Why These Exercises Help
Pregnancy causes predictable changes to the abdominal muscles, pelvic floor, ligaments, and posture that do not automatically reverse after delivery. The rectus abdominis muscles are stretched apart (diastasis recti), the pelvic floor is stretched and potentially damaged, and the ligaments remain lax for up to 3–6 months postnatally due to the hormone relaxin. Returning to exercise too quickly or inappropriately can worsen diastasis, cause pelvic organ prolapse, or lead to persistent back pain. These graded exercises rebuild foundational strength safely and prepare the body for more demanding activity progressively.
6 Safe Postpartum Exercises
1. Diaphragmatic Breathing with Pelvic Floor Activation (Days 1+)
Sets/Reps: 3 sets × 10 slow breaths, multiple times daily | Difficulty: Beginner
How to do it: Lie on your back or side. Breathe in slowly through the nose, allowing the belly to rise and the pelvic floor to gently lower. On the exhale, allow the pelvic floor to naturally lift and recoil. Once comfortable, gently enhance the pelvic floor lift on exhalation without bearing down. This can be started within 24 hours of delivery for vaginal births and is often the first exercise recommended after caesarean.
Physiotherapy tip from Dr. Vaishali Suri: This is the most important exercise in the entire postnatal period. It reactivates the deep core system, reduces postnatal oedema through the pumping action of the diaphragm and pelvic floor, and begins the process of healing the stretched tissues — all without any risk of harm.
2. Pelvic Floor Contractions (Week 1+)
Sets/Reps: 3 sets × 10 repetitions (3–5 second holds), twice daily | Difficulty: Beginner
How to do it: In a comfortable lying or sitting position, gently draw the pelvic floor muscles inward and upward. Hold for 3–5 seconds, breathing normally. Fully release and rest for 10 seconds. Start very gently — you may feel very little contraction initially, especially after vaginal delivery. Any contraction is beneficial, however small. Gradually increase the hold time toward 10 seconds over 6 weeks.
Physiotherapy tip from Dr. Vaishali Suri: Many new mothers feel embarrassed that they can barely feel their pelvic floor contracting. This is completely normal after delivery. The nerve supply to the pelvic floor can be temporarily disrupted during delivery, and gentle daily stimulation promotes nerve regeneration. Persist even when contractions feel very weak.
3. Heel Slides (Week 2+)
Sets/Reps: 3 sets × 10 reps per side | Difficulty: Beginner
How to do it: Lie on your back with knees bent. Gently activate your pelvic floor and draw the lower belly inward. Slowly slide one heel along the floor, extending the knee until the leg is straight. Pause, then draw the heel back. The lower back must not arch during this movement. Begin with one leg, progressing to alternating legs as control improves.
Physiotherapy tip from Dr. Vaishali Suri: Heel slides begin rebuilding core control with minimal load on the abdominal muscles. They are particularly important for women with diastasis recti because they engage the transversus abdominis without the abdominal doming that sit-ups and crunches produce.
4. Glute Bridge (Week 4–6+, after GP clearance)
Sets/Reps: 3 sets × 15 reps | Difficulty: Beginner
How to do it: Lie on your back with knees bent. Activate the pelvic floor and gently brace the core. Press through heels and squeeze glutes to lift hips. Hold 3 seconds at the top, squeezing the glutes firmly. Lower slowly. For caesarean deliveries, ensure the scar area is comfortable with hip extension before beginning — typically 6–8 weeks postnatally.
Physiotherapy tip from Dr. Vaishali Suri: The Glute Bridge is one of the best early postnatal exercises because it rebuilds the gluteal strength that protects the lower back during lifting, standing, and carrying a baby — activities new mothers perform hundreds of times daily. It also does not stress the abdominal wall.
5. Clamshell (Week 4–6+)
Sets/Reps: 3 sets × 20 reps per side | Difficulty: Beginner
How to do it: Lie on your side with hips and knees bent to 45 degrees. Keep the pelvis completely still and open the top knee upward, feeling the contraction in the outer buttock. Hold 2 seconds at top, lower slowly. This restores gluteus medius strength, which is weakened during pregnancy due to altered gait and postural changes.
Physiotherapy tip from Dr. Vaishali Suri: Pelvic girdle pain is extremely common after delivery and is often related to gluteus medius weakness combined with ligamentous laxity. The clamshell exercise directly addresses this combination and is central to resolving postnatal pelvic girdle pain.
6. Walking Programme (Week 6+)
Sets/Reps: Start at 10 minutes, add 5 minutes per week | Difficulty: Beginner
How to do it: Begin with a flat, comfortable 10-minute walk at a conversational pace. Wear supportive footwear. Increase by 5 minutes each week as tolerated. Monitor for any pelvic heaviness, leakage, or lower back pain during or after walking. If symptoms occur, reduce duration and seek physiotherapy assessment before progressing further.
Physiotherapy tip from Dr. Vaishali Suri: Walking is the most important cardiovascular exercise in the early postnatal period. Do not be tempted to begin running, classes, or gym work until you have completed an 8-week walking progression and have been assessed for pelvic floor and core readiness. Running places 2.5 times body weight through the pelvic floor with every step.
Safety Precautions
- Stop if any exercise causes increased bleeding, pelvic heaviness, leakage, or pelvic pain.
- Avoid sit-ups, crunches, double-leg lifts, and planks until diastasis recti has been assessed and treated by a physiotherapist.
- Do not return to running, jumping, or high-impact exercise before 12 weeks postnatally and only after pelvic floor clearance from a physiotherapist.
- Complement home exercises with professional postnatal physiotherapy for a formal postnatal assessment.
When to See a Physiotherapist
A postnatal physiotherapy assessment at 6–8 weeks after delivery is recommended for all women, whether vaginal or caesarean delivery. Dr. Vaishali Suri at Realign Rehab Clinic, NIT-5 Faridabad provides comprehensive postnatal assessments including diastasis recti screening, pelvic floor testing, and exercise prescription for return to sport. Call +91 9818185589.
FAQ
How often should I do these exercises?
Pelvic floor contractions and diaphragmatic breathing should be performed multiple times daily from day one. Other exercises should be performed once daily, 5 days per week, progressing as strength and comfort allow.
Can I do these exercises after a caesarean section?
Yes, with modifications. Breathing and pelvic floor exercises can start within 24 hours. Heel slides and walking can begin within 1–2 weeks. Glute bridges and more challenging exercises should wait until the scar is comfortable, typically 6–8 weeks. Always follow your obstetric team's guidance alongside physiotherapy advice.
How long before results?
Pelvic floor strength begins improving within 2–4 weeks of consistent twice-daily exercises. Core and functional strength rebuild over 8–12 weeks. Combine home exercises with physiotherapy at Realign Rehab Clinic Faridabad — +91 9818185589.