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Pelvic floor exercise programme

Post natal exercises

1. Pelvic floor activation

Imagine that you are trying to stop yourself from passing wind and at the same time trying to stop your flow of urine mid-stream. The feeling is one of 'squeeze and lift', closing and drawing up the back and the front passages.

It is important to do this without:

  • Pulling in your tummy
  • Squeezing your legs together
  • Tightening your buttocks
  • Holding your breath

In other words, only your pelvic floor muscles should be working. This is the 'secret exercise' that no one can see you performing. This is call pelvic floor contraction.

Make sure you read right through the programme before commencing the exercises.

First determine your 'starting block'. Tighten your pelvic floor muscles as described above. Hold tight for as many seconds as you can (up to a maximum of 10 seconds). Make a note of your 'starting block' times and repetitions as per the instructions below, so that you can refer back to them to check your progress.

a. How long can you hold the contraction?

Release the contraction and rest for 4 seconds. Repeat the tighten, hold, release, as many times as you (up to a maximum of 10 repititions).

b. How many times can you repeat the contraction?

This becomes your 'starting block' e.g 2 secs 4 reps

Repeat your starting block as many times as you can throughout the day .. Every hour if you can! As a result of this muscle training your pelvic floor will get stronger and your starting block will change. E.g. 4 secs 6 reps. This becomes your new starting block.

This programme builds up the endurance of the muscle group so that the muscles can work harder for longer. It is also important that these muscles are able to react quickly when, for example, you cough or sneeze.

c. How many quick contractions can you do?

Aim to increase this number (up to a maximum of 10).

Your exercise programme should consist of:

  • Endurance - slow controlled exercises ('starting block'), followed by:
  • Speed - short, quick exercises

That's the easy bit! The most difficult part of the programme is remembering to do the exercises! Here are some tricks to help trigger your memory:

  • Wear your watch on the wrong wrist
  • Put post it notes in places that will catch your eye, such as the fridge, kettle, telephone, steering wheel etc.
  • Exercise after you have emptied your bladder

For an occasional check to see how strong the muscles are becoming try halting the flow of urine in mid-stream (but not if you have a urinary tract infection). It may take 3-6 months to achieve good results, but persevere, it will be worth it.

2. Rectus abdominus

Lie on your back with your knees bent. Place a sheet around your waist, crossed as if tying a knot.

Raise your head only with chin towards chest, whilst pulling sheet up and out at a 45??? angle. Hold for a count of 5 seconds, exhaling during the count.

Repeat 10-30 times per session, two sessions per day. This exercise helps to pull the rectus abdominus (superficial abdominal muscles) back together in the case of diastisis.

3. Obliques

Bent knee fall out

Lie on your back with your knees bent and hip width apart, arms down by your side palms to floor.

Slowly allow one knee to fall out to the side whilst keeping the pelvis level (try and keep the hip of the static leg pressed down in to the floor to avoid twisting). Only let the knee fall as far as you can without the pelvis moving. The aim is to control the movement slowly rather than get your knee to the floor.

Standing diagonal arms with or without theraband

Stand with your feet shoulder width apart, knees slightly bent. Place a theraband under one foot and hold with the opposite hand so that there is no tension in the theraband when you arm is down in front of you.

If it feels too much using the theraband you can start the exercise without it and just move your arm.

Slowly raise your arm up and out diagonally, feeling the resistance of the band, but keeping your pelvis level and without twisting your body.

Repeat 10 times each side x 3 sets.

You can vary this exercise by adding a small squat as you lower your arm, pushing up through your legs and gluteals as you return to standing as you stretch the band. Make sure you keep your knee over your middle toes as you squat.

4. Knee rolls

This gentle exercise helps to ease tension in the lower back and reduce stiffness.

Lie on your back with your knees bent, feet flat on the floor and arms down by your side, palms facing down. Keep your knees together and slowly let them roll down to the floor on one side only going as far as comfortable. Bring the knees back to centre and slowly roll to the other side. Repeat 10 times.

Variation: bring arms out to your sides at 90??? and turn your head to the opposite side from your knees.

5. Thoracic extension with towel or foam roller

All of the activities that involve looking after your newborn baby (breastfeeding, carrying, changing) involve forward bending, and tend to put a lot of stress through your upper back, neck and shoulders. Therefore it is important to stretch in the opposite direction to release these structures and relieve the tension.

You can perform this exercise either lying on a foam roller as per the picture, or on a rolled up towel placed lengthways down your spine and with a pillow to support your head.

Lie on your back with your knees bent, feet flat on the floor and arms down by your side, palms facing down. Keep your pelvis in a neutral position so that your back is not flat against the roller or floor, but has a slight curve. Your chin should be tucked towards your chest to keep your neck long and relaxed. Lie for 5-10 minutes thinking about opening through the front of your chest and letting your shoulders relax towards the floor. Please contact us to book an appointment or for more information on any of the services available at our clinic in Kensington.

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