Yesterday my Facebook feed was inundated with multiple shares of this NPR article titled, “Flattening The ‘Mummy Tummy’ With 1 Exercise, 10 Minutes A Day.” After all, with a title like that who wouldn’t want to click on the article and and learn what seems to be such a simple fix for diastasis recti. The trouble is that the “Fix” is never this simple.
While I appreciate the awareness this article is bringing to the topic of diastasis recti and recovery of the partpartum core, Diastasis recti is far more complex than any one single exercise for one single muscle. Diastasis recti is not just about the abs, but moreover is about full body alignment and optimal intra-abdominal pressure regulation. One of the things that I talk to my patients about all the time is that I can give them the world’s best abdominal exercise program to perform 10-20 minutes a day, but what they are doing the other 23 hours and 40-50 minutes makes a bigger difference to their diastasis recti.
Core muscle function is so much more than static recruitment of a single abdominal muscle. Your transverse abdominal muscles, pelvic floor muscles, diaphragm, and deep back muscles form your deep core canister. They all work together to provide anticipatory stability. So few women realize that their breathing pattern is connected to their abdominal wall performance and their pelvic floor muscle function. My colleague, Julie Wiebe PT has a wonderful video about how all these muscles coordinate together on her webpage. Check it out. If we do not consider breathing pattern when rehabbing a diastasis recti, we are missing a big part of the picture. Chronic drawing in of the abdominal wall is not the answer! If we squeeze in the middle all the time, what are we doing to our pelvic floor down below… setting it up for issues down the road.
The research on diastasis recti is emerging and evolving. There is no way to prevent it during pregnancy by doing an exercise. It is a normal part of many women’s pregnancies. Don’t get me wrong, there are definitely things that you can do before and during your pregnancy to reduce your risk of a large diastasis recti and improve overall core function and support. However there other factors such as one’s genetics, overall tissue laxity, number and proximity in time of pregnancies, and singleton versus multiple pregnancy to name a few.
What’s a Woman to Do?
While this article is good to raise awareness, it barely scratches the surface of what is really needed to address the postpartum core rehabilitation. My best advice is to seek the care of a women’s health physical therapist to do a full assessment of core support system. At Legacy Physical Therapy, we see women all the time who think they are doing the right thing to rehab their core, but find that despite performing the exercises their symptoms are getting worse. If you cannot get to see a women’s health physical therapist, then please do your research when searching for solutions online. Below is a list of some of my favorite go to sites.
- Julie Wiebe PT
- Mutu System
- Brianna Battles – Everyday Battles
- Jessie Mundell
- Healthy Habits Happy Moms
If you think that you are dealing with a diastasis recti or postpartum core weakness, we can help. Give us a call at 636-225-3649 to chat with one of our women’s health physical therapist to see how we can help. If you are not sure if you have a diastasis recti and want to be checked by a professional, call us to set up a free screening appointment. We are happy to help.
Did you know that there are physical therapists who focus especially on female issues? In fact, there are physical therapists here in St. Louis who are Board Certified in Women’s Health Physical Therapy (WCS).
There are multiple times in a woman’s life in which physical therapy may be appropriate. We will talk about 2 important time periods in this article: 1) during pregnancy, and 2) postpartum
Physical therapy can be a wonderful adjunct care provider during pregnancy to help with common pain complaints such as:
- Low back pain
- Sacroiliac joint dysfunction
- Carpal tunnel syndrome
- Pelvic and pubic pain
- Foot pain
- Incontinence (bladder leakage)
- Round ligament pain
Physical therapy treatment during pregnancy may include:
- Posture education to avoid injury and decrease pain
- Manual therapy to restore alignment and improve soft tissue guarding
- Therapeutic exercises for improving muscle performance and posture
- Abdominal and pelvic floor training
- Fitting for various support belts to help with stability and pain
If you are like many pregnant women, you may have concern about what exercises are appropriate during pregnancy. A physical therapist is a great resource for instruction on the do’s and don’ts of exercise during pregnancy.
The stresses of pregnancy, vaginal deliveries, and C-sections may lead to myofascial complications following the birth of the baby. Many women suffer in silence because they feel their symptoms are “Normal” after they have a baby. Fortunately, many of these symptoms can be easily treated by a physical therapist specializing in postpartum care.
Common Postpartum Complaints include:
- Low back and lower extremity pain
- Upper back and neck pain associated with breastfeeding
- Upper extremity pain or numbness associated with child care
- Diastasis recti: Separation of the abdominal muscles which commonly occurs during healthy pregnancies.
- Pain with intercourse or orgasm
- Clitoral, vaginal, rectal, pubic, or tailbone pain
- Pain and decreased mobility at scar of C-Section, episiotomy, or perineal tear
- Pelvic floor weakness
- Urinary or fecal incontinence
- Urgency and frequency
- Pelvic pain
How Physical Therapy Can Help:
- Soft tissue mobilization, myofascial release, deep tissue massage
- Therapeutic exercise for improving abdominal and pelvic floor muscle performance
- Posture, lifting techniques and biomechanics
- Home exercise program
- Abdominal binder/brace fitting
- Scar massage
- Therapeutic ultrasound to breakup clogged milk ducts
- Modalities for pain control
- Instruction in return to exercise safely
- Instruction in proper lifting/carrying of baby, stroller walking, and other activities of daily living to avoid injury
Pregnancy, childbirth and childcare are all events that result in significant physical changes and new stresses on a woman’s body. Women’s Health Physical Therapists are specifically trained to meet the special needs of women during this time of their lives and beyond.
Call us today at 636-225-3649 to set up your FREE SCREENING to see if physical therapy is right for you.
I have been wanting to get classes together for my pregnant and postpartum clients for awhile now. The childbearing years bring about so many changes in women’s bodies that can set them up for problems down the road. There are so many preventative things that women can do to avoid these problems.
I am excited to say that I will teaching 2 different classes geared towards pregnant and postpartum women in the St. Louis area. On the 3rd and 4th Wednesday of the month from 6:30 to 7:30 pm I will be teaching at the Town & Country Cottonbabies.
Mommy and Me
This class is intended for moms in their last trimester or new moms. In the class you will learn how to regain muscle strength in key areas, “back, bellies, and bottoms,” how to get tone back in the abdominal muscle, and how to minimize back pain. We will teach ways to incorporate your baby into your work-out and how to protect your body from common overuse injuries that new moms encounter.
In this class participants will learn musculoskeletal changes during pregnancy, understand reasons for back pain during pregnancy, learn techniques to minimize pain, and get self help ideas for comfort. This is great class for expecting moms and their partners.
Space is limited. Please register for this class by calling the CottonBabies Store at 636-220-7720