Postnatal Exercise Class
This leaflet gives information about the postnatal exercise class run by the Pelvic
Health Physiotherapy service at St George’s Hospital. If you have any further
questions, please speak to the physiotherapist caring for you.
What is the postnatal exercise class?
The postnatal exercise class is a virtual exercise class for women who have
musculoskeletal pain, rectus abdominis diastasis (RAD) or pelvic floor muscle dysfunction
after having their baby. The class aims to:
• Assist you to have a supervised, controlled return to exercise
• improve your awareness and knowledge of postnatal symptoms and how to manage
them
• improve your core strength and control
• improve your mood and energy levels
• improve your confidence to do exercises at home.
Classes last for one hour and you will be booked into six weekly sessions. To get the most
out of them, you are expected to attend all six sessions. The class involves a variety of
exercises focusing on strengthening exercises and stretches.
• Please wear clothing in which you feel comfortable to exercise.
• Please have water available, an exercise mat if you have one and if you would like to
use weights but do not have any, then use tins / bottles as required.
Who can attend the service?
You can attend if your physiotherapist has enrolled you into this class to help you return to
exercising after having your baby.
What exercises should I do at home?
A selection of the class exercises is listed overleaf. You should only do these exercises
if you have been taught them by a physiotherapist or have attended the class.
It is important to carry out the exercises from the class at home at least twice each week to
get the most benefit. After completing the class, we encourage continuing with either some
of these exercises or engaging in a form of exercise you enjoy. If any of these exercises
cause any increase in pain or your continence symptoms do not settle, please consult your
physiotherapist so the exercises can be modified for you.
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The Pelvic Floor
The pelvic floor is a large group of muscles which forms a bowl shape from your pubic bone
at the front to your tail bone (coccyx) at the back. These muscles support your bladder,
uterus and bowel.
Pelvic floor muscles
It is extremely important to exercise your pelvic floor muscles (PFM) after your
pregnancy, to help prevent problems with urinary incontinence (leakage of urine), pelvic
organ prolapse, lower back and pelvic pain and to increase sensation during sex.
Pelvic floor muscle exercises
To exercise your pelvic floor muscles, slowly tighten the muscles around your anus and
vagina, lifting up and inwards as if trying not to pass wind and urine. Then fully relax the
muscles before repeating. Do this either while lying or sitting and progress to a standing
position. Avoid tightening your buttocks, squeezing your legs or holding your breath.
Do this three times a day in the following two patterns:
1) Hold for as long as you can up to 10 seconds, then fully relax, repeat up to 10 times or
until your muscles feel tired.
2) Imagine the muscles are a lift and lift as high as you can for about one second, then fully
relax. Repeat 20 times.
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You can find a video on female pelvic floor muscle exercises from the following QR code:
Class exercises
Warm up
March on spot (elbow to opposite knee)
Neck movements (left to right)
Heel raises
Bottom kicks
Shoulder rolls
Star jump step
Trunk rotation
Spinal roll down
Main Exercises
Repeat 8-15 reps x 3-5 sets of all the strengthening exercises. You can progress by
adding a weight.
Squat
Level 1 - body weight
Level 2 - both arms in the air as you squat down
Level 3 - holding a weight
Standing with your feet hip width apart, squat down as if you
are sitting onto a chair or as low as you feel comfortable, then
slowly stand back up tall again squeezing the bottom muscles
as you stand back up. Ensure you remain balanced. If you lose
your balance do not squat quite as low.
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Lunge
Level 1 - Body weight, arms as pictured
Level 2 - Arms in the air
Level 3 - Weighted
Take a large step forward with one leg.
Allow both legs and hips to bend, so that your knees are at 90
degrees, your back heel comes off the floor and the shin of
your front leg is vertical.
Pushing through your feet return up to the starting position and
repeat.
Make sure your knees travel directly always forwards over your
toes.
Side lying hip abduction
Level 1 - Body weight
Level 2 - Add an ankle weight or TheraBand for resistance
Lie on your side, making sure there is a straight line from your
head, through your trunk and down your legs.
Pull the toes up towards you.
Raise the top leg straight up, then slowly bring your leg back
down. Try to keep your pelvis still throughout this movement.
Clam shell exercises
Level 1 - Body weight
Level 2 - add an ankle weight or
resistance band
Lie on your side with your feet, ankles and
knees together.
Bend the legs a little and tighten your core
muscles.
Keeping the feet together, lift the top knee.
Make sure you don't roll your body back with the movement.
Control the movement as you bring the knee back down to the starting position.
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Bridge
Level 1 - Glute bridge as pictured
Level 2 - Glute bridge with both hands
pointing to the ceiling
Level 3 - Glute bridge with alternate leg
lifts.
Lie on your back and bend your knees.
Activate your pelvic floor and lower
abdominal muscles by gentle rolling
your lower back into the mat.
Lift your bottom and lower back off the mat starting with your bottom until you are resting on
your shoulder blades
Inhale and hold the shoulder bridge position.
Exhale, lower your body back onto the mat by beginning with the highest vertebrae of your
bridge and finishing with your tailbone, to return to the neutral position.
4-point Transverse abdominal activation with pelvic floor
contraction
Start in a kneeling position (as pictured)
with your hands under your shoulders and
knees under your hips.
Your back should be flat.
Contract your pelvic floor and lower
abdominal muscles, pulling the muscles
in towards your spine. You should feel
your abdominal wall lift.
Hold this position for as long as you can
up to 10 seconds, relax, and then repeat.
Ensure you do not hold your breath during the exercise, continue to breath normally whilst
holding the contraction.
Superman
Level 1 - arm lift only
Level 2 - Leg lift only
Level 3 - alternative arm and leg
simultaneously as described below
Start on your hands and knees, with
your hands under your shoulders and
knees under your hips.
Tighten the abdominal muscles.
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Extend the opposite leg and the opposite arm simultaneously, ensuring you maintain
control in your core.
Do not allow your body or hips to rotate.
Repeat on the other side.
Plank
Level One: Knee plank
Lie down on a mat on your front.
Lift your chest and hips up off the
floor using your forearms but
keeping your knees on the floor.
Keep your shoulders strong and do
not sink down at the hips or the
chest, your back should remain flat.
Hold for as long as you can.
Relax and return to the starting position.
Level Two: Full plank
Lie on your front with your toes on the
floor.
Place your forearms on the floor and
push up, lifting your trunk and legs.
Hold a straight line from your
shoulders to your feet for as long as
you can, try and stop your back from
arching by staying strong in your core.
Table-Tops
Level 1 - Crook lying table-top
Lie on your back and bring your legs up
to a table-top position with your hips and
knees at a right angle.
Relax your upper body and drop one bent
knee to the floor whilst maintaining the
table-top position with the other (as
pictured).
Bring this leg back up and repeat with the
other leg.
Ensure you keep your core strong and back flat on the floor throughout this exercise.
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Level 2 - Table top with straight leg
drop
Lie on your back and bring your legs up
to a table-top position with your hips
and knees at a right angle.
Relax your upper body as you extend
one leg down to the floor, whilst
maintaining the table-top position with
the other.
Bring this leg back up and repeat with
the other leg.
Ensure you keep your core strong and your back flattened to the floor throughout this
exercise.
If you find that your lower back is arching off the floor, go back to the level 1 exercise.
Cool Down
Child Pose
Start on your hands and knees and
drop your bottom into the back of
your heels (as pictured).
Reach your hands forwards, with
your head between your shoulders
facing the floor
You should feel this stretch through
your back and upper arms.
Hold this position for 30 seconds. Complete once or twice per day.
Cat Cow
Start on your hands and knees with your back in a neutral position.
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Start by arching your back upwards, tucking your head and tail bone in and pulling your
belly button in towards your spine
Hold this position.
Next, arch your back down and lift your head.
Hold this position and then repeat.
Hold each position for five seconds. Complete x 10 repeatss once or twice per day.
Glute Stretch
Lie on your back with your knees bent.
Cross one leg over your other knee,
placing the outside of your ankle just
above the knee.
Lifting the other foot up off the mat and
place your hands around the back of the
thigh (as pictured).
You should feel a stretch through your
buttock.
Hold for 30 seconds. Complete once or twice per day.
Hip Flexor Stretch
Kneel on the floor and place one foot in a large stride
in front of you.
Drop your hips forwards and keep your body straight
until you feel the stretch in the front of the hip of your
back leg.
Hold this position.
Hold for 30 seconds. Complete once or twice per
day.
Addendum
We hope these classes will help you feel stronger and more able to carry on exercising at
home. Joining a local exercise class will also help you to carry on improving your strength
and ability.
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Contact us
If you have any questions or concerns around postpartum exercise please contact Pelvic
Health Physiotherapy, on 020 8725 1333 (voicemail only) or email
[email protected]. Please leave a telephone message on the
number above and we will contact you as soon as we can.
For more information leaflets on conditions, procedures, treatments, and services
offered at our hospitals, please visit www.stgeorges.nhs.uk
Additional services
Patient Advice and Liaison Service (PALS)
PALS can offer you on-the-spot advice and information when you have comments or
concerns about our services or the care you have received. You can visit the PALS office
between 9.30am and 4.30pm, Monday to Friday in the main corridor between Grosvenor
and Lanesborough wings (near the lift foyer).
Tel: 020 8725 2453 Email: [email protected]
NHS Choices
NHS Choices provides online information and guidance on all aspects of health and
healthcare, to help you make decisions about your health.
Web: www.nhs.uk
NHS 111
You can call 111 when you need medical help fast but it’s not a 999 emergency. NHS 111
is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile
phones.
Tel: 111
AccessAble
You can download accessibility guides for all our services by searching ‘St George’s
Hospital’ on the AccessAble website (www.accessable.co.uk). The guides are designed to
ensure everyone – including those with accessibility needs – can access our hospital and
community sites with confidence.
Reference: PHY_PNE_03 Published: February 2023 Review date: February 2025
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