Updated: Oct 9, 2020
Hmm...maybe flatter isn't the most accurate and healthiest goal—how about getting my abdominals and entire core more powerful so I can care for my baby better? Or return to running sooner? Or get rid of my back pain faster?
While we would all love to have a flat stomach after having a baby, flat does not equal powerful. The desire to have a flat stomach is often intertwined with our self-image, which can understandably take a hit when we go through a pregnancy and birth, and improving our self-image can be multifactorial. As a physical therapist, I have found with my patients that the quickest path back to restoring self-image is not to focus on the flatness of our abdominals per se, but on their power.
That's not to say that our abdomens don't get flatter as we work on core power--they often do; but by focusing your attention on returning to doing what you love, the result is often much more rewarding! Consider this 3-pronged approach:
1. Define what it is you are having difficulty or pain doing, post-baby. Be as specific as you can.
Maybe your back hurts when you change your baby's diaper, or you leak when you cough or exercise; maybe your neck hurts after feeding or nursing your baby, or you can't pick your toddler up without pain. Or maybe you are just beat at the end of your day and you don't really know why. Choose one or two specific challenges that are impacting your life the most right now and write them down. Try to be specific (and bonus points if they are measurable!). Examples might include:
I feel great in the morning, but by 4:00 pm my back really hurts
I leak whenever I sneeze hard, or jog more than a block
My neck and shoulders hurt every time I nurse my baby
My hips hurt when I stand more than 15 minutes
My bottom feels like it is falling out when I stand more than 10 minutes
My c-section scar aches whenever I hold my baby more than 5 minutes
Specifically defining your physical challenge(s) now will make all your hard work on strengthening your core much more rewarding, as you will be able to clearly see your progress as you compare your yourself from start to finish. We all need that motivation!
2. Understand the anatomy. If you don't understand what muscles make up the core, then it is harder to get where you need to go!
What do we mean by core? Is it the same as abdominals? Should I just start doing a bunch of sit-ups? (Answer—no!)
There is a lot more to the core than the "six-pack" muscles. In fact, six-pack refers to the rectus abdominis, part of your outer core muscles. Post-baby, we need to first focus on the inner core—the foundation of our core strength. Your inner core for our purposes here is comprised of 4 sets of muscles which are designed to work in sync to hold everything together and give us the stability and support we need to do the things we love to do. These 4 muscle groups are:
your pelvic floor muscles
the multifidus muscles deep in your back
and yes, your abdominals, specifically the transversus abdominis (deepest of the 4 layers of abdominals)
See why we can't just focus on the tummy muscles alone? There's a lot going on here!
But don't let the beautiful complexity of our core muscles scare you. Strengthening them doesn't have to be complex. Read on to learn some simple exercises to help get your core back online after baby.
3. Establish a simple, regular routine of exercise targeting your core
Consistency and specificity is key here, not difficulty. No need to strive for 1000 sit-ups a day. It is really important to establish a targeted exercise routine that is simple yet effective, so you can be consistent—exercising consistently is the secret to bringing you the results you are looking for. And if anything can railroad a new exercise program, it is a baby, so keep it simple!
Here are 3 simple exercises to consider for re-harnessing the power of your core post-baby.
Kegels, for strengthening your pelvic floor muscles
If you are unsure how to correctly do a Kegel, you can read here and here, consult with your healthcare practitioner, or schedule a virtual appointment with me. You can do this exercise in any position—lying on your back or side, sitting, or standing. Inhale to get ready, then exhale as you contract your pelvic floor muscles by pulling them up and in, and hold for 5 seconds; relax for 5 seconds. Repeat this 10 times. As you get stronger and this gets easier, work toward holding the kegel for 10 seconds, and then rest for 10 seconds.
Tummy pull-in, for strengthening the transversus abdominis
First, sit or lie on your side and let your tummy relax and sag. Inhale to get ready; then exhale as you draw your lower tummy inward and hold for a count of 10 seconds (or as long up to 10 that you can manage). Relax and let your tummy muscles rest for 10 seconds, breathing normally. Repeat for 10 repetitions.
Quadruped leg lift—for targeting the multifidi muscles in your back.
If you are physically able, get onto your hands and knees on the floor; engage your core by pulling your tummy up and keeping your back straight. Hold this position as you lift one leg out behind you and hold for count of 3, then lower leg back down to starting position; repeat with other leg. Repeat, lifting each leg 5 times, working up to 10 times as you get stronger. Remember to keep breathing during this exercise, exhaling each time you lift your leg.
Strive to do all 3 exercises once per day to start. If you are really industrious and can find the time, you can work up to doing these exercises twice per day as you get stronger. (Pro tip: the first two exercises can be done while you feed/nurse your baby, and the third can be done while on the floor while playing with your little one. You'll be done with your exercises before you know it!)
What about the diaphragm? Don't worry—we didn't forget about this part of your core! You actually engage your diaphragm with every rep of the above 3 exercises, by coordinating your breath correctly with each repetition—no breath-holding here. If you remember the mantra "Exhale with the Effort", you'll be good to go.
Remember that consistency of exercise is key to see the results you're looking for, so after you've done the above exercises daily for 2 weeks, check in on the challenges you wrote down--how are you doing? Can you stand for longer, sneeze without leaking, get further in the day before you have pain, hold your baby longer without hurting, exercise harder before having a problem? How about after 4 weeks? 6 weeks? After 4-6 weeks of regular exercise, you can expect to see a big difference in your challenge. (And oh yes, your tummy should be flatter too!)
What are you waiting for? Power up your pelvis!
Note: Be sure to check with your healthcare practitioner before starting any new exercise program. If you have just had a baby, your physician/healthcare provider will tell you when it is safe to return to exercise. Also, if you are unsure if you are doing these exercises correctly or have any pain, stop and discuss with your healthcare practitioner, or schedule a virtual appointment with me. You can do this!
About the Author:
Angela is the owner of My Pelvic Therapy, PLLC and a licensed physical therapist. Prior to starting her telehealth private practice, she worked as a senior physical therapist for 17 years at Advocate Lutheran General Hospital in Park Ridge, IL, specializing in helping both women and men overcome their pelvic floor challenges. She received her physical therapy degree from Duke University, biology degree from University of Illinois, and is a lifelong learner of all things PT.
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