Postpartum Recovery Pilates with Sarah Jane Walls

The postpartum time period is very exciting for most women, but it can be very stressful as well. Women are going through the process of healing their bodies after the birth, dealing with drastic hormonal changes, and adjusting to life with a newborn. Most women are physically exhausted and may have extreme emotional swings. Regaining their prepregnancy body is often a main concern.

The Postpartum Body
During the course of pregnancy, the abdominal muscles will stretch over 50% of their original length. During the fifth month of pregnancy, the majority of women will begin to notice that their rectus abdominus is no longer united in the center and has moved laterally. This is called a diastasis recti. The diastsis recti is a normal occurrence and is actually a protective response. It’s able to occur due to the hormonal softening that occurs in the body’s soft tissue structures. The rectus abdominus is a narrow muscle with less surface area to stretch, so the separation and lateral movement helps prevent excessive stretching.
After the birth, with time, the abdominal muscles will shorten due to the demands of normal activities of daily living, but without specific exercises and focus, they often do not shorten to their pre-pregnancy state. The diastasis recti, likewise, may naturally close without too much attention, but in most women, specific focus on abdominal rehabilitation is necessary to close the diastasis.

Closing the Diastasis
On average it takes most women (even extremely fit women) approximately six months to one year to regain full integrity of the abdominals. So, this is a slow process and one that should not be rushed. Advancing abdominal strengthening too quickly can jeopardize the joining of the recti and leave women with a central weakness. This is not always something that women can feel, but it is most evident if they later go on to have a subsequent pregnancy. They will begin the next pregnancy with a diastasis, which may put them at risk for separation of the deeper layers.

Ribcage Position
Another important focus postpartum is restoration of the position of the ribcage. During pregnancy, the ribs flare considerably. The ribcage actually changes in diameter by 2 cm. Postpartum, it is necessary to restore the ribcage position as it affects the length of all the muscles attaching into the thoracic cage, including the abdominals, the pectorals, the erector spinae and the diaphragm. Following the physics principle of the length-tension relationship, as long as the ribs are flared, the body will not be able to reach its maximum strength potential. Furthermore, flared ribs put more stress on the diastasis recti and make it more difficult for the obliques to engage and the abdominal muscles to unite centrally.

Restoring Posture
A final important focus in postpartum rehab is posture. Pregnancy causes major postural changes to occur. All of the spinal curves become more exaggerated, and these excessive spinal curves often continue into postpartum. Most women have to pay attention to restoring their posture. They need to tune into their bodies and notice when they are slumping, and initially, the act of sitting up straight will be an exercise. Becoming aware of postural habits is the first step towards correcting them.

Pregnancy and postpartum is an incredible and exciting time but not without its physical challenges. New mothers need to be strong to handle all of the stresses that are placed on their bodies. Babies get heavy rapidly, and mothers need to be able to carry their babies into their toddler years. Women need to take care of their bodies so that they can enjoy wonder of watching their babies grow!