor and shoulder-width apart. Relax your core so that your lower back and abdomen are in their natural positions. Brace your abs, and raise your right arm and left leg until they’re in line with your body. Hold for 5 to 10 seconds. Return to the starting position. Repeat with your left arm and right leg. Continue to alternate back and forth. Try to keep your hips and lower back still, even as you switch arms and legs. Start with 5 repetitions per set, do 3 sets and slowly progress to 20 repetitions per set.

SQUAT AGAINST THE WALL

Also known as a seated squat, stand with back against the wall, feet out in front of body. Slowly lower body to a seated position so knees are bent at a 90° angle. Contract abs toward spine as you raise the body back to standing position. Optionally, this exercise can also be done using an exercise ball placed against the wall and your lower back. Complete 20 Repetitions, 3 sets.

SQUAT WITH SQEEZE

A variation to the “squat against the wall” is to place a small resistance ball between the knees, and squeeze the ball as you lower your body to the seated position. Complete 20 repetitions, 3 sets.

LUNGES

Stand straight with legs wide apart. Place hands on hip or hold dumbbells. Place right leg forward and come onto the toes of the rear (left) foot. Balance and bend the knees. Make sure the knees come 90 ̊ and the right bent leg should not cross the toe line. Repeat 10 times for each leg. Do 3 sets.

SQUATS

Stand with the feet apart in the line of the hip, place hands forward as if to reach something or hold onto a bar/ chair. Now sit down as if trying to sit on the chair and then stand tall again. Repeat this ten times per set. Do 3 sets.

Hope you have a great time doing these exercises! Please note: always consult your doctor before starting a new exercise regimen.