Exercise for Postpartum Back Pain at 3 Months
Start with a gradual aerobic exercise program of 150 minutes per week of moderate-intensity activity (such as walking 3000 steps/day in 30 minutes) combined with muscle strengthening exercises 2-3 days per week, specifically including abdominal crunch exercises and core stabilization work, as this approach reduces both pain intensity and disability in postpartum women with persistent back pain. 1, 2, 3
Aerobic Exercise Foundation
- Begin with walking as your primary aerobic activity, aiming for 3000 steps daily completed within 30 minutes, which can be structured throughout the day 1, 2
- Progress toward 150 minutes per week of moderate-intensity aerobic activity spread across most days of the week, preferably all days 1
- If previously inactive or experiencing significant fatigue, start conservatively at 45 minutes per week and gradually increase to the 150-minute target over several weeks 1, 2
- Any intensity of physical activity provides benefits, including light activity as a replacement for sedentary behavior, so avoid prolonged sitting periods 1, 2
Specific Strengthening Exercises for Back Pain
Abdominal crunch exercises produce superior results compared to other core exercises for reducing inter-recti distance and associated low back pain at 3 months postpartum. 3
- Perform abdominal crunch training 2-3 days per week, as this specific exercise protocol demonstrated a mean reduction of 1.95 cm in inter-recti distance and significant improvement in disability scores after 6 weeks 3
- Include core stabilization exercises targeting the transversus abdominis and multifidus muscles, which improve postural stability and increase trunk muscle activation 4
- Perform muscle strengthening exercises 2-3 days per week targeting all major muscle groups, not just the core 1, 2
Additional Exercise Components
- Add pelvic floor exercises (Kegels and pelvic movements) to your routine, as pelvic floor muscle training reduces urinary incontinence risk and improves overall pelvic function 2
- Include balance activities 2 times per week to support neuromuscular coordination 2
- Incorporate stretching exercises, as both lumbar stabilization and stretching protocols demonstrate comparable pain reduction (approximately 1.68 points on VAS) and improved balance after 6 weeks 4
Exercise Intensity and Progression
- Start with light to moderate intensity activities and gradually progress over weeks 1
- Avoid vigorous activity initially if you were previously inactive 1, 2
- The gradual progression approach is consistently recommended across international guidelines, with most emphasizing a slow build-up starting from your current fitness level 1
Breaking Up Sedentary Time
- Interrupt prolonged sitting every hour with at least 5 minutes of movement (standing, walking, stretching) 1, 2
- Limit consecutive sitting to less than 2 hours excluding sleep periods 1, 2
- Replace sedentary screen time with physical activity of any intensity, as this provides measurable health benefits 1
Important Clinical Context
The evidence shows mixed results for exercise effectiveness at 3 months postpartum, with some studies demonstrating that specific stabilizing exercises alone may not be more effective than natural recovery. 5 However, the combination of aerobic activity with targeted abdominal strengthening (particularly abdominal crunches) shows the strongest evidence for pain reduction and functional improvement 3, 4.
- Movement-related daily activities are significantly more difficult when pain can be provoked in clinical tests of the lower back, making early identification and treatment crucial 6
- Both lumbar stabilization and stretching exercises reduce pain by similar amounts (approximately 4.81 points on McGill Pain Questionnaire), so either approach is reasonable if abdominal crunches are not tolerated 4
- The majority of women still experience some back pain almost one year after pregnancy regardless of intervention, so realistic expectations are important 5