Rebuilding core strength after pregnancy: Why muscle recovery matters

As part of a broader postpartum recovery plan, Emsculpt Neo may help strengthen abdominal muscles while reducing localised fat.

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After giving birth to her first child, Joan*, a Pilates instructor, noticed a persistent bulge and loose skin around her midsection that did not improve despite regular exercise.

“She became very self-conscious and started choosing exercise attire that concealed her tummy,” recounted Dr Ng Hong Yi, founder of Zion Aesthetic Clinic, where he oversees treatment planning and clinical protocols. He also trains medical professionals in selected aesthetic procedures, including dermal filler and collagen-stimulator injection techniques.

Loose skin and weakened core muscles are common after pregnancy. In some women, increased pressure during the third trimester may stretch and weaken the abdominal muscles, causing them to bulge.

Studies suggest that around 45 per cent of women still have some degree of abdominal muscle laxity six months after giving birth, while 33 per cent remain affected after a year.

GOING BEYOND FAT REDUCTION

Addressing postpartum abdominal changes may require more than fat reduction alone. Because these changes can involve the muscles, skin and fat, Dr Ng said the initial consultation should identify which areas need to be addressed.

He added that patient education and safety were important considerations during the consultation, with treatment options clearly explained and recommended based on each individual’s concerns and medical suitability. For Joan, he recommended Emsculpt Neo.

The non-invasive body-contouring treatment combines high-intensity focused electromagnetic energy (HIFEM+) with synchronised radiofrequency (Sync RF). According to the manufacturer, Emsculpt Neo is the only technology cleared by the United States Food and Drug Administration to combine both forms of energy for muscle strengthening and fat reduction. The clearance followed a review of safety and performance data for the device’s intended use.

HIFEM+ triggers repeated muscle contractions intended to stimulate muscle growth, while Sync RF raises tissue temperature in a controlled manner, increasing blood flow and heating fat cells, which are then broken down and eliminated naturally by the body. Both forms of energy are delivered simultaneously in a single treatment rather than through separate procedures, which Dr Ng said was key to its effectiveness.

A study cited by the manufacturer reported increases of about 25 per cent in abdominal muscle thickness and reductions of about 30 per cent in subcutaneous fat at three months. The study also reported an average reduction of 5.9cm in waist circumference.

Besides the abdomen, the technology can be applied to areas such as the buttocks, hamstrings, quadriceps, calves, biceps and triceps.

Dr Ng said the treatment may be suitable for women with postpartum abdominal laxity, people who are close to their ideal weight but have areas of fat that do not respond to diet and exercise, and those who prefer a non-surgical approach to body contouring.

“It can complement weight management efforts and is suitable for people with a body mass index of up to 35,” said Dr Ng. “It may also benefit those who have reached a fitness plateau or are unable to exercise while recovering from an injury.”

Depending on the patient’s medical assessment and concerns, the treatment plan may combine Emsculpt Neo with other procedures.

“In the first phase, we use high-intensity focused electromagnetic technology – such as Emsculpt Neo – to focus on strengthening the deeper abdominal muscles and improving core stability,” said Dr Ng.

For patients who also have concerns about loose skin or localised fat, a second phase may include radiofrequency-based skin-tightening treatments and cryolipolysis, a controlled-cooling procedure used to reduce localised fat.

Each Emsculpt Neo session takes about 30 minutes, and Dr Ng typically recommends up to six sessions. He said the short treatment time may suit mothers who find it difficult to set aside time for themselves.

A HOLISTIC APPROACH TO POSTPARTUM RECOVERY

Dr Ng emphasised that Emsculpt Neo is intended to complement, rather than replace, regular exercise and a balanced diet.

“Exercise supports overall health, metabolism and cardiovascular fitness, while diet plays a key role in weight management,” he said. “Emsculpt Neo may help improve body contouring in areas where diet and exercise alone do not produce the desired definition.”

Dr Ng said rebuilding core strength could also support stability, posture, movement and everyday function.

“Core strength can make everyday activities such as lifting your baby, carrying groceries or climbing stairs more manageable,” he said. “Maintaining muscle strength also supports mobility and independence as we age.”

For women beginning postpartum core recovery, Dr Ng recommends exercises that strengthen the core, such as Pilates, yoga, resistance-band exercises and training with machines or free weights.

“Set realistic expectations and understand that recovery looks different for every individual,” he said. “Recognise what your body has accomplished during pregnancy, be kind and patient with yourself, and allow yourself time to recover.”

If you are concerned about changes to your abdominal muscles after pregnancy, speak to a doctor to understand your options.

*The patient’s name has been changed to protect her privacy.