rcises
exe Instructions for
after giving birth
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Pelvic floor 1. Pelvic floor muscles 2. Spine 3. Rectum 4. Uterus and vagina 5. Urinary bladder 6. Pubic bone
Pelvic floor muscles During the later stages of pregnancy and then childbirth the pelvic floor stretches heavily and the muscles might even be damaged. Additionally, hormonal changes may have caused the tissues to loosen. Having overweight also puts a strain on the pelvic floor. After giving birth you should avoid heavy lifting. You should get out of bed by turning on your side and then rising to a sitting position. You should start exercising the pelvic muscles immediately after giving birth. The muscle function and strength will recover in a few months with daily exercises. Recovery is, however, individual. Pelvic floor muscles that are working properly prevent urinary and stool incontinence, support the pelvic organs and lumbar spine as well as contribute to sexual satisfaction. Take care of your constitution by for example walking. In the beginning you should avoid sports that contain high exertions and shaking such as running and aerobics. Ask the examining doctor when it is safe for you to return to the physical exercises and sports you used to do before giving birth.
EXERCISES During the first weeks it is good to learn to recognize the muscles of the pelvic floor.
Recognizing exercise The exercise can be done lying down, sitting or standing. Relax the abdominal, gluteus and thigh muscles as much as possible, breathe normally. Begin contracting the pelvic floor muscles by gently pulling the anus in and upward. Continue contracting up and forwards around the vagina up to the opening of the urethra. It should feel as if you were holding in your urine. Keep the contraction for 2 seconds, and then relax for 2 seconds. Repeat this exercise a couple of times, 3–4 times a day.
In a couple of weeks when the first exercise starts to feel too easy you can gradually increase power and duration of the contractions. Maximal strength (needed for heavy exertions) Contract the muscles of the pelvic floor powerfully, so that you feel the anus and vagina rise upwards. Maintain the contraction for 5–10 seconds. Repeat 5 times. Speed strength (needed for sudden exertion, for ex. when sneezing) Contract the muscles of the pelvic floor as quickly and powerfully as possible 5–10 times. Endurance strength (needed for daily activities) Contract the muscles for 10–20 seconds and relax for 20 seconds. Repeat 10 times. Always contract the pelvic floor muscles before heavy lifting, coughing, or sneezing. The exercises should be done while performing your daily tasks and in different positions: sitting, walking, and doing dishes and so on. Rest for 1–3 days a week. Exercise twice a week to maintain the muscle strength.
EXERCISES
When you recognize the pelvic muscles and master the exercises even while sitting and standing you can start exercising the abdominal muscles. Start with your hands and knees on the floor. Knees and hips should form a 90 degree angle. Keep your neck straight. Press your hands against the floor so that your shoulders widen. Contract the pelvic floor muscles and round your spine upwards like a cat. Let your abdominal muscles relax until you reach the starting position.
Contract the pelvic floor muscles and round your spine upwards like a cat.
Contract the pelvic floor muscles. Exhale and simultaneously slide one foot forward on the floor. Inhale and slowly slide back to starting position.
Contract the pelvic floor muscles and press your lower back against the floor. Press your chin against the chest and lift your head. Reach towards your opposite knee with your arm, take turns. The straight abdominal muscles can be strengthened by reaching straight forward with both hands (this exercise is allowed about 6 weeks after giving birth).
TAKE CARE OF YOUR BODY
When breastfeeding, sit straight and let the arms rest on the armrests. Relax your shoulders. Place pillows under the baby if necessary.
A good posture can be found using a mirror. The pelvis should be in a neutral position while walking and working. Avoid heavy lifting and activities that require staying in static positions with a forward bent or rotated spine for a long time.
Taking care of the baby can make your shoulders stiff so roll your shoulders and stretch your neck often.
Contract the muscles of the pelvic floor before lifting, bend your knees instead of using your back.
Contact us Physiotherapy
06 213 1341 | 06 213 1111
MATERNITY UNIT
06 213 2072 | 06 213 1111 Vasa Central Hospital Hietalahdenkatu 2–4 65130 Vaasa
Graphic design: Charlotta Järf • Images: Katja Lösönen/ Shutterstock • Vasa Central Hospital 2014