Ah, the dreaded mummy tummy. Not so yummy feeling for lots of ladies and getting rid of it is often the stated goal of post pregnancy workouts. Of course, gaining fat during pregnancy can be a factor of this, but more importantly your Diastasis Recti (DR) may play a role.
DR is covered in my blog Diastasis Recti but to recap it is the resulting separation of the rectus abdominis muscles that often occurs in pregnancy, as the linea alba becomes stretched and remains lax postpartum.
A diastasis is commonly thought to be a two finger or more width separation of the rectus muscle bellies from the midline. The abdominal wall stretches (often, a lot), and so the connective tissue can widen leaving the recti bellies with a gap between them. This is one reason why your postpartum clients may still look 4 months pregnant when their baby is a year old. No one likes to be asked when they’re due when they’re not even pregnant anymore, right?
Step 1: Retraining the Breath
It might seem simple, but you will have to learn how to breathe again. You may be breathing through the chest and shoulders, which is wreaking havoc on your posture and their ability to stabilise the core, left with one big, rib-flaring, unstable, inefficient core.
You need to feel a gentle softening of their pelvic floor and abdominals on your inhale breath, and a gentle contraction of their pelvic floor and abdominals on their exhale breath. Breathing properly and getting the ribcage aligned in a better position over the pelvis will enable proper abdominal contraction and compression to close the DR.
Step 2: Retraining the Abdominals
There are going to be some jiggly bits and bellies going on, and that’s perfectly normal. Recently postpartum, you will likely feel that you are having a tough time getting a solid abdominal contraction, especially in the lower rectus region. They might feel like there are no abdominal muscles left, or you have a serious case of abdominal amnesia. Those muscles have been overstretched, not functioning at capacity for months, and don’t know how to turn on anymore. Practice makes perfect here.
What abdominal exercises should you do? As mentioned, the diaphragmatic breathing exercises for the core should be in every workout and every day life. These will begin reprogramming the pelvic floor and transverse abdominis in order to gain tension in the linea alba and help close the DR. Low level dead bug exercises, pallof presses, and carry exercises will help you to train their alignment and recruit the deep core muscles.
What abdominal exercises should you avoid?
In the case of DR, you need to steer clear of exercises on all fours, front loaded planks, and any supine crunching or flexion movements. They are only going to put more pressure on that weakened connective tissue and exacerbate the separation.
Be cautious of rotation exercises and any loaded exercise where the core has to stabilize a ton. When going from supine to seated or standing, get into the habit of rolling to your side before coming up instead of jackknifing up and bulging the belly. And, be sure not to use front loading baby carriers need to go until that DR is closed as to avoid increased pressure on the abdomen.
Step 3: Retraining the Pelvic Floor
“I laughed so hard, tears ran down my leg”. Nothing should ever be that funny.
To avoid seriously embarrassing leakage accidents, get to know the pelvic floor. Imagine the pelvic floor like a dome. It is a group of muscles and soft tissues supporting the region from pubic bone to base of the spine, and connecting the sitz bones that hold the organs in place. The pressure of the fetus, along with labour and delivery can weaken the tone of these muscles. Pelvic floor dysfunction can range from hypotonic muscles not closing the badder sphincter with enough strength, to a uterine prolapse.
Kegels, pelvic floor contractions, should be done daily (for as long as you remember to do them) and incorporated into your sessions. In your movement prep get in the habit of doing 1 or 2 sets of 10 repetitions with your diaphragmatic breathing exercises. You can progress these into your strength work, for example on the upward movement of a squat they draw the pelvic floor up.
Read more about Pelvic Floor Exercise