Exercise after Childbirth-Proceed with Caution! Part 3

May 31, 2013 in Abdominals, Childbirth, Diastasis Recti, Exercise, Post Partum, Pregnancy

Exercise After Childbirth-Part 3

So we’ve discussed the issues of low back pain and pelvic organ prolapse in two previous posts.  There is one other issue you need to be aware of that doing the wrong kinds of exercises can keep from healing and that is diastasis recti.

Diastasis Recti

A diastasis recti is a separation of the rectus abdominus muscle, otherwise known as the six-pack muscle. The rectus abdmonius muscle runs from the sternum down to the pubic bone and has two muscle fibers separated by a connective tissue called the linea alba. During pregnancy, as the uterus expands the two muscle bellies separate and the linea alba gets stretched thin. It is very important to allow this connective tissue to heal so the muscle bellies can come back together. Any activity that causes the abdomen to move forward forcefully causes this connective tissue to stretch out thus preventing it from healing.

Also any twisting motion causes the rectus muscle bellies to separate making the diastasis larger. You need to avoid all twisting motions and any forward forceful movements so you can let your rectus muscle to come back together and heal. Sit ups or crunches, especially with twisting are the worst thing you could be doing right after having a baby as the transverse muscle is so weak it can’t keep the lower abdomen from jutting out.  Many moms are doing sit up wondering why they aren’t getting their bellies smaller.  Sit-ups are working the wrong muscle and doing more damage than good in the post partum period.  It’s the transverse muscle that needs to be strengthened.

I’ve written a another post on how to prevent diastasis recti in pregnancy and I also teach a class and offer a video on healing Diastasis Recti you can check out here.

What is the best way to strengthen the abdominal muscles?

Pulling your belly button all the way back toward your spine and holding it there, WITHOUT HOLDING YOUR BREATH, and then trying to do little pulses to take it back even farther.   When the muscle is weak you will notice movement with your pulses at end range of your abdominal contraction.   You want to get the muscle stronger to when you go to pulse there is actually no movement that occurs.   That will help shorten your lengthened abdominal muscles.  Start off just doing 10 pulses and work you way up to doing as many as you can at one time with 100 being your goal.  Doing this several times throughout the day will help you lose the pooch that so many women have after pregnancy.

 

Abdominal Hernia’s-Diastasis Recti in Post Partum Women

April 22, 2013 in Abdominals, Diastasis Recti, Post Partum, Pregnancy

Diastasis Recti- Abdominal Muscle Separation

Do you know what one of the most commonly untreated issues women face after delivering a baby?  It hardly ever gets diagnosed and if it does the medical community doesn’t think there is any solution other than surgery.

Diastasis Recti

I’m talking about Diastasis Recti.  This is the separation of the rectus abdominus muscle, which is the “six-pack” muscle in our abdomen.  The rectus abdominus muscle has two sets of muscle fibers that run up and down from the sternum, or chest plate, down to the pubic bone. They are connected by a connective tissue called the linea alba. These muscle bellies can become separated and the connective tissue between them stretched thin with pregnancy.   The muscle bellies get forced out to the side to make room for the expanding uterus.  Also, activities with a forward forceful movements as in coughing, sneezing, laughing, or doing sit ups incorrectly can create a diastasis or make an already existing one worse.

Abdominal Muscles

The abdominal muscles are one of the most important muscles in our body. They are responsible for all of the support and movements in our trunk and consist of three layers. The most superficial layer, the Rectus abdominus, otherwise known as the “Six-pack” muscle, helps us to bend forward or sit up from laying down. The middle layer includes the Internal and External Obliques which helps us to twist and the deepest and most important layer, the Transverse abdominus, helps to compress the abdomen in and is part of our core muscles to stabilze the spine and pelvis.

How do you know if you have Diastasis Recti?

The separation of the Recti muscles is called a Diastasis Recti. You will know if you have one if you are laying down on your back and you place your fingers pointing down toward your spine in your belly button. When you lift your head any fingers that fill the space between the two muscle fibers of the rectus abdminus let’s you know you have a separation.  One to two fingers separation is considered normal.  However you also need to check the depth of your connective tissue.  That linea alba needs to be very superficial.  If you sink down past your fingertip the connective tissue still needs to heal.

Also another key sign you have a

Doming of linea alba in Rectus abdominus with diastasis recti

Doming of linea alba in Rectus abdominus with diastasis recti

separation is when you lift your head do you have any doming in the midline of your abdomen?

There are certain things we do like getting in and out of bed, doing abdominal crunches, and playing golf and tennis that can make this separation worse and keep it from healing.

At Intuitive Hands PT we offer training and education to teach you a 4 step program to help you heal a Diastasis Recti and also to help you lose the “pooch” from pregnancy. By learning how to use your body and strengthen your transverse abdominus muscle correctly you can loose your “pooch” and bring the rectus abdominus muscle bellies back together again.

Anyone with a diastasis can be helped no matter how long your muscles have been separated.   If you are currently pregnant, reading this previous post on how to avoid developing onein the first place can help save you ton of effort in the post partum period.

Caring for your Belly During Pregnancy-Preventing Diastasis Recti- Part 2

March 27, 2013 in Abdominals, Diastasis Recti, Pregnancy

Part 2-Preventing Diastasis Recti in Pregnancy

Diastasis Recti is a separation of the rectus abdominus muscles that is a common occurrence during pregnancy.   What we do with our bodies during pregnancy can make this separation worse and the recovery process longer.   There are three aspects you need to be aware of to help prevent diastasis recti.   In a previous post we talked about the first aspect of how rib thrusting contributes to the development of diastasis recti.  See this post to review rib thrusting.

The second aspect you need to be aware of to avoid diastasis is to protect your abdominal muscles with all your activities.   Any time the belly protrudes forward forcefully, like when you laugh, cough or sneeze, the abdominal muscles get strained apart.  The more strain the more separation.  If you are in your late second or third trimester and you notice any doming in the midline of your belly, this is the abdominal muscles separating.  You want to avoid this.

The third trimester is the period of time that greatest strain is placed on the abdominal muscles.   The less your belly domes up in the middle the less separation there will be.

How do you stop the doming and separating?

You can stop the separation of the abdominal muscles by pulling the belly button back to the spine before you do any activities that may strain the belly.  So before you cough, laugh or sneeze bringing your belly button into your spine.   Also before you go to lift anything heavy, contract your abdominal muscles back toward your spine.

DON’T DO SIT UPS OR CRUNCHES

Doing a crunch shortens the recti muscles and actually makes any separation worse.  When the muscles shorten they bulge out in the middle.   Crunches also increases pressure in the pelvic bowl area.  This can weaken the pelvic floor muscles and contribute to pelvic organ prolapse.   You don’t want that!

Sit ups should be avoided and are not an exercise I ever recommend to my patients.  There are other more effective ways of doing abdominal strengthening than sit ups.

Best form of Exercises during Pregnancy

If you want to strengthen your abdominal muscles just pulling your belly button back to your spine is the safest and most effective way to do so while pregnant.  Walking is another way to strengthen the abdominal muscles, as they have to work to support the spine.  In my opinion, walking is the best form of exercise you can do while you are pregnant.

So protecting your belly by contracting your belly button back to your spine with everything you do is the second step in avoiding a diastasis recti while pregnant.

In the next post we will cover the third aspect, which is the most common motion we do at least twice a day that can contribute to diastasis recti.   Stay tuned!

If you want to know how to heal Diastasis please check out my video How to Lose the Pooch For Good and Heal Diastasis Recti 

 

What is this thing called our Core?

January 18, 2013 in Abdominals, Diastasis Recti, Exercise, Post Partum

What is this thing called our Core?

Our body is an amazing machine.  What keeps it strong and allows us to move and do all sorts of activities is having strong core muscles.  Core strengthening is all a buzz these days and rightfully so because without good strength in our core muscles our performance can be diminished and can lead to back pains and problems.

So what is our Core?

Our core is made up of 3 groups of muscles, the abdominal, the pelvic floor and the multifidi muscles of the back.  While the other two are important I’m going to focus in on the abdominals and how certain things can really put us in danger of weakening these muscles.

The abdominal muscles 

The abdominal muscles are responsible for all of the movements in our trunk and consist of three muscle layers, the rectus, obliques and the transverse. The most superficial layer, the Rectus abdominus, otherwise known as the “Six-pack” muscle, helps us to bend forward or sit up from lying down. The middle layer of the abdominal muscles includes the Internal and External Obliques which helps us to twist.   The deepest and most important layer, the Transverse abdominus, helps to compress the abdomen in and is part of our core muscles to stabilize the spine and pelvis.

Do you ever see a bulge in your abdomen when you go to sit up from lying?  

If you do, then you have a Diastasis Recti.  That is a separation of the six pack abdominal muscle known as the Rectus abdominus.  The rectus abdominus muscle has two sets of muscle fibers that run up and down from the sternum, or chest plate, down to the pubic bone. They are separated by a connective tissue called the linea alba. These muscle bellies can become separated and the connective tissue between them stretched thin with pregnancy, increased pressures in your abdomen or by just having a big belly.   The muscle bellies get forced out to the side with the increased pressures.  Also, activities with forward forceful movements as in coughing, sneezing, laughing, or doing sit ups incorrectly can create a diastasis or make an already existing one worse.

So how do you know if you have a separation of the recti muscles, or a diastasis recti? 

You will know if you have one if you are lying down on your back and you place your fingers perpendicular to the rectus muscles, pointing down toward your spine in your belly button. You need to be pushing down into the tissue and not just have your fingers resting on the belly.  When you lift your head any fingers that fill the space between the two muscle fibers of the rectus abdominus let’s you know you have a separation. One to two fingers width separation is considered normal.  However you also need to address the connective tissue and see how deep you can poke down before you feel the connective tissue. Normal is very shallow.  Anything past your first knuckle needs some attention.  You want to assess this in three places, at the belly button, 2 inches above and then 2 inched below.  It is normal to have different measurements in all three areas.

Also another key sign you have a separation is when you lift your head does anything pop forward in the midline around your belly button?  That bulge is actually your colon protruding out.  There are certain things we do like getting in and out of bed, doing abdominal crunches, and playing golf and tennis that can make this separation worse.

Do you still have a “pooch” from being pregnant?

It doesn’t matter how old your baby is, our stomachs can still be stretched out from carrying the baby.  The transverse muscle runs like a corset from our spine around the front and inserts in the rectus sheath in front.  If you haven’t restrengthened this muscle it will continue to stay stretched out.  Granted, after the baby left your womb the transverse muscle did come back in somewhat but not to where it was prior to pregnancy.  There are some exercises you need to learn to help restrengthen this transverse muscle and we can show you how.  Regular sit-ups, Pilates and yoga do not address this muscle like it needs to be to help you lose your “pooch” for good.

At Intuitive Hands Physical Therapy we teach classes in the Boulder/Denver area and also have a video you can purchase that addresses all the issues with your abdomen.  You can lose inches and have a flatter belly by learning how to do two simple abdominal exercises that you can do anytime and anywhere.  There is a 4 step program that helps heal your diastasis recti so you can keep your organs in place and protect your back from injury.  We can also teach this class online via Skype.  For more information and to register for a class or purchase the video, click here.

 

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