When working with post-natal clients and creating their exercise program, it is important to consider their new role as a mum.
Some women – especially if they haven’t exercised much or primarily worked in an office environment, are faced with the most physically demanding job in the most de-conditioned state they have ever been in. Many women are physically and emotionally drained. They may have a baby that doesn’t sleep, be struggling with feeding and adapting to their ‘changed body’.
During this time mums should be encouraged to understand their bodies, re-build from the inside out and build a base level of strength.
A better knowledge of how and why they ‘feel’ the way they do on a day-to-day basis could truly change their experience of early motherhood.
I took some time to think about my top three favourite and essential exercises that I like to teach all of my post-natal mums. Choosing only three was a tough job, but here they are:
1. Pelvic Floor and Transversus Abdominis (TA) Breathing
My absolute favourite and one that can be done as soon as a new-mum feels ready, this exercise is the foundation of the postnatal woman. Learnt and performed well, it can help to rehabilitate her pelvic floor and has the potential to help correct any abdominal separation preventing further injury down the track.
To ensure this exercise is performed correctly, I recommend every new mum should see a Women’s Health Physiotherapist (WHP) at around the 6-week mark. If a pregnant mum can be taught how to do this and sees a WHP during her pregnancy, it will be beneficial.
How to correctly teach pelvic floor breathing:
- Ask your client to lie on her back
- Ensure knees are bent and feet are hip width apart
- Check the spine is in neutral to avoid over-arching of the lower back or pushing it into the ground
- Client should place one hand on one of her obliques (you can also do the same to check whether the correct muscles are contracting)
- Take her/your other hand and lay it from hipbone to hipbone— this is the area to concentrate on throughout this exercise
- When your client is ready, ask her to take a natural breath in, then breathe all the way out and draw in and up through her front passage. (I use the very glamorous analogy of asking her to imagine she has a tampon inserted and she is gently trying to squeeze it in and up when talking about this pelvic floor activation)
- Once you feel she has got her pelvic floor contraction right you can move on to add TA activation
- Ask her to take her natural breath in and as she breathes out she can gently draw her pelvic floor in and up away from the hand laying across her hip bone to hip bone, drawing toward her tailbone to activate her TA
It’s important to remember this is a gentle movement—no big ‘tensing’ or ‘bracing’ of the abdominals. There is no external way you can truly know your client is most effectively activating her Pelvic Floor and TA without her seeing a WHP.
Almost every new mum complains of upper back and trap tiredness or pain, along with a tightness through her chest muscles. This is caused by a constant need to carry and feed her new baby,
leaving many women in a rounded position for hours on end. A cobra stretch can simultaneously help to strengthen your client’s back muscles and stretch out her chest—pair it with a chest stretch for the best effect.
A cobra can be performed lying or standing but for post-natal mums I chose a standing cobra, as many women will experience tender or sore breasts.
How to correctly teach the cobra stretch:
- Ask your client to stand with her feet hip width apart and a slight bend in her knees
- Ensure the chest is up, shoulders down and she has an awareness through her PF and TA
- She has a neutral spine tip and her hands are resting on her knees
- Ask her to tip at her hips until fingers are on her knees
- Then lead with the thumbs drawing her shoulders back and down taking arms out to the sides
- She should squeeze between her shoulder blades (rhomboids)
- Keep her chin slightly tucked and traps relaxed throughout
- Hold for 3 and slowly return to the starting point.
Repeat for 10-12 reps.
3. Hip raise
Many mums report tight hip flexors and a lazy bum—a hip raise is a fantastic easy-to-do glute-activation exercise that she can also include her baby in when she feels ready.
For a mum with sciatic pain this exercise may not be ideal as it may create more pressure on her sciatic nerve at the top of the movement.
How to correctly teach hip raises:
• Ask your client to start lying on her back, knees bent and feet flat on the floor, hip width apart
• Her hands are relaxed by her sides
• Ask her to push through heels and squeeze bum to raise her hips off the floor until there is a nice line between shoulders and knees
• She shouldn’t feel a pinch in her lower back—if this is the case, lower slightly keeping her bum squeezed
• Hold for 3 and slowly return to the ground
Repeat for 10-12 reps.
I believe each of these exercises help to create a strong foundation in any new mum. They are a great place to start, especially if your mum-clients are new to training or you are new to training postnatal clients.
Once we have learned foundation exercises such as these, move on to teaching basic movement patterns performed well, i.e. squat, lunge, push and pull including light twisting and turning. The intensity is completely dependent upon any postnatal contraindications like abdominal separation, pelvic floor weakness, prolapse etc.
Mums have to move in many awkward positions and as fitness professionals, I believe we need to teach them to move well.
Not Your Average Pre & Postnatal Education – Check out the 2018 dates for Safe Return to Exercise courses in your state.
Article written by Jeb Dugard for for the What’s New in Fitness Magazine – Summer 2017 Edition.