Happy Monday, Fit Mamas!
This past week a friend tagged me in a Facebook conversation about postpartum exercise. Some of her friends (whom I don’t know) were embarking on a 30-day ab challenge using a free app. Several of these postpartum moms were jumping on the virtual bandwagon. Fun and motivating, right? Well, yes and no. Yes, I am 100% in favor of getting a group together to cultivate commitment to a challenge! But with this challenge, something bothered me: I looked up the app they were going to use, and the image on the app is of a woman doing a full sit up. Noooooooo!
What’s wrong with that?
Diastasis Recti, that’s what.
Let me say that again. Diastasis Recti. I want every woman to know these two words.
Diastasis Recti, or DR, is a very common postpartum condition. Most women have this condition after pregnancy, but few know they have it and many walk around for years without knowing. Commonly women with a DR complain of lacking core strength, having back pain, leaking when they sneeze or jump, or having a loose, protruding tummy. Some have even had a hernia. Ouch!
Here’s how a DR happens:
Your outermost abdominals, the rectus abdominus, are held together by connective tissue or fascia called the Linea Alba. During the final months of pregnancy, this connective tissue stretches and the recti muscles naturally move to the sides of womens’ bodies, rather than holding their position front and center. Much like cellophane, the tissue holding these muscles together makes room for your baby to grow, creating a gap between the muscles. This divide, called the Diastasis Recti, or DR, is found in most women in the later part of the second or third trimester of pregnancy. Here are a few different variations of how a DR might look in a woman’s body.
After delivery, the recti muscles and connective tissues don’t automatically return to their pre-pregnancy position. Thin connective tissue does not support the back or the organs inside the abdomen well at all. For many of us, this causes poor posture and/or back pain and makes getting our abs back into shape extremely challenging. For others, digestive issues, pelvic floor weakness, and hernia may result. When women turn to abdominal workouts consisting of crunches and sit-ups, conditions in the abdomen worsen instead of getting better. For women with a Diastasis Recti, sit ups and crunches, bicycle crunches, and other common core strengtheners will not bring the abdominal muscles back together. In fact, these movements actually hinder recovery and can make matters worse. I know women who have been working their abs this way for years after their babies without the flat tummy results they are sweating for. How frustrating for them!
To avoid wasted effort that could make matters worse, it’s important to determine whether or not you have a Diastasis Recti, and to follow a safe program to correct the issue. The best way to know if you have this condition is to be checked and measured. Some birth professionals and physical therapists can check your abdominals, and I would be happy to measure you for a DR. Unfortunately not all birth professionals know enough about Diastasis Recti and how to measure for it. Some doctors have even encouraged clients of mine to do sit-ups to help tighten up their core. I encourage you to find a professional in your area who understands postpartum abdominal fitness that can accurately measure you. In the meantime, here are some other signs that you might have a Diastasis Recti:
- A belly that protrudes or is soft and loose
- A belly that domes up when you lift your head and shoulders off the ground
- Back pain
- Pelvic floor issues (prolapse, for example)
- An “outie” belly button (especially if you had an “innie” prior to having a baby)
- Postural problems
- Umbilical or ventral hernia
- Urinary incontinence since having your baby
Do any of those symptoms sound familiar? Well, you’re not alone! Fortunately something can be done about it. In most cases, many of these symptoms can be addressed and possibly resolved (with the exception of a hernia) by doing some simple, daily exercises. Once you have been measured and know the depth and width of your DR, you’ll have a way to gauge your progress as you start a safe program geared toward closing the gap.
I know you are wondering what kind of exercises are in a safe DR recovery program. Here’s the secret! The key to increasing strength post-partum is identifying and using the Transversus Abdominis (TA) muscle.
This muscle is a deep, internal abdominal muscle and works like nature’s corset to help stabilize the core. It wraps around the body and attaches to the connective tissues in the abdomen and the low back, the ribs, and the pelvis. I often have clients place both hands on their abs and cough to find the muscle. In a cough, the TA pulls away from your hands. Several programs out there, including mine, focus on strengthening the TA in a series of movements that increase in duration and intensity each week. Depending on the depth and width of the Diastasis Recti, closing the gap may take as little as six weeks or as much as a year or more. In my program, for example, you can expect to feel results the first week. I have a current client who within 6 weeks has eliminated her back pain and can pick up her child in a safe and strong manner.
Reputable programs will not have clients working their abdominals against gravity right away (i.e. full plank position) or doing any forward flexion (sit ups). In general, any movements that are a forceful flexion forward of the abdominal muscles will hinder progress or may re-open a DR. Movement that draws the sternum toward the pubic bone, engaging the rectus abdominus, can increase the gap between the muscles and weaken the connective tissue. Other movements can overstretch or further compromise the connective tissue. These types of exercises include:
- Standard crunches and sit-ups: If you watch someone do sit-ups, you can see their stomach “tent up” (the recti muscle contracting and pushing out) as they lift their head. Since the recti muscles have already been stretched and taxed, we want to give them a break and avoid these exercises. Each time the belly sticks forcefully out like this during exercise, there is a risk of further separating the ab muscles.
- Head and feet off the ground while lying on your back: Bringing both extremities off the ground causes the belly to poof out or “tent up,” further separating the recti muscles.
- Cross-overs: This includes exercises in which knees are going one direction and arms are moving in the opposite direction. This can create a shearing effect on the already separated recti muscles. Examples of cross-overs include Russian Twists, bicycle crunches or sit-ups, Turkish get-ups and tennis, baseball, or golf swings (forceful twisting).
- Deep Backbends: Also avoid these movements, as you don’t want to overstretch the recti muscles or the fascia connecting them.
Any exercise in which you cannot hold the Transverus Abdominis in may not be safe.
Next Monday, I’ll continue with more information about postpartum fitness, starting with a few diastasis-safe Transversus Abdominis exercises. Let me know what questions you have by commenting on this post.
Is it time to jumpstart your postpartum exercise routine? Are you ready to address your abs (even if you had your baby years ago)? Let me help guide you; it’s never too late! Contact me to talk more about healing your abs.