If you scroll through Instagram or Facebook, you are bound to see lists and reels of people demonstrating exercises that are good for your core and pelvic floor and ones you should avoid at all costs. These posts are rooted in fear, full of telling people what they can and cannot do, at the risk of damaging their muscles beyond repair forever.
And I want you to ignore every single one of them.
Blanket statements of “always good” and “ always bad”, are rarely correct in the rehabilitation and exercise world. Everyone comes into pregnancy and postpartum with different goals, training history, type of exercise they enjoy, prior injuries or pain, and varying levels of hydration, sleep and adequate nutrition day to day. Because of this, we cannot apply a one size fits all approach to core and pelvic floor exercise.
Most of the fear-based conversations around exercise and the core and pelvic floor are in regards to worsening a diastasis recti (separation at the abdominal muscles that occurs in everyone by the third trimester of pregnancy), bladder leakage, or prolapse (vaginal heaviness). All of these problems have to do with managing pressure within the “canister” that is the diaphragm (breathing muscle at the bottom of the rib cage), pelvic floor muscles and back/abdominal muscles. If diastasis, bladder leakage or prolapse feel as though they are worsening during exercises, it means the muscles of the canister are having trouble managing that added pressure from the exercise. Learning proper breathing mechanics and bracing techniques can help to manage this pressure.
So what is a brace? In the lifting world, bracing is often taught as a pushing out at the abdominals and down into the pelvic floor while holding your breath. You can see how this type of brace increases the pressure in our “canister” and may not be ideal for someone who is having dysfunction of the abdomen or pelvic floor. Something you can try instead is exhaling through a difficult movement when you often see coning at a diastasis, feel the onset of bladder leakage or feel a heaviness or bulging at your pelvic floor. A common example of this is coming up from a squat or deadlift position (think picking something up off the floor). The exhale will take the pressure off those structures, allowing the muscles of the canister a better chance at managing the pressure of the activity.
Above all else, remember that being strong is one of the best things you can do for your body across all life phases. Don’t let people scare you away from exercise or lifting weights. If you are interested in being evaluated and learning more about your specific situation, reach out to schedule a consultation.
Dr. Jaclyn McCullough, PT
Physical Therapist
