Pregnancy & Physical Therapy 101 – Week 2

As promised, this week’s pregnancy blog focuses on exercises that are safe to perform while pregnant, and the week’s following the birth of your little gem. **Please check with your doctor before performing these exercises!

Regular exercise after having a baby can help decrease stress levels, increase energy, and improve quality of sleep. The American Congress of Obstetricians and Gynecologists recommends 150 minutes of moderate intensity exercise weekly.

Most physicians and physical therapists recommend waiting six weeks before starting a formal exercise program if you had an uncomplicated vaginal delivery, or eight weeks if you had a C-section.

Over the course of pregnancy, abdominal muscles and the surrounding connective tissue stretch to accommodate your growing baby. Unfortunately, they don’t magically snap back into shape a few weeks after you give birth. In fact, it can take months to recover and you may need some guidance along the way.

Abdominal rehab is a type of physical therapy to strengthen and tone weak stomach and pelvic muscles to help postpartum women regain core strength and return to their pre-pregnancy body.

The following are a group of exercises you can perform in the comfort of your own home:


  • Contract your pelvic floor muscles (those that you would use to stop urinating) by pulling them in. Act is if you were sitting on a cold block of ice pull your pelvic muscles away from it.
  • This is a subtle motion so keep all other muscles relaxed, including your buttocks, legs, and abdominal muscles
  • Don’t forget to keep breathing
  • Practice short, quick contractions as well as longer, sustained contractions
  • As you feel more comfortable try doing kegels in different positions such as sitting/standing and eventually walking/hiking.

Pelvic Tilts

  • Lie on your back with both legs bent, feet flat on the floor, and tighten your stomach. Tilt your pelvis backwards to flatten your back on the floor. Repeat sets of 10 repetitions.
  • When this feels easy, advance by performing the tilt, then slowly lifting one foot a few inches off the ground, place your foot back down and repeat with the other leg, maintaining the pelvic tilt
  • Further advance by straightening one leg, sliding along the table and slowly returning to your staring position, repeat with the other leg, maintaining pelvic tilt.


  • Begin lying on your back, both knees bent, feet flat on the floor
  • Contract your glutes, lifting your hips off the floor towards the ceiling
  • Hold for 5 seconds, slowly lower hips back down to the floor
  • Repeat 10 times, perform 2-3 sets

Side Planks

  • Start lying on your side with your body in a straight line.
  • Prop up on your elbow, lifting your hips, so that you maintain a straight line from your nose to your toes.
  • Hold 30 seconds, repeat 2-3 sets each side

Chest Press

  • Start lying on your back, both knees bent, feet flat on the floor.
  • Hold your baby right above your chest, elbows bent
  • Contract your abdominals, performing the pelvic tilt from above, slowly straighten your arms, lifting baby up toward the ceiling and slowly lower back down to starting position
  • Repeat 10 repetitions for 2-3 sets.

Shoulder Press

  • Start standing with feet about shoulder width apart, hold your baby so you are face to face.
  • Contract your stomach and lift your baby up toward the ceiling, pause and slowly lower back down to starting position
  • Repeat 10 repetitions for 2-3 sets.


  • Start: standing with feet shoulder width apart, wearing your baby in their favorite carrier.
  • Lower your hips down and back, like you are sitting in a chair, making sure to push your knees out so that they stay aligned over your feet.
  • Tip: perform these in front of a mirror to make sure your knees are in alignment.
  • Repeat 10 repetitions for 2-3 sets.
  • Variation: Wall Squats – squat to 90 degree knee bend with your back against the wall and hold 3 x 30 seconds.


  • Stand up tall, wearing your baby in his/her favorite carrier
  • Step one foot forward, bending both knees
  • Make sure your front knee doesn’t go forward past your toes, ideally both knees will be at 90 degrees
  • Return to your starting position
  • Repeat 10 times, perform 2-3 sets each leg


  • Often overlooked, walking can by a simple yet effective form of exercise.
  • Take your baby with you in the stroller starting with 10-15 minutes and gradually increasing.

Exercises to avoid – forward planks, crunches/sit-ups, leg lifts

Crunches won’t fix the problem and will likely make it worse.

Why don’t crunches help?

Traditional sit-ups and crunches target the rectus abdominis (6-pack muscle). But after pregnancy, the connective tissue between these bands of muscle is stretched out, causing each side to pull apart and no longer support your core. Doing regular crunches tends to make the muscles tighter, pushing them further apart and stretching the connective tissue even more so that it grows thinner and weaker.

It may be beneficial for you to see a professional prior to starting exercise. Dysfunctions that may develop and require treatment after pregnancy/delivery include:

  • Diastasis Recti – As mentioned above, the rectus abdominis gets stretched out during pregnancy. If it stretches enough the muscle may separate, leaving a vertical gap that allows your belly to sag through.
  • Low back/Pelvic Pain – Experts estimate that anywhere from 24% to 90% of women experience low back or pelvic-region pain when they are pregnant. Many women find that this pain goes away when the baby is born. However, more than a third of women still have pain 1 year after giving birth.

Damage to the pelvic floor muscles during pregnancy or delivery may cause:

  • Pelvic Organ Prolapse – This occurs when the organs of the pelvis are not well supported against gravity and cushioned against pressure, causing them to literally begin to drop.
  • Dyspareunia – or pain with intercourse. This can occur when the pelvic floor muscles spasm and/or if scar tissue is present following an episiotomy.
  • Incontinence – difficulty evacuating or retaining the contents of the bladder or bowel. This occurs if the superficial sphincter muscles grow weak or are impaired by labor and delivery.

In many cases, insurance will cover the cost of evaluation and treatment for these dysfunctions. Check with your insurance provider to see if you need a physician’s referral to visit a physical therapist.