The goal of this phase is rest and recovery with a gentle intro to intentional movement.
0-2 weeks: survival mode
- baby snuggles
- deep breaths
- standing up tall and upper body stretches (clasp hands behind back, doorway stretch) *be careful following c-section, you shouldn’t feel pain at the incision when you stretch the chest.
2-6 weeks: start intentional movement
- TA and pelvic floor breathing: inhale to relax, exhale to contract
- do stairs regularly
- take walks inside and outside, start with a small goal like 5 min and build up from there.
- resume household activities for vaginal birth. *limit weight lifted to no more than the weight of a baby during household activities following c-section.
- once bleeding stops start to add in gentle stretches and exercises that don’t increase the pressure in the abdomen (glute bridges, figure 4 stretch, hip hikes, clamshells)
**being postpartum is like starting to exercise for the first time all over again, BE PATIENT, go slow and ask for help!
Postpartum phase 2: 6-12 weeks
(or you’re postpartum by any # weeks > 6-12 and you never rehabbed anything.)
Maybe you’ve been working out and feel disconnected from your abs or body...this is the phase you should come back to.
This is your rehab phase where the goal is to slowly introduce more activity and movement to the body without overdoing it to cause strain or injury, but to gradually build your strength back up.
The key to this phase is you’ve stopped bleeding and you’re cleared for exercise. You should be looking for gradual progress: baby steps over big leaps. It takes 6 WEEKS of consistent exercise to strengthen muscle fibers so don’t expect things to happen overnight.
- do exercises that break down movements to strengthen the smaller supportive muscles (ex: strengthen hips, knees + core before returning to the running program you were doing pre-pregnancy)
- work to build endurance and stamina
- create balance in the body by stretching tight muscles and strengthening weak ones (ex: tight chest, weak upper back + tight hip flexors, weak glutes)
- normalize posture so the body can move and function how it was designed
Get a little uncomfortable to improve function:
1. Exercise: start or increase cardio + strength training. If you only do what is comfortable or feels easy you won’t make progress. Start small and increase only one of these things at a time; reps, sets, speed, duration.
2. Scar massage: massage you c-section scar once it’s fully healed. This never feels good at first so don’t wait for it to feel good to start! Releasing the tightness + sticky points will give you more feeling, better blood flow, more movement and decrease the look of skin hanging over the scar.
3. Sex: there’s a lot of factors that can lead to discomfort here; tearing, c-section scar, birth trauma, pelvic floor tightness, pelvic pain, anxieties. Have sex when you’re ready, 6 weeks is a guideline. Sex should feel less painful each time. ***If it doesn’t get better, please don’t wait for it to get better there are exercises, tools and people who specialize in helping you, so ask!
The goal of this phase is to continue challenging yourself to achieve recommended physical activity levels AKA return to exercise classes or normal exercise routine (...CAN be done sooner depending on ab strength and how you feel during exercise!) If you’ve put in the work to consistently build strength from 6-12 weeks, you’ll feel the strength that took the body 6 weeks to build, and you’re ready to progress exercise quicker than the last phase.
What to avoid: nothing (kind of!)
What to do:
Use this phase to build up to normal exercise levels:
CARDIO: 2.5 - 5 hours of moderate physical activity/week or 75 min of vigorous physical activity/week. (Moderate: walking, dancing, tennis, biking slowly Vigorous: running, hiking uphill, pushing a stroller, HIIT, stair master, elliptical)
STRENGTH: 2 days/week for 35-60 minutes.
**For endurance and a lean look: lift lighter weights and do more repetitions.
**For power and a built look: lift heavier weight and do fewer repetitions.
We need all of this for motherhood and life so do any combination that suits you!
This phase happens at different times for everyone with the 2 requirements being
1. your cycle restarted AND
2. you are done nursing: if you never nursed then you’re waiting for your cycle to restart and at least 12 weeks postpartum.
You’re waiting until you’re done nursing to enter this phase of exercise because the risk of dehydration is way less and you don’t need to worry about negatively effecting your supply. Your cycle is a good sign that your body has built nutrient levels back up and is healthy enough to have a cycle.
What’s different about this phase? You can push yourself to fatigue; challenge yourself past what you’ve been doing. Train for a race, add in plyometrics or speed work, lift heavier weights, do longer workouts and if you don’t want a rest day you don’t need to take one.
Your energy expenditure has gone way down now that you’re not nursing so adjust the food intake and start to balance back out to pre-pregnancy nutrition as you feel you can.
Friendly reminder to listen to your body, check in with soreness and pain, reassess the abs and tissue tension every so often as you progress your workouts.
**If you haven’t been slowly strengthening after baby - this isn’t your starting point - start at phase 2 and go through the phases to protect yourself from potential injury.
The SI joints are where the bones of the hip meet the lowest part of the spine. These joints need to move properly to be pain free. Too much or not enough movement makes them painful.
When pelvic alignment is off, and you have SI joint pain it’s recommended to see a chiropractor to normalize the movement in the SI joints. If you skip this step, the bones will continue to move too much or not enough and any strengthening you do will be reinforcing poor positioning and could cause more pain.
**Side note: if pelvic alignment is off and it’s NOT PAINFUL, I hesitate to correct alignment because it could cause pain by giving the bones too much movement. This is very case specific, but just want to put it in your head that having pelvic alignment that is off isn’t something that absolutely needs to be corrected.
Steps to help SI pain + alignment
1. See a chiropractor (one you know and love!)
2. Start doing the stretches shown 1-2 times per day. Repeat 2-3 times per side, holding 20-30 seconds.
3. Begin strengthening the core (diaphragmatic breathing with TA contraction, glute bridges, hip hikes + more!)
4. Use a pillow between the knees and/or under the belly while sleeping
5. Avoid movements that involve twisting or stepping on one leg if they are painful
**The top two stretches shown are safe for all of pregnancy, and the bottom two are only recommended until 20 weeks.
As always, contact me with questions or if you are unsure this is what is causing your pain.
I sprained my ankle freshman year of high school while playing basketball. I started physical therapy with the coolest PT, Megan at Advanced Physical Therapy, and she made PT a learning experience and a competition. I remember the exact moment I decided I was going to be a physical therapist in the middle of my exercises. Who wouldn’t want to wear Adidas pants and tennis shoes to work?!
From three years old through high school, I ran track, played volleyball, softball, soccer and basketball, I figure skated and danced. I gave up team sports in college, but the athletic mindset of being active and working out for physical and mental well-being continued. I’ve never been very good at sitting still so being a physical therapist seemed like the perfect way for me to combine my love of movement, science and sports. No chance I was sitting at a desk, so this made perfect sense.
On my senior spring break cruise I contracted a parasite that made me so sick and weak that I had to postpone going to my first semester of college. In those months of being home and recovering [read: learning to eat again, psychiatrist appointments and battling anxiety] I started volunteering at a physical therapy office. I kept that job during the summers until I moved out of state for physical therapy school.
Physical Therapy school was no joke. Mix an already anxious person with way too much coffee and overwhelming schoolwork, and it ends in a mental breakdown. I managed my anxiety by giving up caffeine and decided to get a job to distract myself from the demands of school. Well, let me tell you-working at lululemon in Clarendon, VA was the best decision I could’ve made; distraction and friendships at it’s finest. I was on track in the best mental space I could ask for.
Jump through the years of 2011-2018, which were filled with graduation from physical therapy school, moving to Chicago, falling in love, moving home to Michigan, getting married, and having two amazing children and it’s the path that lead me to be an entrepreneur.
In June 2018 I quit what used to be “the perfect job”. I was working at a large physical therapy company with a group of orthopedic surgeons, who I have great respect for. I worked at the office for over five years, was clinic director and had a great rapport with patients. I loved it.
So what changed? I had my second child, in December of 2017. A few weeks after I returned to work, he decided he was no longer taking a bottle and preferred to only nurse. Cue the tears and the stress. I spent my days checking the daycare app to see if he magically drank his bottles, but he kept starving himself all day until I could nurse him. After many pediatrician appointments and more weight loss I knew what I needed to do.
I was devastated and relieved all at once. I knew deep down I wasn’t done being a physical therapist, but the challenge was to figure out how to make it all work. One day it clicked.
PhyAFit was born out of encouragement from my husband and the thoughts swimming around in my mind about how to make physical therapy more accessible for women’s health. I set out to be a resource for women during and after pregnancy as well as provide a modernized service for anyone needing physical therapy. It's been a great adventure so far and I'm excited to see where it goes.
THANK YOU FOR YOUR SUPPORT!
This pain is sharp and occurs in the center of your pelvis. It’s common for it to begin in the second trimester and unfortunately, it can continue after giving birth.
If you have this pain, you know there are certain movements that make it worse. The biggest modification is to avoid stretching or moving in positions that cause the legs to be stretched to far apart (wider than hip distance). This pulls on the already painful pubic symphysis and makes your pain worse by over-stretching the already irritated joint.
Here’s a few ways to change your movement to avoid irritating the pubic symphysis.
Walking - take shorter steps
Stairs - go up/down sideways
Putting on pants - sit down and put both feet in together
Rolling over in bed - keep the knees together while you roll
Getting out of the car - keep the knees together and rotate your body so your knees point out of the car before you reach to step out
So, why does this happen?
With pregnancy, there’s a surge of hormones that tell the body to relax the ligaments so the hips can expand for baby to grow. The pelvis supports the majority of our body weight and when the ligaments relax, we need to increase muscular strength to support our pelvis. If we don’t strengthen the muscles attaching to the pelvis during pregnancy, our bones can move too much and cause pain, which is what happens with pubic symphysis dysfunction.
Here’s a quick rundown of which muscle groups to strengthen to reduce your pain and stabilize the pelvis. Focus your strengthening on the abdominals, hip adductors (inner thighs), glutes, lats and deep back muscles. If you want to see a change in pain, you’ll have to address all of these muscle groups, and not just one. The pelvis needs support from all directions.
Here’s some exercise ideas to get you started.
Posterior pelvic tilts
Ball squeezes between your knees
Women do very well with consistent exercise and movement modifications during pregnancy and postpartum to control pubic symphysis dysfunction.
Do these exercises 2-3 times per week throughout pregnancy, the sooner you get started, the better! Set yourself up with a strong body that's ready for your baby's growth, don’t wait until you have pain , do what you can to prevent it!
If you're a pregnant or postpartum mama, or any woman with pelvic pain, schedule a free phone consultation! You know you need physical therapy and you tell yourself you'll do anything to make the pain go away, so here's your chance-give yourself the tools you need to be more comfortable, you deserve it!
for new moms who want to learn how to strengthen the core safely. This means I’m taking my physical therapy knowledge and breaking down everyday movements to smaller parts. The smaller parts train your body step by step so when you put the steps together for the full movement, you are strong at every joint that is working.
For example, if you want to do a squat a typical exercise class will have you squat right away. In a rehab-based class you will be taught to strengthen the glutes, hamstrings, quads, low back and abdominals before you squat, minimizing injury risk due to an area of weakness.
When it comes to re-training the core muscles after pregnancy this is the approach of hardCORE mother. The core is made up of the abdominals, low back and hip muscles. I will teach you to activate the deepest level of the abs (transverse abdominis or TA) and low back muscles while you are sitting still or lying down. Once you can properly engage the muscles in those positions, I will add arm or leg movements to train the core with gentle activity. In addition to training the muscles in a static (still) position I will also instruct you in dynamic (moving) activities. Gradually building core strength from the deepest level is the key to being hardCORE. You need to master each step along the way in order for your body to be ready to do traditional exercises.
Because the TA connects into the pelvic floor the core strengthening we do directly effects the health and strength of the pelvic floor. In addition to building core and pelvic floor strength, the exercises you’ll learn will correct posture after baby, reducing the larger low back curve that develops as baby grows throughout pregnancy.
Everything I instruct in hardCORE mother is a “sneaky” core exercise. I don’t instruct typical ab exercises because there are too many other ways to strengthen the core that doesn’t put stress and strain on the abs, low back or hips after they’ve been stressed for over 9 months during pregnancy. This is not a traditional workout class, this class builds your foundation for movement so you can eventually go to your favorite exercise classes without worrying about what’s safe or how to modify. You’ll have new knowledge of safe core exercises that you can switch out whenever needed. An added bonus for moms who want more babies – all the exercises you’ll learn are safe to do throughout pregnancy, will keep you strong and help with labor, delivery and recovery!
There’s nothing worse than being ready to exercise and hesitating because you don’t know what’s safe or right for you. Join hardCORE mother with confidence that you are healing your body by jump starting the connection to your core after baby!
Treatment is as on the go as you are.
Mobile physical therapy + wellness allows you to manage work, life and health and wellness without wasting time in the car or sacrificing precious before or after work hours.
We have freedom to treat patients more effectively and provide a better patient experience every time because YOU are the priority.
to stay healthy,
to improve wellness,
to recover from an injury,
to be more confident with exercise + activity
- OPTIONAL but recommended - so we know we’re the right person to help you, make sure it’s a good fit (do YOU like us??), get some questions answered before you start treatment
an hour long appointment where we screen and test to learn more about you,
we take the time to figure out exactly what you need,
develop an individualized plan,
and get you started with exercise.
we build a personalized exercise plan that changes often to give you the challenges you need, give you one-on-one private attention every session,
the location of your sessions can vary for your convenience, and you get a much better + more personal patient experience!!
At the initial evaluation we’ll give you a recommendation of a “treatment plan” = how many times/week and for how long.
This recommendation is based on our experience of what it takes to fully achieve your fitness or injury goals and gives you a timeline or roadmap of where we're headed and what's expected with treatment.
After each session your home exercise program (HEP) of videos and instructions is updated and sent to you to access by email or on your phone in the StriveHEP app. This helps you keep working on your own between sessions.