During pregnancy, women are told the importance of strengthening their pelvic floor — the diamond-shaped group of muscles that run from your pubic bone to your tailbone and from sit bone to sit bone — for labor and delivery. But focusing on building up these muscles after birth is just as essential to postpartum recovery.
That’s because your pelvic floor muscles not only play a large role in preventing incontinence (they create a hammock under your rectum, bladder and uterus) but also in breathing, improving sexual function and blood flow, and creating a stable lower back, core and hips, said Helene Darmanin, an orthopedic and pelvic health physical therapist and founder of Mama Bear PT.
The benefits of strengthening your pelvic floor
Postpartum life brings an onslaught of new aches and pains for moms, including rounded shoulders and a tight upper back and neck from breastfeeding, wrist pain from holding a newborn, and lower back and hip pain. By strengthening your pelvic floor, you can help prevent and treat some of these muscle imbalances and compensations.
“In general, if there is a body part that is not supporting itself or moving as well as possible, that will add stress to the surrounding areas. So, in the case of the pelvic floor, if it’s not quite pulling its weight, it can add stress to the lower back and hips, which can affect the upper back, neck and shoulders,” Darmanin explained.
And if you’ve been given the green light to start working out again, prioritizing pelvic floor exercises in your routine can help re-engage your core after a long hiatus from planks, situps and other traditional ab moves you skipped during the last half of your pregnancy.
If you think of your core as a box, the pelvic floor is the bottom.
Helene Darmanin, PT
“If you think of your core as a box, the pelvic floor is the bottom. Boxes with a good, strong bottom are generally most helpful, so a strong, supple pelvic floor is an important component of a strong core,” Darmanin said. “Additionally, the pelvic floor usually co-contracts with the transverse abdominis, aka the deep, corseting ab muscles, so strengthening the pelvic floor and the surrounding muscles can help facilitate the recovery of the transverse abdominis, which has been stretched during pregnancy.”
But strengthening your pelvic floor isn’t the only thing you need to do postpartum. These muscles also need to relax, Darmanin said. When you were pregnant, the pelvic floor muscles helped support the weight of your growing baby, which might have caused them to become tight.
“There is some thought that a vaginal birth might stretch them out and release them, but you may not get a release with a Cesarean birth,” she explained.
Allowing your pelvic floor muscles to relax and lengthen ensures that they are functional through their full range of motion and can contract effectively.
“Think about the difference between doing a bicep curl from a straight arm versus an elbow that’s already really bent. [Pelvic floor muscles] need to be supple to respond to downward pressure such that the pelvic organs hit a trampoline — not a brick wall,” Darmanin said.
The 5 best pelvic floor exercises
With that said, Darmanin shared her go-to pelvic floor exercises for strengthening and lengthening below. She recommends doing these exercises 3 to 4 times a week for the best results.
“Many of my clients are more successful when they do their exercises daily because they can easily turn it into a routine, like after putting the baby to bed or squeezing them in for 10 minutes a day. But also, some [exercise] is more than none! It's important to give yourself grace, especially at this time of monumental change and do what you can do!” she said.
This stretch helps the pelvic floor relax by opening the bottom of the pelvis, Darmanin said. It also stretches the upper back and shoulders, which could get tight from carrying your baby.
How to: Get into a tabletop position on the floor with your hips directly above your knees and your shoulders above your wrists. While keeping your hips over the knees, stretch your arms forward as you bring your forehead and chest to the ground. Hold this position for 30 seconds and take big breaths to expand the rib cage.
Your diaphragm — the muscle that sits at the base of your chest and controls breathing — and pelvic floor mirror each other’s motions when you take deep breaths, Darmanin said. Doing this exercise helps you get into the rhythm of contracting and relaxing your pelvic floor muscles.
How to: Lie face-up on the floor with your shoulders relaxed and place one hand on your belly and the other on your chest. Breathe in through your nose for a count of 5, making sure to fill air into your ribs, from front to back and side to side. Your chest should be relatively still. Purse your lips and exhale slowly for a count of 5.
“This is one of my go-tos for engaging the transversus abdominis, which co-contract with the pelvic floor, and strengthening some great postural muscles in the shoulders,” Darmanin said. Because it forces you to recruit your deep ab muscles, this move may also help relieve pressure in the lower back and pain in the upper back, shoulders and neck.
How to: Get into a tabletop position on the floor with your hips directly above your knees and your shoulders above your wrists. Press your hands against the floor to lift your knees just a few inches off the ground, keeping the lower back in a neutral position (not tucked or arched), and the chest wide. Make sure to fully exhale on the way up. Slowly lower your knees back down to the ground and repeat. Start with 2 sets of 5 reps, working your way up to 10 reps.
This variation of the clamshell exercise focuses on strengthening the outer glutes as well as the muscles that form the side walls of the pelvic floor. “It moves the hip joint through a full range of motion, which can prevent them from being tight from sitting,” Darmanin said.
How to: Lie on one side and bend your knees to 90 degrees, stacking your hips and legs on top of one another. Keeping your hips square, open your top knee like a book, keeping the feet together. Then rotate your knee down and your foot up toward the ceiling so that you are in the reverse of the first position. Repeat for 2 sets of 10 reps.
Sit to stand
A highly functional move, this squat variation builds up your glutes, quads and pelvic floor muscles, as well as your core. “I'm definitely grateful for the strength in these muscles when trying to get off the floor holding my toddler,” Darmanin said.
How to: Start standing with a chair or couch behind you. On an inhale, slowly lower your butt down to sit in the back of the chair. Then, press into your heels on the ground and exhale as you stand back up. Repeat for 2 sets of 10 reps.