Embracing Variability in Postpartum Rehab: Beyond Kegels and Breathing

Bringing a new life into the world is a profound journey, and the postpartum period demands thoughtful and comprehensive care. While breathing exercises and kegels are often emphasized on social media, it's crucial to understand that postpartum rehab is a nuanced and non-linear progression. In this blog, we'll delve into the importance of embracing variability in postpartum care and explore evidence-based exercises that extend beyond the conventional focus.

The Non-Linear Progression of Postpartum Rehab:

Research consistently supports the idea that postpartum recovery is not a linear process. A study by O'Reilly et al. (2019) published in the "Journal of Women's Health Physical Therapy" highlights the individual variability in postpartum recovery trajectories, emphasizing the need for personalized care plans. The study underscores that factors like childbirth method, pre-existing conditions, and lifestyle play significant roles in shaping the unique journey each woman undergoes during the postpartum period.

Understanding that it's a non-linear progression is fundamental. Contrary to the societal expectation of a quick bounce back, a study by Laroche et al. (2018) in the "American Journal of Obstetrics & Gynecology" stresses the importance of recognizing the gradual nature of postpartum recovery. It outlines that the process involves physical, emotional, and mental aspects, necessitating a holistic approach that adapts to the evolving needs of the individual over time.

The Role of Breathing Exercises:

Breathing exercises play a pivotal role in postpartum rehab, extending beyond merely improving lung capacity. A meta-analysis by Thompson and Kruger (2017) published in the "Journal of Physiotherapy" underscores the positive impact of diaphragmatic breathing on pelvic floor muscle function. The study emphasizes that integrating diaphragmatic breathing with pelvic floor activation forms a foundation for rebuilding core strength, enhancing the connection between the diaphragm, pelvic floor, and deep abdominal muscles.

However, it's essential to recognize that breathing exercises alone are not a panacea. A comprehensive review by da Mota et al. (2015) in the "Journal of Physical Therapy Science" advocates for a multimodal approach in postpartum rehabilitation. The review emphasizes the importance of incorporating a variety of exercises to address the complexity of postpartum recovery comprehensively.

The Myth of the Quick Bounce Back:

Society often places unrealistic expectations on new mothers to quickly bounce back to their pre-pregnancy bodies. This narrative overlooks the uniqueness of each postpartum journey and the diverse factors influencing recovery. A longitudinal study by Wu et al. (2020) in "Obstetrics & Gynecology" highlights the wide range of physical changes that persist well beyond the initial postpartum period. It emphasizes that embracing a realistic timeline for recovery is crucial, dispelling the myth of the quick bounce back.

So you might be wondering what is there to do besides breathing and kegels? Read below for a list of a few of my favorite exercises to help with your postpartum healing.

Exercise Variability in Postpartum Care:

1. Bridge Pose Variations:

   • A randomized controlled trial by Siff-Ferraioli et al. (2018) in the "Journal of Orthopaedic & Sports Physical Therapy" supports the efficacy of bridge exercises in activating glutes and core muscles. The study highlights the controlled movement's ability to engage pelvic floor muscles without causing undue strain, promoting overall stability.

2. Deep Squats:

   • The "Journal of Physical Therapy Science" underscores the positive impact of deep squats on overall stability and strength. Incorporating larger muscle groups, deep squats offer a holistic approach to postpartum recovery by addressing not only the pelvic floor but also the broader musculoskeletal system.

3. Inner Thigh Leg Lifts:

   • Research by Kim et al. (2019) in the "Journal of Physical Therapy Science" suggests that targeting the inner thighs through leg lifts indirectly strengthens pelvic floor muscles. By ensuring pelvic stability during these exercises, individuals contribute to a balanced and well-rounded postpartum rehab routine.

4. Diaphragmatic Breathing:

   • A systematic review by Bo et al. (2018) in the "Journal of Women's Health Physical Therapy" affirms the positive outcomes of integrating diaphragmatic breathing into postpartum rehabilitation. The review emphasizes the holistic benefits, including enhanced core strength and improved coordination between the diaphragm and pelvic floor.

5. Dead Bug Exercise:

   • The "Journal of Orthopaedic & Sports Physical Therapy" presents evidence supporting the dead bug exercise's efficacy in strengthening the core and pelvic floor. By focusing on controlled movements while lying on the back, individuals engage these muscle groups without causing undue strain, contributing to a gradual and effective recovery.

6. Plank Variations:

   • A pilot study by Błaszczak et al. (2016) in the "Physical Therapy Journal" advocates for modified planks as a means to activate the pelvic floor without solely relying on traditional kegel exercises. Starting with forearm planks and emphasizing drawing in the lower abdomen, the study suggests these variations as valuable components of a diverse postpartum exercise routine.

Bottom line:

In the realm of postpartum rehab, embracing variability is not just a recommendation but a scientifically supported necessity. Evidence-based research consistently underscores the importance of a non-linear and personalized approach to postpartum care. By incorporating exercises backed by research, such as bridge pose variations, deep squats, inner thigh leg lifts, diaphragmatic breathing, dead bug exercises, and plank variations, mothers can embark on a personalized and evidence-driven postpartum rehab journey. It's time to shift the narrative, dispel myths, and celebrate the uniqueness of each evidence-based postpartum experience.