Julie Bagshaw, MSc PT, Pelvic Physiotherapist
The Most Important Exercise You Can Do For Your Core Postpartum
Helping mamas strengthen their core postpartum is where I love spending my time as a pelvic floor physiotherapist. Most postpartum clients come to Vital after their six-week check up where they’ve usually been ‘cleared’ by their doctor to return to gradual exercise. Like many of our clients, you might feel unclear about where to start when it comes to strengthening your core muscles. Returning to strength training postpartum, especially when it comes to strengthening your core, means that you have to rehabilitate your muscles first. So, before you jump to your crunches, planks and or, even kegels, the most important exercise you can do to strengthen your core immediately postpartum, is remind your body that you actually have a core.
Let’s recap our anatomy for a minute – think of the deep inner core as a set of muscles that always turn on to help prepare your body for movement, and the outer core muscles as ones that actually move our body to accomplish a task or exercise. Both are important, but the key is to start retraining from the deepest layer and progressively working to include all of the muscles. In the postpartum body, both decreased awareness and motor control of our deep core muscles occur due to the changes associated with a growing baby.
Retraining your reflexive core is the number one thing you should do when determining what exercises to START with postpartum. When your core is reflexive it refers to the ideal state where your deep inner core muscles (diaphragm, pelvic floor, transverse abdominis, and multifidus) turn on automatically in response to movement. This is important because the deep core muscles are responsible for stabilizing our trunk on our pelvis every time we move. Hodges et al. proved this reflexive action of the deep core muscles back in 1997 with their studies looking at which core muscles engage with movements of the arm and with changes in posture. In all test cases, the deep core muscles turned on just prior to movement whereas the larger outer core muscles (e.g. obliques, rectus abdominis) turned on selectively depending on the direction of movement.
DO I HAVE A REFLEXIVE CORE?
So, how do you know if you have a reflexive core? Here are a few simple, functional tests you can try at home:
1) Cough Test – Place your hand on your lower abdomen, just above your pubic bone and cough. If your belly tightened and pulled slightly back toward you spine your core is likely turned ON. Rather, if your belly bulges outward your core is likely turned OFF. This means we have to retrain your brain to find and use your inner core muscles!
2) Standing Knee Raise – Again, place your hand on your lower abdomen and stand with feet about hip distance apart. Raise one knee toward your chest. Similar to the cough test, if your belly tightened and pulled slightly back toward your spine, your core is likely turned ON. Rather, if your belly bulges outward your core is likely turned OFF.
As I’m writing this blog, I am currently 5 months postpartum with my little boy. Working on my reflexive core has been my primary focus postpartum as I try to take care of a fussy baby who likes to nap 25 minutes at a time! My sleep deprived body hasn’t been ready to take on returning regularly to the gym, however that doesn’t mean that I can’t find and activate my deep core muscles! I worked hard to maintain awareness of these muscles during pregnancy and have been assessed by my own pelvic floor physiotherapist (at Vital!!!) to ensure that I’m engaging my muscles properly in my daily movements.
One tip you can try at home to activate your core muscles with daily movements is to perform a pursed lip exhale just prior to any movement. Typically the action of forced exhale will help you to recruit your deep core muscles. For example, before standing up from the couch or nursing chair with your baby in your arms, try inhaling through your nose and feeling your ribs expand at the side and back (near your armpits and spine) and then exhale like you are blowing out a candle prior to, and throughout the process of standing up.
These simple tests and tips are just intended to get you started on the road to retraining your brain to find and use your core muscles again. If you think your core is turned off (or you’re not quite sure!), now might be the time to check in with a pelvic physiotherapist or another postpartum specialist to help you wake these muscles up! Remember, it is never too late to strengthen your core postpartum. So even if you are 1 year, 2 years or 10 years or more postpartum, let’s make sure your deep core muscles are turned on so that you can take your core strength to the next level!