Postpartum Exercise and Rehabilitation

Benefits & Goals - Bounce Back Basics

• Physical Restoration:
  • Aids weight management & improves cardiovascular fitness.
  • Strengthens core (abdominal muscles, diastasis recti management) & pelvic floor (prevents incontinence).
  • Boosts energy levels, improves sleep quality.
  • Reduces risk of blood clots (DVT).
• Mental Well-being:
  • Alleviates symptoms of postpartum depression & anxiety.
  • Enhances mood, reduces stress, improves self-image.
• Overall Goals:
  • Achieve safe return to daily activities & pre-pregnancy fitness.
  • Prevent long-term musculoskeletal dysfunction.
  • Promote holistic recovery.

⭐ Gentle pelvic floor exercises (Kegel's) can be initiated within 24 hours of uncomplicated vaginal delivery, promoting healing and preventing future urinary incontinence (UI).

Timing & Safety - Safe Start Signals

• General Guidance:
  • Start slow; gradually ↑ intensity & duration.
  • Adequate hydration & nutrition are vital.
• ⚠️ Stop Exercise & Consult Doctor if:
  • ↑ Lochia (brighter red, soaking >1 pad/hr).
  • New/worsening pain (pelvic, incisional).
  • Urinary/fecal incontinence (new/worsening).
  • Dizziness, undue breathlessness, chest pain.
  • Wound infection signs (redness, pus) or dehiscence.
• ⭐

  Screen for diastasis recti abdominis (DRA) before starting specific abdominal exercises to prevent worsening the separation.

Exercise Types - Mama Moves Menu

• Pelvic Floor Muscle Training (PFMT/Kegels):
  • Start ASAP (within 24 hrs post-vaginal delivery).
  • Action: Contract as if stopping urine; hold 3-5 sec, relax 3-5 sec.
  • Reps: 10-15 reps, 3x/day.
  • 📌 Mnemonic: "Squeeze the PEE, for a strong ME!"
• Core Strengthening:
  • Begin after 6 wks (vaginal), 8-12 wks (C-section), with MD clearance.
  • Focus: Transverse abdominis activation (bracing), pelvic tilts.
  • Avoid: Crunches/sit-ups initially, especially with diastasis recti.
• Aerobic Exercise:
  • Low impact: Walking (early), swimming (post-lochia/wound healing).
  • Gradual: Start 10-15 min, build to 30 min, 3-5 days/wk.
• Stretching & Flexibility: Gentle stretches for back, neck, shoulders.
• Postural Correction: Emphasize during all activities.

⭐ Diastasis Recti Abdominis (DRA) assessment is key before abdominal exercises. Gap > 2 finger-widths requires modified exercises.

Special Conditions - Fix-It Focus

• Diastasis Recti Abdominis (DRA)
  • Definition: Rectus abdominis separation >2 cm (or 2 fingerbreadths).
  • Assessment: Palpate inter-recti distance during modified crunch.
  • Fix-It: Transverse abdominis (TrA) activation, pelvic tilts, modified planks. Avoid crunches/sit-ups. Taping/binding for support.
• Pelvic Girdle Pain (PGP) / Symphysis Pubis Dysfunction (SPD)
  • Symptoms: Pain in pubic symphysis, SI joints, gluteal region.
  • Fix-It: Pelvic floor muscle training (PFMT), core stability, pelvic support belt. Avoid asymmetrical loading (e.g., wide lunges).
• Urinary Incontinence (Stress/Urge)
  • Fix-It: PFMT (Kegels) first-line. Bladder training for urge. Lifestyle modifications.

  ⭐ Diastasis recti often resolves spontaneously by 6-8 weeks postpartum; persistent cases with functional issues benefit from physiotherapy.

• Perineal Trauma & Pain
  • Fix-It: Gentle PFMT, scar massage (once healed), sitz baths. Gradual return to impact.
• Postpartum Carpal Tunnel Syndrome
  • Fix-It: Wrist splinting (nightly), nerve gliding exercises, activity modification.

High‑Yield Points - ⚡ Biggest Takeaways

• Early ambulation prevents venous thromboembolism (VTE).
• Start Kegel exercises immediately for pelvic floor support and to prevent incontinence.
• Abdominal exercises (modified) can begin after ~6 weeks (vaginal) or later post-C-section, once pain-free.
• Gradually resume moderate aerobic activity (e.g., walking).
• Cease exercise if warning signs appear: ↑bleeding, significant pain, dizziness.
• Address diastasis recti with specific exercises; avoid standard crunches.
• Breastfeeding mothers: feed before exercise, wear supportive bra_