Regaining Form and Function After Childbirth

Things to consider to regain your shape after giving birth

What is normal trunk movement and what is not normal? Here's how to know if you need help.

Now that you have had your baby, you may have planned on regaining your shape and returning to "normal." If you have had a vaginal or a Caesarean birth, your abdominal and pelvic floor muscles have been stretched or possibly damaged. It is very important to get them working properly again.

You may find that some of the exercises you do may create back pain or difficulty controlling urine or stool, or dropping of the uterus and other pelvic organs. It is important to know when and how
this happens. By knowing what is normal posture and movement, you can prevent your risk of injury and prevent further problems. A physical therapist can help guide you through this important time in your life.



What is normal muscle movement?

0-8 weeks after pregnancy and delivery:

  • You may feel like your bottom is falling out and not know how you should be standing or sitting.
  • You may experience pain in your back, hips or pubic area.
  • You may have difficulty controlling urine, gas or stools.
  • Your neck, arms and hips may be sore as you adjust to lifting and feeding your baby.

Things to work on as you heal

  • Don't slouch when sitting, standing, nursing or carrying your baby. Work on upright posture during these activities to prevent increased back pain while developing good habits.
  • Begin gentle pelvic floor contractions and
    deep abdominal tightening. Your pain should not increase, but you may feel sore back muscles in the next 1-2 days, which is normal. Hold each contraction 5 seconds; work toward a 10-second contraction as you get stronger.
  • Work on stretching the back, buttocks, legs and shoulders, which will relieve soreness.
  • REMEMBER TO REST! This is very important as your body is continuing to heal.
  • Proper breathing- when holding belly in, inhale while letting the chest expand, then exhale, pulling your belly in tighter.

8+ weeks after pregnancy and delivery

  • Your bleeding has stopped, and by this time
    your incisions and tears have healed.
  • Control of your bladder and bowel movements is returning.
  • You should be pain-free.
  • You should be returning to exercises/practice, but before you do, read this symptom checklist:

What is NOT Normal? CHECKLIST

√ Continuing back, pelvis, groin or abdominal pain
Leaking urine, gas or stool when laughing, coughing,
   jumping, sneezing or running
√ Leaking urine or stool when you have a strong urge
    to go
√ Pressure or bulging in the vagina or rectrum
√ Bulging of your abdomen during ANY exercise
Difficulty doing any of your every


  • Consult your physician about a referral to physical therapy.
  • In the meantime, do not do sit-ups or any
    other form of core strengthening. Your core muscles (deep abdominal and pelvic floor muscles) need to be specifically trained before they can be strengthened.
None of the symptoms on the checklist are normal, and they will not go away on their own.

How do you know if you are ready to begin an exercise program without risk of injury?

  1. Curl-up Test - Lie on the floor with your knees bent, then slowly lift your head and shoulders up off the floor, keeping your chin tucked.

  2. Leg Lift Test - Lie on your back with your legs straight and lift one leg up off the ground about 2 inches.

    Not Normal

During each test as pictured to the left:

  • Do you have back pain or pubic pain?
  • Is there a separation in your abdominal
    muscles when lying on your back?
  • Do you have bulging in your abdominals as pictured?

Feel your pelvic floor (the opening of the vagina), with these exercises as pictured; is
there a descent or a bulging out?

If any of the above occurs, it is important to discuss these findings with your physician for a referral to physical therapy. 

Your physical therapist will provide an assessment and work toward a treatment program with education, manual therapy and exercise instruction. After treatment, your physical therapist can advise you in returning to a regular exercise program.



Indian Path Medical Center
2204 Pavilion Drive, Suite 114
Kingsport, TN 37660

Johnston Memorial Hospital
445 Portfiled Highway
Abingdon, VA 24210