One key to healing your core after pregnancy is your alignment. I often discuss how three key alignment changes (hips over heels, neutral pelvis, and neutral ribs) minimize intra-abdominal pressure and turn on the deep core muscles.
But for many new moms, a common question arises: how can I maintain alignment and healing while baby-carrying or baby-wearing?
Holding a squirming bundle in our arms, or in a carrier, throws off our posture and strains our core.
So let’s discuss how to do this in the most core-safe way.
How to Baby Carry In a Core-Safe Way
The Newborn days
In those first few weeks, when your newborn has no head control, you’re likely using your hips to support the weight, and rounding over to keep them secure. It’s very hard to maintain good alignment in this newborn stage!
The good news…This only lasts a couple months. Don’t put extra pressure on yourself in those early days.
Once Your Baby Has Head Control
However, once baby has a little more head control and is getting heavier, it’s time to become more mindful of your body position.
Holding in Arms
Our tendency is to throw one hip out to one side (usually the same hip every time) and let the baby rest on the shelf of our hip bone. This position is less than ideal.
It makes it hard to engage our deep core muscles and increases outward pressure on the abdominal connective tissue. This increase in pressure is particularly harmful if you have diastasis- recti or a prolapsed pelvic floor.
We can ease that pressure by keeping the hips square. When you pick the baby up, use your arm to hold the baby (as much as possible) rather than the hips. When one arm gets tired, switch to the other side. You can also take them in front with both arms as support. At first, this feels hard and strange. With time, you will build arm strength and it will become easier.
As your baby becomes a toddler, try to use the piggy-back method when they need to be carried. This allows you to keep alignment and squared hips while giving tired toddler legs a break.
For those of you using a baby carrier, here are a few tips that will help you maintain alignment and minimize intra-abdominal pressure.
As soon as baby is big enough, move them to the back instead of carrying on the front. This allows you to use the natural protection of the bones in the back, the ribcage and spine, to avoid straining the core.
If your baby isn’t big enough or isn’t ready to be on the back, make sure that while you front carry you don’t shift your hips forward as you get tired. Instead, lean forward slightly and take breaks often.
Regardless of whether you wear your baby in front or back, makes sure that the straps are fitted properly. You want the baby nice and snug against your body and the waistband snug around the hips. When the straps are too loose, we tend to move into poor alignment to compensate.
In general, make sure you take breaks as often as possible to avoid fatigue in your muscles.
Even though it feels like you will be carrying that heavy child around forever, I promise you, those days will be behind you soon enough! Your core (and entire body) will appreciate the time and attention you put into proper baby carrying during this season of your life.
As moms, it has become normal to joke about peeing our pants. I get it. We use humor when talking about difficult topics.
While incontinence may be common in postpartum women, it is not normal. In fact, leaking is a sign of dysfunction in the core/pelvic floor system.
Today I’ve got two tips to share for those of you struggling with leaking. These are actions you can take right now to work on improving this.
Tip #1: Find Pelvic Floor Balance
First, a little anatomy. Your pelvic floor is a huge set of muscles that connect from the pubic bone at the front of your pelvis, to the tailbone at the back of your pelvis. We should be able to engage the entire set of muscles. But, often, women who leak are instructed to “do more kegels” by just squeezing the muscles that shut off the flow of urine. That cue engages only a small portion of the pelvic floor muscles.
You want to make sure you are engaging the entirety of your pelvic floor – both the front and back. We do this by playing with our pelvis positioning.
To test out your balance, try this. Sit on a chair with your feet flat on the ground.
1. First, engage the muscles at the front of the pelvic floor.
a) Tilt your hip bones forward to move your pelvis into an anterior pelvic tilt position.
b) Then engage your pelvic floor by squeezing the muscles that shut off the flow of urine.
c) Try to hold that engagement for 10 seconds and observe what happens.
2. Then engage the muscles at the back of the pelvic floor.
a) Tilt your hip bones back and tuck your pelvis under you (Posterior Pelvic Tilt Position).
b) Now engage the back of your pelvic floor by squeezing the muscles that shut off the flow of gas.
c) Again try and hold that engagement for 10 seconds.
3. Now engage the entire pelvic floor.
a) Bring your pelvis back to a neutral position (sitting on your sit bones)
b)Now engage the entire pelvic floor by engaging the muscles that shut off the flow of urine AND the muscles that shut off the flow of gas.
c) Now you have all your pelvic floor muscles firing. What happens when you try to hold for 10 seconds?
While doing this, ask yourself: how is your balance? Does one part feel stronger or weaker? If so, you would benefit from creating balance in those muscles.
You might be asking…but what does this have to do with leaking?
The muscles that are responsible for holding urine are in the front of your pelvis.
By positioning your upper body in a slightly forward position, you encourage the muscles at the front of the pelvic floor to engage more readily…which helps prevent leaking! (Watch the video above for a clear visual of how this works!)
Tip #2: Work the Fast and Slow Twitch Muscles
So now that we’ve got the body positioned to help these muscles fire more efficiently, the second step is to work both muscle types. Your pelvic floor has two types of muscles, fast-twitch and slow-twitch.
The slow-twitch muscles help hold your internal organs in. They are designed for holding a low level of engagement over a long period of time. When you hold a kegel for 10 seconds, you are engaging your slow-twitch muscles. If they are weak, you may find them getting shaky as you hold them. However, these are NOT the muscles that stop the flow of urine.
Fast twitch muscles turn on with sudden demand (like when you sneeze or hit the ground in a jumping jack). These are the primary muscles that help you prevent leaking. These muscles engage quickly, for just a moment, and then they relax.
For this reason, it’s important that your pelvic floor training works both types of muscles. You want to engage your pelvic floor with long holds (e.g. 10 seconds) and multiple reps of quick pulses (squeeze, release, squeeze, release). This will train your pelvic floor to respond to the demands of daily life and those sudden moments of intense pressure (like a sneeze).
The unpleasant leaking that many moms experience does not have to be a fact of life. Body positioning AND training both fast- and slow-twitch muscles can help reduce leaking once and for all.
Upper back and neck discomfort are some of the most common issues we hear about from moms.
Why is that?
Well, for one, moms spend a lot of time ‘rounding.’ As a mother to a little one you may be breastfeeding and carrying babies. On top of that, we live in a culture with excessive sitting and we spend all day looking at a phone. These all contribute to a more rounded posture. This rounding causes muscle imbalances that lead to pain.
There are also specific postpartum changes that can worsen this issue. These include extreme tightness of back muscles and changes in our breathing patterns from pregnancy. I have three simple tips that can help reduce this common discomfort.
Here are my top 3 very simple tips for addressing and reducing this discomfort:
Tip 1: Correct your head position.
When your head is aligned over the spine, it puts very little weight on your spine. But if you move your head forward, you increase the pressure/weight pulling on your spine substantially. When our spine and head are stacked properly, things are working as they should be. But once that stack has shifted, we create a lot more work for our muscles.
The best way to remedy this is what I call ‘the eavesdrop.’ Instead of leaning in, imagine you are listening to a super juicy conversation…behind you. When you do this, your head pops back in line with the rest of your spine and creates some immediate relief for your upper back and neck.
Tip 2: Breathe properly.
During pregnancy, many of us learn to breathe in a less than ideal way. Instead of using our diaphragm and extending our rib cage (as is ideal), we start using secondary muscles in our necks and shoulders to breathe. Breathe in, shoulders lift. They lift to try to create more space in the rib cage, but the result is fatigued and tight muscles.
Instead, keep your shoulders down, keep the neck soft, and inhale and feel your rib cage expand left to right and forward and back. When you do this, your belly is going to move and your rib cage will expand. The shoulders and neck won’t need to work to help you breathe, and can get a much needed break.
Tip 3: Open your back body.
In the previous tip, we talked about expanding the rib cage to breathe…however, a lot of postpartum women are extremely tight in their back muscles and find that when they try to expand their rib cage, it doesn’t move! Those tight muscles prevent the movement of your ribs.
To open the back body, I recommend a simple exercise. Find something low to the ground, like a stable chair, and come into a squatting position in front of it. Grab hold of the bottom (chair legs, couch, etc) with your arms around your legs. Have a rounded spine, and drop your chin to your chest.
As the legs are pressing against the front of our body and we breathe in, this opens the back muscles from the inside. Let your head relax down, and breathe really deeply and feel the expansion in the back body.
Do 5-10 breathes like that every day to help open up these muscles and rib breathing will become much easier.
A quick note: if this doesn’t feel good on your pelvic floor…maybe it feels like you will pee if you do that, you can modify this by sitting in a chair and place your feet on blocks in front of you. Wrap your arms around yourself, and tuck your chin into your chest and do these same deep breaths.
Becoming a mom does NOT mean you must struggle with tight, achy necks and shoulders. If you are looking for a comprehensive system to help strengthen your post-baby core and bring some balance back to the body, you might be interested in my FREE training: How to Strengthen Your Post-Baby Core (Once and for all!). Click here to sign up.
Some of the most common (and beloved!) poses in yoga include traditional hip openers…but these poses may not be serving your post-baby body. Read below (or watch the video) to understand why!
As a new yoga teacher I LOVED putting people into some long hip openers. Think half-pigeon and Baddha Konasana, poses where legs are externally rotating to open the hips.
Well, you know what they say… when you know better, you do better. Now, when I see extended hip openers in yoga, I cringe. For most postpartum bodies, these poses aren’t helping…and are possibly making hip issues worse.
Pregnancy As An Injury
In many ways, pregnancy acts like an injury to the body.
Pregnancy creates certain muscular imbalances and these imbalances destabilize parts of the body.
Most notably, the core and pelvic floor weaken, and the back and hip flexors tighten to compensate.
The Role of The Core
In a normal body, the core creates stability for the spine and pelvis (among other jobs).
The muscle tone in your core keeps your spine from being too loosy-goosy. This prevents herniated discs and other back issues that we don’t want.
The abdominals also stabilize the pelvis from above and keep the pelvis from shifting around with every step we take.
Muscular Changes During Pregnancy
However, as your baby grows during pregnancy, your core muscles weaken and can’t provide the stability the body needs.
Other parts of the body pick up the slack. The muscles of the back and the hip flexors, especially the psoas, lock down to stabilize the spine.
This creates a lovely, messy cascade in the body.
With the psoas doing the job of the core, the pelvis loses stability.
As a result, another muscle, the tensor fasciae latae (TFL), starts locking down.
The TFL is on your outer hip, around where your pant pockets would be. It’s primarily responsible for turning the leg out.
But when it needs to, it can tighten to create stability in the pelvis. (Sidenote: the TFL connects to the IT band. If your ITB has been bothering you since pregnancy, the TFL might be the culprit!)
So, as your core is weakening, the back, psoas and TFL are working overtime on jobs they aren’t designed to do. This impacts other body parts.
The TFL is a bully to the glutes, and shuts them off.
When that happens it causes more instability for the pelvis, so other areas kick in.
Sometimes this includes the pelvic floor. (If you’ve got a tight pelvic floor…this might be why!)
What do you get from this big mess?
Things like extremely tight hips, an unstable pelvis, SI joint instability, IT band flare ups, and that post-pregnancy mom-butt!
STRETCHING IS NOT THE ANSWER!
When we feel tight and achy…what do we do?
Most of us immediately think ‘STRETCH!’
We get into half-pigeon and other hip openers to get some relief.
Unfortunately, when we stretch, we force muscles to lengthen that are working REALLY hard to create stability.
Think about that for a moment…what are you doing to your body?
By stretching muscles that are holding things in place, you destabilize the entire system.
This is the reason that any relief that comes from the stretching doesn’t last for long…and why you may feel EVEN tighter afterward.
Your muscles are trying to protect you from the length you’ve created.
A Different Approach
So what do we do? If you’re feeling chronically tight or unstable, I know you want relief.
And while stretching can be helpful, our top priority must be to rebalance the imbalances pregnancy created.
We need to strengthen muscles that are weak so that the overworked muscles can chill out!
Connecting to your deep core muscles, particularly your transverse abdominals.
From a seated position (or while nursing), first take a breath in and let the belly relax. Imagine a corset around your midsection. As you exhale, feel the corset draw in gently. This should create a feeling of length in the torso. This action helps bring your core muscles back on-line.
If you are desperate for some movement, walk!
Walking is low impact and increases circulation (which aids healing). In a perfect world, this walking would happen without holding or wearing your baby. For some of us (like me!) that isn’t possible with a newborn, and that’s ok! But, if you can manage it, walking freely helps bring your body back into proper alignment after pregnancy.
To recap: as you begin to heal in those first six weeks focus on: REST, breathing, core engagement, and walking (if you feel up for it!).
6-Weeks to 4-Months Postpartum
At this point, you’ve had six weeks to heal (and possibly a few weeks longer in the case of a C-section), and your care provider has cleared you for activity. We now enter the six-week to four-month period of recovery.
This period is critical to your post-baby core health. I encourage my students to approach this stage with care and caution.
Elevated hormone levels and muscular imbalances from pregnancy leave your body, particularly your core, in a compromised state. And doing too much too soon can lead to postpartum issues like diastasis, prolapse, and hernias.
This is especially true for a woman who was active during her pregnancy. Her arms and legs are strong. She feels like she can do everything. But her core is weak and cannot support that effort.
My recommendations for this period include:
Continue working on the basics.
Engage your deep core muscles regularly and get the breath down. Pregnancy alters the core muscles and breathing system and it takes time to get them working well again!
Add in activities that rebalance your post-baby musculature.
Rebuild mobility in the mid-back. When your back and chest are tight, simple activities, like reaching or lifting, strain an already weak core.
Balance the muscles of the hips. By rebalancing the muscles of the hips, you create a healthier pelvic floor.
In the next few weeks, I’ll be sharing some of my favorite yoga postures for this critical postpartum period. Stay tuned!
High-intensity impact activities. No running, burpees, HIIT, Crossfit. These activities put excessive demand and load on your core and it’s not ready for that yet!
Front-loading ab activities. Planks, crunches and all the ‘typical’ ab exercises will do more harm than good.
Excessive back bending postures and deep twist positions like you find in many yoga classes.
Remember, this is a critical period for your body and recovery. You have the chance to create a solid foundation that will allow you to begin incorporating more intense activities in the near future. If you overexert yourself during this period you could end up weaker at six-months postpartum than you were at six-weeks.
4-Months Postpartum and Beyond
Recommendations become less cut and dry after 4 months.
Some who’ve spent the first 4 months building the foundation can safely introduce high-intensity activity at this point.
Others would benefit from continuing with lower-intensity activities for longer. This would include anyone who falls into the following categories:
Breastfeeding extends the critical period for your body. The hormones associated with breastfeeding create laxity in your ligaments. In other words, they make you loosey-goosey and create instability in your body. If you are an extended breastfeeder (like I was!) you should approach high-intensity activities with caution until you finish nursing or are down to 2 or 3 feedings a day. After that, the hormones shift and allow more stability in your ligaments.
If you tend to be a very flexible person, you are likely genetically predisposed to instability. You’re super flexible because your joints are looser. If this is the case for you, you also want to be more conservative in your post-baby movement. You would benefit from giving your body more time to rebuild core stability.
Family History of Postpartum Issues:
If you have a family history of things like hernias or prolapses it likely means you are genetically predisposed to these issues. Again, this is an indication that you may want to give your body more time to build a foundation of stability and strength before jumping into high-intensity activities.
How to Begin Increasing Intensity of Your Exercise
You’re done nursing (or are down to 1-2 times a day), you’ve mastered deep breathing, and have a solid connection to your deep core muscles.
Awesome! Let’s increase that intensity!
Here’s how to do it in a mindful, core-safe way.
Start With Lower Intensity.
Your body has gone through a huge transition and you should not jump into any activity at your pre-pregnancy intensity. Start at 50% of your “usual” and see how it feels. If you feel back pain, hip pain, if you leak, or feel like your core isn’t supporting you, those are all signs that you are working beyond your ability.
Short Intervals Are Best.
If you’re getting back to running, don’t start by heading out and knocking out two miles. Instead, try five minutes and then check in. If you’re doing a yoga class, take a break every 5-10 minutes and see how everything is feeling.
Again….Does your back hurt? Do your hips hurt? Did you leak any urine? Do you feel unsupported in your core?
If you answer yes to any of those questions, your body hit its limit. You’ll want to move to even shorter intervals and spend more time building that foundation.
If, after five minutes, you are feeling good and aren’t having any of those symptoms. Awesome! Next time, try 7 minutes and see how that goes. You want to build your intervals slowly.
Check In Frequently!
It’s likely there will be a point at which you will reach the limit of what your body can do in a strong, safe way. And once you hit that limit, stop! That’s your limit, but just for now. You build from there.
Remember: Start back to your activity of choice with less intensity, shorter durations, and continual check-ins with yourself. The moment you see any signs of disfunction, back off or stop. From there, we continue to build! By respecting your body’s limits rather than pushing through them, you give your core the chance to rebuild it’s pre-baby strength.
Hi There. I'm Catherine Middlebrooks, a yoga instructor and postpartum corrective exercise specialist.
I'm on a mission to help moms reclaim their core and pelvic floor strength so they can get back to the activities they love.