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Exercise Modifications for Pre and Post Natal Women

The top 3 Do’s and Dont’s of Abdominal Separation by Sarah Campbell as featured on PBC Parenting Insights

1/8/2018

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Do you have weakness in your abdominal muscles after having your baby? It may feel like a gap between your stomach muscles or look like a bulge in your stomach when getting out of bed. This is what we call Abdominal Separation or Diastasis Recti, and you’re not alone.


At least two thirds of women in their third trimester of pregnancy have separation (Pelvic Floor First Australia).


The downside is that it can stick around after having your baby, and there are definite Do’s and Don’ts when it comes to fixing it.

So why does it happen?

Separation is a weakening of the connective tissue between your abdominals (Hsia et al. 2000). It occurs when there is a prolonged increase in intra-abdominal pressure within your abdomen. This happens during pregnancy when the uterus puts pressure on the abdominals and pelvic floor muscles. The pregnancy hormone Relaxin is also partly responsible for separation as it makes muscles and ligaments stretchier in preparation for labour.

Did you know the greatest recovery period for separation is between one day and eight weeks post natal (Coldron et al. 2008). Another study suggests that the degree of abdominal separation can be greatly minimised by doing safe core exercises during pregnancy, and also after birth (Benjamin et al. 2014). So whether you are pregnant or have just had your baby, get proactive and know the Do’s and Don’ts…

The Top 3 Do’s of Abdominal Separation

At Mumma’s On The Move, we suggest…
1. Regular pelvic floor exercises throughout pregnancy and as a post natal- Research has shown pelvic floor strengthening can reduce strain on ones abdominals, decrease lower back pain and reduce the risk of incontinence and prolapse. Our favourite resource to learn more about the pelvic floor is The Continence Foundation of Australia, follow the link to watch a tutorial on how to engage these muscles properly. https://www.youtube.com/watch?v=e2xcgG2WAg0



2. Work your Transverse Abdominus, your deepest abdominal muscle. Think of this muscle as a corset that wraps around your waist. By focusing on these deep abdominal muscles, rathe than your outer six pack muscle, it equally distributes pressure within the abdomen, supports the spine, and minimises pelvic floor dysfunction.

Here’s a simple exercise you can do at home: kneel on all fours and relax your stomach completely. Whilst keeping a straight spine, think of scooping your lower belly in and up. If pregnant, imagine you’re giving you’re drawing your baby in for a hug with your stomach muscles. You should feel a drawing and lifting sensation.


3. Wear a gentle compression garment- Women’s Health Physiotherapist, Shira Kramer from Pelvic Floor First Australia advises wearing a gentle compression garment in combination with a tailored program to achieve optimal results.


The Top 3 Don’ts of Abdominal Separation:

During Mumma’s On The Move fitness classes, we recommend women stay clear of the following exercises.
  1. Take the focus off working your six pack muscles. Cease doing sit ups, crunches, planks, pushups on your toes, and any jack-knife motion.
  2. Minimise high impact activities such as burpees, running, sports that involve a lot of jumping, twisting
  3. Reduce any heavy lifting as this can put undue strain on your deep abdominals and pelvic floor. If you do weights, do not hold your breath, especially whilst lifting heavy weights over your head or from the ground.

Always seek help from a qualified health professional for the diagnosis and treatment of separation. Excellent resources include The Pelvic Floor First App, The Continence Foundation of Australia helpline 1300 330 066, or a qualified Womens Health Physio.

To find out more about how you can exercise safely with separation during pregnancy and beyond, register for your complimentary session of Mumma’s On The Move. Feel empowered with our pre and post natal fitness classes and regain your confidence with outdoor Mums and Bubs classes. Just go towww.mummasonthemove.com.au or talk to our friendly staff at the PBC expo.


References:
Benjamin, D.R., Van de Water, A.T.M., Peris, C.L (2014). Effects of exercise and diastasic of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Chartered Society of Physiotherapy, 100, 1-8
Coldron Y, Stokes M, Newham D, Cook K. Postpartum characteristics of rectus abdominis on ultrasound imaging. Man Ther 2008;13: 112–21.
Continence Foundation of Australia (2017), https://www.continence.org.au/pages/pelvic-floor-women.html
Hsia M, Jones S (2000). Natural resolution of rectus abdominis diastasis. Two single case studies. Australian Journal of Physiothery; 46:301–7.
Shira Kramer (2016). Re-thinking abdominal training in pregnant and post natal women. http://www.pelvicfloorfirst.org.au/pages/re-thinking-abdominal-training-in-pregnant-and-post-natal-women.html
Spitznagle T.M, Leong F.C, Van Dillen L.R., (2007). Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct, 3, 321-8.
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    Self confessed dog lover, foodie and adventure lover  with a passion for helping women exercise throughout their pregnancy and beyond!

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