One component of the six-week postpartum visit is the assessment of the rectus abdominis muscles. Separation of these muscles is normal during pregnancy as the muscles and connective tissue stretch and thin to accommodate your baby. It can take several months for these muscles to begin to heal and move closer together after giving birth. For some individuals, the separation can remain significant, a condition called diastasis recti. This condition can lead to a weak core, back pain, and a stubborn postpartum belly. Fortunately, diastasis recti can be greatly improved or healed all together with the slow implementation of certain core stabilizing exercises.
First, it is helpful to
check for the degree of muscle separation. Lying on your back, lift your head and shoulders slightly off of the floor (like doing a mini crunch) and push your fingers down into your belly button. If your fingers sink into your abdomen, you have a separation of your rectus abdominis muscles. You can then move your fingers above and below your belly button to feel the different degrees of separation in different areas. Becoming familiar with your degree of separation is helpful when beginning exercises in order to track your healing progress. Here is a demonstration on how to check for diastasis recti.
Before we talk about exercises we that should be doing to premote diastasis closure, lets quickly review what we shouldn’t be doing. Abdominal exercises like crunches, sit-ups and planks are counterproductive when dealing with diastasis recti and can, in fact, make the condition worse. Any exercises that cause the abdominal muscle to bulge away from the body (put your hand on your stomach while doing a crunch to feel it for yourself) put additional pressure on those already weak abdominal muscles. Planks force the abdominal muscles to support the internal organs, also increasing abdominal pressure and outward force. Once your diastasis is healed, these exercises can be added back into your routine, but it is important to avoid them while rebuilding your foundational core.
One of the first exercises to begin with after your 6-week postpartum visit is a simple breathing exercise that can help to isolate your core abdominal muscles. Lay on your back, knees bent, with the arch of your back pressed against the ground (you want a flat spine). Place your hand on your belly and take a deep breath, trying to expand your abdominal muscles to push your hand up and away from the floor. As you exhaled, contract your abdominal muscles and pull your belly button towards your spine. This “pulling your belly button towards the ground” action is the foundation for all of the other exercises to follow. You can do this simple exercise in repetitions of ten several times throughout the day until you feel that you have a good grasp on the technique.
Next add the “pelvic tilt” to your practice. Here, start in the same position on your back with your knees bent. This time curl your hips towards your ribcage while engaging your abs and pressing your lower back into the ground. This is a very subtle movement, which works both the core abdominal muscles and the pelvic floor muscles. Check this out for visual examples of the pelvic tilt.
As you progress in your strength and technique, you can add other exercises into your routine. Here is a great guide to 6 exercises for healing diastasis recti (some of which we already discussed above).
Lastly, here are some other gentle, beginning exercises to work with…
Ultimately, a physical therapist is going to be able to best asses your muscular weaknesses and tailor individual exercises. If you feel that you would benefit from professional physical therapy, please speak to your provider about a referral.
Here are a few physical therapy resources for the local Philadelphia, PA area (**note that we do not endorse any of these providers. This list is simply a place for you to start your own research).
Image Property of Fit2B https://fit2b.us/how-to-check-for-diastasis-hd/
We know how busy families are with life, children, and especially new babies. I am sure that you are laughing at the idea of exercising with a 6-week-old infant at home. Fortunately, these exercises are really quick and simple and can be broken up throughout the day or even integrated into floor play with little ones. The sooner that you implement gentle core exercise (after getting the go ahead from your provider of course), the better your body will heal. Even if you had your babies many years ago, it is never too late to strengthen these important abdominal muscles!
For those of you planning on having more babies, check out this post on healthy musculature/pelvic structure and their important role in optimal fetal position for delivery.
Next time we will address pelvic floor dysfunction and how to regain strength in your pelvic floor. To kegel or not to kegel? That is the question! Best wishes for your self care endeavors!
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