The 4 Pillars to Postpartum Exercise | Tulsa Moms Network

Hi! My name is Keisha Gansen and I am a certified Pre and Postnatal Personal Trainer and the owner of Whole Mama Fitness. I live in Broken Arrow with my 2-year-old son Behrett and my husband Steve. We moved here from Denver, Colorado a year and a half ago to be closer to family and because the living in Colorado is not cheap, ya’ll.

A quick back story on why I became a personal trainer:
Before I got pregnant, I was in the best shape of my life and kept exercising to some degree through my whole pregnancy. My son came fast and furious on October 31st, 2017 and afterwards I learned that I had suffered an injury during pregnancy or birth — a severe 4-finger Diastasis. Diastasis is when your ab muscles separate and do not heal on their own. I was shocked that this had happened to me, and I felt angry and afraid and very alone. For the next year I sought out several avenues to try to heal, most of which taught that there would be some things I would just never be able to do again and left me with the fear that surgery would be my only option for healing. Finally, I found a program that taught hope and healing and I began to heal myself. I knew that I didn’t want any other woman to have to feel the way I had felt. I wanted to be the person I wish I’d had both while I was pregnant, to teach me about deep core strengthening and proper exercise, and postpartum to help me heal with hope. So here I am, trying to bring both of those things to the moms of Tulsa and beyond.

First things first, let’s do a quick overview of what the core and pelvic floor are. Most of the time, we think of the core as our ab muscles; while they are definitely a part of our core, they are not all of it, or even the most important part of it. Our core is like a canister.

– The top is your diaphragm

– The bottom is your pelvic floor

– The front and sides are your abdominals

– The back is your back muscles.

Your pelvic floor is more than just the area around your urethra. It is actually a diamond shape that connects in the back on the tailbone, through the sides to your sitz bones and in the front to your pubic bone. It is a much larger area than most people realize.

There are other pieces to the puzzle and this is why just doing crunches or kegels is not going to fix your incontinence or give you a strong core.

Ok, now that we at least know what the core and pelvic floor are (there is SO much more to this topic and it is extremely important, you can find more conversations about this on my Instagram page — @wholemamafitness). Let’s talk about the 4 Pillars to Postnatal exercise:

  1. Progressive overload – This concept is pretty widely taught in the exercise world, but I feel like it can be forgotten for some reason when it comes to postpartum women. We are either told to act like we are broken and any wrong move could ruin us altogether, or we are told we are totally fine and to immediately go back to everything we once did before getting pregnant. Both of these are wrong and potentially damaging. If you have any sort of injury postpartum, it is not the end — you can more than likely get back to doing the things you loved. If you are told by your doctor after 6 weeks that you are completely healed and can return to doing all that you were doing and you jump in full steam ahead, this is not wise. Both of these scenarios can be remedied with progressive overload. Start small. Smaller than you think you should. Rehab first and then start progressing the weight or load or progressing the reps or sets, as long as you have no symptoms and it feels good. PROGRESSIVELY add on. This allows your body to heal and strengthen in a healthy way.
  2. Cueing – At the beginning, when you are recovering (or learning, if you are further out postpartum and just never knew about your core and pelvic floor), you will need to start by cueing your pelvic floor and core to engage with every rep. Engage and then move. You will want to think of your pelvic floor coming together and then lifting up, like your are lifting a marble all the way up to your head. Eventually your body will start doing on it’s own, but don’t be discouraged if it takes a while. Retraining your body and mind and reforming connections is not an overnight task.
  3. The 4 P’s – peeing, pain, pressure and peaking. These things should always be avoided or adjusted for in exercise. Peeing and pain are pretty self-explanatory, but lets talk for a minute about “pressure” and “peaking”. Pressure refers to any pressure felt in your pelvic floor, any heaviness or bulging feelings tells us there is something to take note of. Peaking refers to your core muscles; any doming or bulging in your core tells us your body is having a hard time managing pressure in your core. If you notice any of these things with an exercise, try the W-A-I-T method (explained below). Do not immediately give up or assume you cannot do that exercise anymore. Just try something different.
  4. W-A-I-T – if you are experiencing any of the 4 P’s try these:

– W – Whole Body: are you using your whole body or are you only using a small part of body? For example, in a push-up are you using your whole body or are you just focused on using your arms to push you away from the ground, forgetting to engage your core, pelvic floor, back and glutes. Try utilizing your whole body and see if your symptoms lessen or disappear.

– A – Alignment: In most cases, the most effective and safest alignment for our body to be in is head over ribs, ribs over hips. This is a “stacked” position and sets us up for the best leverage and pressure management in exercise. However, there are times when a slightly tucked pelvis or a slightly arched back may be a better choice for us, for that exercise. Try adjusting your alignment in the movement and see if that helps relieve the symptoms you were feeling.

– I – Inhales and exhales: just try breathing a different way. Earlier I talked about engaging your core and pelvic floor before each exercise. This engagement usually happens on the exhale of breath and is called “exhale on exertion”. You would then inhale “on your way back up” For example with a squat, you would inhale and lower down into your squat and then exhale and engage before pushing back up to standing. While this is the most common way to breathe and engage, it is not the only way. You can also try to exhale through the entire exercise. Using a squat again, this would look like exhaling at the top of the squat and continuing to exhale as you lower down and rise back up, saving your inhale for when you are finished and back to standing. Play around with your breath until you find what feels best and most supportive for your body

– T –Tension: this refers to the amount of effort you are using for a movement. The amount of effort used should match the exertion needed to perform the exercise. Over-engaging both your core and pelvic floor is not only unnecessary but it can also lead to its own set of problems. You do not need to be squeezing with all your might or engaging at a level 10 when you are doing a glute bridge for example. This movement (while it can be difficult) should only require a light connection through your core and pelvic floor and glutes. Resist the urge to go “all in” Try taking a breath, relaxing everything and trying again.

If you have tried all of these and you are still experiencing one of the four P’s, try modifying the exercise. Elevate it, lessen the range of motion or go slower.

Remember mamas — strengthening and healing our bodies as well as retraining our minds takes time. It took me over two years to get to a place I feel confident in most exercises and daily movements. Above all, give yourself so much grace and credit for what your body has done. You are a warrior and you’ve got this.

Light and love,
Whole Mama Fitness

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