Exercises for postnatal abdominal separation

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We’re back to talk even more about diastasis recti! For those of you who were able to check out part one of the blog, and were left feeling like you wanted more information, this is the blog for you!  As expected, our body does change after we have shared it with a growing babe.  If this means that you have diastasis recti, you will most likely find this blog very helpful!

What can YOU do to help with DR?

Follow these 3 steps:

1. RELEASE

Your pelvic floor muscles have been through quite the battle to deliver your baby!  You may feel like your pelvic floor is very weak (hello peeing when you laugh, sneeze, jump, get surprised, or have to hold it too long!) You may have torn during delivery and now you have scar tissue that needs to be broken up (you may need to go visit a Pelvic Floor Physiotherapist to help with this!) The bottom line is that your pelvic floor might need to be released as it is in the middle of the fascial line running from your abdominals, starting at your sternum, through your belly button, down into your pelvis and up into your low back.

  • To release, you are going to sit on a foam roller or a medium firm ball (a bit bigger than a baby’s head size)
  • Sit on the foam roller with the length of it going between your legs. You’ll feel either side of your sit bones on the sides of the foam roller
  • You want to have a neutral, upright position while you are sitting on the ball/roller so you do not have too much weight back on your tailbone. You can bend your knees and sit on your shins if you are on the floor.
  • Another option is to put the ball or roller up on a bench where you can sit, so your knees are at a 90 degree angle.
  • This release can be very intense the first time you do it. If it is too intense, use your hands on the mat and/or a bench to support some of your weight.
  • Take ten deep slow inhales and deep exhales. You want to envision relaxing and releasing- not holding your muscles tight against the ball/roller.

2. REALIGN

This technique helps move the abdominals back towards your front line by using a foam roller to roll from your back to front (from spine to belly button), releasing the tight low back and oblique muscles and realigning the rectus abdominus muscles.

In order to do this, place a foam roller on a yoga mat and line it up so it lays across the mat.

  • To do your right side first, sit on your bum with your knees bent just in front of the roller on the left side of the mat
  • Lean back and slightly to your right side, placing your low back on the roller, just above the top of your pelvis (hip bone) and below your lowest ribs
  • Place your right elbow on the other side of the roller on the mat
  • Slowly roll your body from your back all the way towards your belly button.  Take it slow and keep the roller between your hip bone and your low ribs
  • You can extend your right leg long on the mat and use your bent left leg to help you roll and then bring your left knee onto the mat as you roll onto your front
  • Once you have rolled to your front and your chest is towards the mat, push yourself up with both arms (do not roll back to the starting position!)
  • Bring yourself up to sit again and line up your left side and roll towards your frontline.  Repeat this 3 times per side.

3. STRENGTHEN

Vaginal delivery is achieved by all of the pelvic floor (PF) muscles stretching, moving, sometimes tearing or being cut to allow baby to come through! It is essential to strengthen your pelvic floor muscles again after birth. Even if you had a C-section, just carrying the weight of baby during pregnancy will also require you to do PF exercises!

PF Exercise #1:  Imagine a clock. 12 o’clock position is your pubic symphysis or you can even think 12 o’clock is your clitoris and 6 o’clock is your anus. 3 and 6 o’clock will be your right and your left sides of your PF.  Go around your clock trying to activate the muscles one at a time 12, 6, 3, 9.  Then 6, 9, 3, 12.  You may not feel anything but bring your awareness to the area!  Once you have figured out your clock, try and engage all sides equally and try to hold the contraction for 3 seconds.  Work up to hold for 5-10 seconds as you progress.

PF Exercise #2: ‘Elevator Lift’- contract your PF and then lift up towards your heart.  If your centre had 10 levels- 1st being minimal and 10th being maximum exertion, work your way (while gently inhaling and exhaling to lift) from floors 1-10. When you are doing exercises, your goal effort should be around the 6-7th floor. There is no need to overcontract any muscles. For example, if you were going to pick up your purse or something light off the floor you would not need to contract your PF muscles to level 10. If you are picking up a heavy child, squatting, or lifting heavy weights, then yes, you need to contract and lift more to balance the pressure being exerted to lift the heavy load!

**You may want to try the PF exercises by elevating your hips above your heart.  Think head and shoulders on the floor, hips up on a few pillows, and your legs resting up on the couch or bed.  This takes the pressure off your PF, as it can be hard to engage a muscle if it is feeling compressed.

**It is essential that you do all of the following work by first engaging your PF muscles, but remember to release and relax the PF muscles in between breaths (relax on the inhale, contract on the exhale).

How do you properly breathe while doing these exercises?

The deepest abdominal muscles (transverse abdominus) can be worked two ways: by compressing the abdominal contents and through forced exhalation.  The following exercises uses the latter- using your breath to activate the transverse abdominus.

BEGINNER: While laying down, with either legs long or knees bent and head resting, place your hands on your tummy.

  • Start with your hands on your belly button. Take a long slow inhale (through your nose if you can), just feeling where the breath wants to go, and likely your hands will rise up
  • Exhale through your mouth, keeping it long and slow, pushing out all the air possible, dropping your belly button to your spine, and your hands will follow
  • Take 10 breaths. You don’t need to force an abdominal contraction. You are just trying to wake up these muscles
  • Move your hands higher up on your belly with your palms resting on your lower ribs.
  • Repeat the 10 breaths, but this time as you exhale, try to pull your ribs and the palms of your hands together (the ribs splay during pregnancy to make room for baby). This will activate your obliques and upper abdominals.
  • Place the palms of your hands on your hip bones and your finger pads on your low belly. Repeat the 10 breaths.  This time, think about drawing your two hands together, interlacing your fingers.

INTERMEDIATE: start on hands and knees, hands below your shoulders and knees below your hips.

  • Keep your spine still in a neutral position- you will have a small sway in your low back. Keep your head lifted and neck long- although its tempting to try and watch your belly!
  • ‘Pregnant Cat’- inhale and release your belly, letting it sink towards the floor (don’t move your spine to do this, just relax the muscles)
  • Exhale and pull your belly button up towards your spine and lift and contract your pelvic floor.  Inhale and release.  Repeat for 10 breaths.

ADVANCED– While on your hands and knees, inhale wide into your side ribs and into your back body.  Exhale and draw your core up and in like in pregnant cat

  • Now, as you inhale, try to keep your core and PF contraction on breathing into your back body, exhale and contract your core again deeper
  • Try for 3 to 5 breaths then take a break (push back into a child’s pose). Repeat again.

Are there any other exercises that can be done to further help with DR?

The next step is pelvic curls (adding on from the level above).

BEGINNER:  with knees bent and feet flat on the floor, exhale; curling your tailbone to your pubic bone and pubic bone to your chest, ribs together, flattening the space between the mat and your low back (do not lift your bum off the mat, and do not squeeze your butt muscles to do this curl).

  • Inhale and tip your pelvis back to neutral and a slight extension. If you like imagery- imagine you have a bucket of water on your low belly- exhale and tip the bucket to pour the water onto your chest, inhale to tip the bucket to pour the water between your legs
  • As you curl, you are trying to draw your belly button down towards the mat- compressing your core and firing your deep abdominals

INTERMEDIATE:  from hands and knees, inhale to prepare, then exhale and curl your tailbone to your pubic bone, pubic bone to chest, drawing your abdominals and PF up and in towards your spine

  • Keep the upper portion of your spine still
  • Inhale and release the curl, lifting your sit bones up to the sky and arching your lower back, while keeping your low belly connected and supporting your spine. Repeat 5-10 times.

ADVANCED:  ‘Seated curl backs’- sit on your mat with your knees bent and feet flat, legs together

  • Hold onto the back of your thighs, sit nice and tall and inhale
  • Slowly begin to curl your hip bones back, scooping your abdominals towards your spine, gently curling your spine into a long C curve
  • Be sure you are not slumping down towards the mat- you want to curl and lean back a few inches, but don’t loose your height
  • Only go back as far as your belly does not “pouch” out. You are trying to draw those core muscles together, not force them apart. If this is too hard as you begin- don’t worry- go back to the beginner and intermediate exercises
  • Go back to your foam roller, release your PF and roll your side body to realign your muscles
  • Repeat another two rounds of exercises with one more release and realignment in between

If you have further questions or need clarifications on anything, please do not hesitate to reach out!

Alana is a comprehensively trained Classical Pilates Instructor with 2 boys under 4 years old. When Alana was pregnant with her first son in 2014, she took the Pre and Postnatal Pilates & Diastasis Recti Recovery specialized training from the Centre of Woman’s Fitness by Carolyne Anthony.

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