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The Functional Core In The Postpartum Body

Updated: May 13

As a pelvic health PT, I often refer to the diaphragm, core, and pelvic floor as the “functional core.” These three systems work together with every breath and movement we make to sustain pressure management and optimal movement. Although the functional core is important in everyone’s body, it becomes even more important during pregnancy and postpartum.

In this clinic, I often see new mamas struggling to understand the aftermath of pregnancy. It’s hard to wrap their minds around how even a healthy pregnancy could lead to physical dysfunction after the fact. In this post, we’re going to look at the anatomy of our core, common dysfunctions, and what can be done.

Postpartum Functional Anatomy

Just as we address the diaphragm, pelvic floor, and core as the functional core, the same can be addressed as our “functional anatomy.” This is true because as mentioned before, these three structures play a vital role in every movement we make and work together to ensure optimal function.

Another term that is often used is the “abdominal canister.” A visual of this canister includes the diaphragm at the top, the core in the middle, and the pelvic floor at the bottom. The core in the middle is made up of various abdominal muscles including the transverse abdominus, obliques, and others. Learn more about the deep core muscles in the blog post here.

Postpartum Dysfunctions

Diving into some of the dysfunctions I commonly see in postpartum women, the first thing I notice besides their breath pattern is their posture. Most, if not all of us, sit and stand in a forward head posture. This can be exacerbated postpartum with the tasks mom completes regularly while taking care of her newborn.

To think about it logically, if our posture is out of whack, it’s safe to say that the functional core is not going to be in the optimal position to function properly. Posture deficits, and thus core dysfunction can lead to issues like headaches, neck pain, low back pain, diastasis recti, and others.

Lastly, labor and delivery can lead to soft tissue injury of the pelvic floor and core. It’s essential that we restore optimal posture to help the postpartum recovery process along its path to healing.

Breath Work as the Foundation

A foundational piece to our functional core working together is learning proper breath patterns. During inhalation, the functional core moves down, lengthening the pelvic floor and shortening the diaphragm. During a good inhale, we should also see mild expansion in the chest and outward movement of the ribs. Inhalation supports the “fight or flight” response in our bodies - the shallower we breathe, the more anxious or on “high alert” we feel.

During exhale, the diaphragm and pelvic floor move upward, the diaphragm lengthening and the pelvic floor shortening. The “rest and digest” response of our bodies is supported by exhalation, helping us to feel relaxed and in control of our bodies.

Practicing proper breath work ensures full mobility of the diaphragm and pelvic floor, promoting optimal function of each. To learn more about the benefits of breath work, read the blog post here.

Exhalation Methods for Treatment

As mentioned before, the exhalation of our breath pattern is essential for the “rest and digest” response within our bodies. There are different ways that we can use exhalation to benefit us in the postpartum phase.

The first method I like to use is called “passive exhale.” I encourage the client to take a deep and slow inhale but then allow a slow flowing exhale - preferably 6 seconds in and 6 seconds out. The second method is what I call the “forced exhale.” This type of exhale can help to engage or emphasize core bracing. This exhale can be used to help the client connect properly with their diaphragm and pelvic floor.

Forced exhalation can also be beneficial movement training to practice in the postpartum phase when performing exerting tasks such as lifting car seats, climbing stairs, carrying groceries, or getting in and out of bed. This ensures proper activation of the core and less reliance on low back muscles for completing these tasks.

Moving Toward Healing

Now that we’ve discussed the anatomy, common dysfunctions, and foundational concepts to address for postpartum healing, let’s discuss some key takeaways. First and foremost, as a postpartum mom, it is essential that optimal posture and breath patterns are achieved to move healing in the right direction. 

In the clinic, your pelvic health physical therapist should be assessing these things, including how they tie into the symptoms you are experiencing or the pain you are having. Postpartum recovery can be tough, but with the proper guidance and support from an experienced pelvic health professional, you can be sure that you’re on the path to healing.

If you haven’t booked an appointment with your local pelvic health professional during the postpartum phase, I would encourage you to do so. In the meantime, check out the blog post here where you can follow along with 4 simple movements to get you started on your path to postpartum recovery.

Interested in learning more about this topic or have questions? Feel free to reach out to us at 502-939-8564 or request a consultation here.

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