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Pregnancy, Abdominals Muscles and, Diastasis Recti

January 29, 2020

 

 

Amy, our Head of Physiotherapy is an expert on Enritsch.com. Read her last blog about the Diastasis! 

 

https://www.enritsch.com/experts/Amy_Gilbert

 

 

Are you wondering if you should or shouldn't be training your abdominal muscles after having a baby?

 

Have you had

 

a baby and fed up with still having a ‘baby tummy’, a ‘pouch’ or just that feeling that your abdominals just aren’t getting stronger? You might feel you always look bloated, or even still about 4 months pregnant.

 

Or perhaps you are suffering with low back pain following pregnancy - have you had your abdominal muscles checked by a Women’s Health Physiotherapist?

 

This is a common feeling. 

 

So why does the tummy sometimes look different post nataly?

 

During pregnancy, as the baby grows, what many women don’t realise is that, to accommodate that growth, changes occur not only in the uterus and skin (stretch marks!), but all the way down to the abdominal muscles.

 

During the later stages of pregnancy, normally during the third trimester, your tummy needs to stretch and expand out further than the abdominal muscles allow. This expansion can only take place because of the linea alba. The linea alba is connective tissue that joins the two sides of your abdominals along the centre line. The linea alba accommodates for your growing baby by becoming lax. This amazing phenomenon allows your body to accommodate the growing baby beautifully. The only downside is that this laxity in the linea alba can cause a separation of the abdominal muscles, known as a ‘Diastasis Recti’.

 

What does a Diastasis Recti look like?

 

  • It may cause bulging along the centre line of the abdomen during movement whist pregnant or postpartum. A common time for bulging is when getting out of bed, getting up off the sofa, and picking up children. Have a look at your abdominal area whilst doing this and check to see if you notice a doming or bulging along the centre line.

  • Postpartum it may cause a ‘pouch’ or ‘post pregnancy tummy’

 

A Diastasis Recti does mean that you have lost some of the support network for your core muscles, your spine, and potentially affecting the pelvic floor and its support for the abdominal and pelvic organs. This decreased support can cause an increased risk of injury to your lower back, and pelvic floor disorders for example incontinence. Please note that when getting up off the sofa and in and out of bed, it is advised to roll onto your side, to avoid straining your abdominal muscles if they are not quite strong yet.

 

Diastasis is very common; roughly 2/3 of pregnant women suffer from it. A Women’s Health physiotherapist can check the depth and width of your diastasis recti, and establish if this is the cause of any pain you might be experiencing, incontinence or lack of participation in exercise that you love to do. The depth and width of a diastasis is a marker for deciding which exercises you should and shouldn’t be doing. Whether a diastasis is 6 fingers or 2 fingers wide there are still ways of exercising and gaining control. A common misconception is that, if you have a diastasis recti you cannot return to having a flat stomach. During and after pregnancy the transverse abdominus muscle commonly does not fire/activate. Re training the transverse abdominis muscle (lower tummy) after pregnancy is a key part of the rehabilitation process of a diastasis recti. It is true to say that a diastasis affects us both physically and aesthetically.

 

Can I, or shoulder I train my abdominal muscles after having a baby? 

 

This is a very common question we get asked by our post-partum mums. We often find that women are at two ends of the spectrum, fearful of training their abdominals and therefore haven’t done so since having their baby, to the opposite where they are desperate to get their ‘pre-baby tummy’ back and so started doing sit ups from week 6 postpartum. 

 

Unfortunately there is no clear cut answer with when you should start training the abdominals, but what is important is that you should be! When and how each person should begin training their abdominal muscles again depends on the type of delivery; vaginal or c-section, whether their pelvic floor is functioning well, whether they have a diastasis recti, their exercise history, the presence of back or pelvic pain and more. The myth surrounding; diastasis and no abdominal workouts is slowly fading and being replaced by controlled loading of the abdominals, the reason for this is that the core is central to our support system and must be re-trained post pregnancy. 

 

Good news!

 

You should be training your abdominal muscles postpartum, and there are many exercises that can be done to help build the strength back in the linea alba and abdominals. It is important to get your tummy muscles checked and be guided by a Women’s Health Physiotherapist post partum, as there are many core exercises that may be too advanced. Postpartum rehabilitation of a diastasis recti is not a ‘one size fits all’ approach.  

 

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