Do I have Diastasis Recti?

Diastasis Recti is also known as abdominal separation. Sounds pretty scary but it is actually very common and some research suggests it happens in all pregnancies, but for some ladies it may heal up before it is noticed.

Why does it happen?

The rectus abdominals are the tummy muscles that run down the front of the tummy, from ribs to pelvis. I like to think of these are being like a zip. There are 2 bands of muscles that run down with connective tissue called the linea alba in between. When you are pregnant this area has to expand to accomodate the growing baby. This means the tissues and muscles are stretched, hence this separation can occur. For some it may occur sooner in pregnancy than others which can be due to a whole host of factors. Your pre-pregnancy muscle tone, your collagen type, if you are hypermobile or not, your nutrition and your current exercise routine can all be factors.

What can I do to help in pregnancy?

During pregnancy itself there are things you can do to minimise this seperation.

  1. Keep your core strong. Pilates is an obvious option! Do make sure that any exercise classes you attend or DVD’s that you do at home are suitable for pregnancy and taught by someone who knows what they are doing. A weekend pre/postnatal course is not enough and yet that is often the level of qualification fitness instructors have. So it is worth having a chat to check their knowledge base out and question any moves you are not sure about.
  2. Breathing is a great way to activate your core and practice the skills you will need postpartum to help with the healing. Breathing into your ribcage, your back, your tummy and pelvis. Letting the breath expand you and your muscles relax. Then exhale from the pelvic floor upwards and your core should engage.
  3. Don’t overload yourself. Loaded moves like lifting or anything that makes you strain should be reduced. This can lead to pressure on that abdominal area. Always exhale on exertion.
  4. Log roll like a pro. When you get up from lying always log roll onto your side rather than sitting up. In fact any sit ups, planks, or intense core work should be stopped.

What can I do to help after baby?

Initially you need your rest, so don’t feel the pressure of bouncing that body back or jumping into exercise. Exercise is the last thing on the list for healing, read here for why. Instead here are 3 things to do:

  1. Deep breathing. Use that core breathing to help your core fire and relax (the video below has breathing tips), your pelvic floor engage and relax and to chill our your nervous system, read more on that here.
  2. Nutrition. Eating a diet with plenty of fibre to help your bowels work without strain, fluid to keep things moving nicely, protein for the connective tissue and muscle healing and fruit and veggies for those micronutrients and antioxidants. It all makes a difference.
  3. Posture. Keep on top of where your ribs, pelvis, shoulders and neck are. It is key. When breastfeeding, nappy changing and sleep deprived your body will start to round forward. Yet these rounded shoulders and slumped postures mean those tissues are saggy and it is harder for them to heal up. So take time in your day to correct your posture. Ribs over pelvis, shoulders down, neck tall, pelvis in neutral.
  4. Abdominal massage can be helpful. It is good to know how your abdominals feel and to give them some love! Check out my video on this here:

If you need some help then I offer a postnatal package of massage, assessment, breath work and nutrition tips, possibly movement if it is appropriate. You can contact me: [email protected] or book a slot in my diary here.

A session may include:

  • Some yummy massage to release those tight areas in maybe your neck and shoulders.
  • Some abdominal massage too to allow those muscles to let go and heal.
  • A diastasis recti assessement.
  • Teaching you about core breathing.
  • Nutrition tips if wanted.
  • Movement advice.
  • Home care tips for what to do to help you heal.

 

Why fixing diastasis recti is not all about movement.

So often I hear the phrase movement heals. Whilst I agree with that there is also a point where movement is not the first point of call. There are so many programs out there now and so much advice on what to do if you have a pelvic floor concern or abdominal separation. The over flow of information is confusing and can just add to the noise in peoples head. How do you know who to listen to? How do you know which advice is correct? As someone who has spent a number of years doing advanced study in this area I’d like to share my top tips. I certainly know that a new mum I did not get it right first or second time around… but third time lucky.
If you can you always want to get somebody who can put their hands on you and give you a thorough assessment. That might not mean that they do an internal assessment but you do you want somebody who can physically I do your body, what you move, and placed their hands on you whilst you breathe and use their hands to correct you and to release you. Now that might not always be possible, and I’m not knocking The online program set out there. However I do think if you can get a one-to-one hands on assessment with the women’s have physio or a very experienced fixed price that you want to do that before moving on to any other form of program.
When looking at a program always look at how rounded it is. If it just focuses on the movement then I would say it’s not a full program. There is so much work to be done before you get to the movement, for example:
I want to woman to be able to breathe properly In a full 360° breath.
I want them to be able to connect the pelvic floor, lower abdominals and feel their back expand as they breathe.
In order to correct your posture work is going to need to be done.
This is going to involve some release moves, possibly some soft tissue work.
It needs to be a daily approach. What you do in a class needs to spill out into your daily life.
It’s also really important to focus on you. Self-care cannot be underestimated. Finding ways to make yourself out of that highly stressed fight/flight state into the calm zen like parasympathetic nervous system is absolutely 100% important. This could involve meditation, mindfulness, breathing exercises, along path, or otherwise of chilling out. However you do it it’s important. If you are living in stress and tension you’re not going to be able to heal your body.
It’s only when all of this has been accomplished movement can be layered on top. That’s why I love doing what I do. I get to work with people either 1-1 or in  class and bring them back to that chilled out relaxed state.
If you want to get involved and get some help that focuses not just on the issues in your body but also on healing all of you, then get in touch.
What is best for you? Hard to say as I work on a person by person basis, we are all different.
If you have a significant diatasis recti or significant pelvic floor issues you are likely to need some 1-1 sessions.
If you have some concerns with leaking, a small separation or feel like your whole system needs a tune up then our Holistic Core Restore EVERYWOMAN 6 week course is for you.
If you want ongoing classes then our pilates classes are the best bet.

Postnatal Care – is it enough?

I’m not even sure where to start with this post. So I will start with my own experience. I’ve had 3 babies in the past 7.5 years and my youngest is about to turn 2 yrs. With each baby, my own recovery, my own postnatal journey and the care offered to me, has been different. I’ve had 3 babies who have lost weight post-birth, 2 of which required a period in hospital, each baby has had a tongue tie and it’s always been a stressful start in those initial weeks. Now I’m a well-educated, opinionated, determined (or bloody stubborn) kind of girl, which has got me through. What I have been, and continue to be surprised at, is the lack of support that is out there for new Mums. I had a hyper-tonic pelvic floor before babies, after babies I was complete unprepared for the change in my pelvic floor! I also had a diastasis recti after baby 2 and 3.

Having baby 1 is overwhelming, you are learning new skills constantly and becoming a new family. Subsequent babies are also equally overwhelming, suddenly you have to balance everyone’s needs. The babe becomes the most important in all of this and Mums come way down the list. But they shouldn’t. The early postnatal period is a critical time for recovery, by offering good support at this stage and preparing Mums we could actually help prevent some problems later on. Even by helping Mums with some simple stress management and practical ideas it could help them feel looked after, nurtured and reduce their cortisol levels. I know I was highly stressed after having my 2nd baby and it really had an impact on my body. Techniques such a deep breathing, meditation, mindfulness and just having time off for Mum can make such a difference. I now recommend Mums have a 2 week chill-out after baby as much as they can and call in lots of help.

Mums are usually offered a 6-8 week check, however this is often more for baby than for mum. It’s a quick assessment and I think a lot more could be offered at this stage, however resources are thin on the ground. The Mums that I see and my experience is that pelvic floor is not really discussed, perhaps a cursory “are you doing your exercises”, abdominal separation is rarely checked but there is a screening for Mums mood and contraception.

Whilst it is great that Mums and babies are seen by the GP and continue to be monitored by the health visitors, I feel we are missing a vital opportunity. A chance to talk to women about their bodies, what is not right, where could they be signposted to get more help. I’m not suggesting these teams can provide the answers but they could link in with NHS or private services who could. For example, local women’s health physiotherapists and postnatal fitness instructors who really specialise in this type of rehabilitation.

We need a revolution in postnatal care, more chat, more information sharing, more love, more respect for how women’s bodies change and more holistic care. I’d love to know your stories and thoughts.

The 3 top benefits of postnatal pilates.

It strengthens your core and fixes your body. This is HUGE NEWS. Mums are lifting, bending, rotating, reaching, rocking, pushing and feeding babies. A whole lot of work and strain on the body. The core is made up of the abdominal muscles, the back muscles and the pelvic floor. This cylinder provides the support for the rest of the body to move. After carrying a baby in your womb for 9 months there has been quite a strain on the core. Your abdominals have been stretched and may have stretched apart slightly (diastasis recti). Your pelvic floor muscles have been supporting a heavy load and then may have helped push a baby out. Your lower back muscles will need supporting and strengthening as your baby grows and gets heavier. This is where Pilates has been invaluable for me and it fixes me weekly. Yes there are plenty of other fitness classes you can do postnatally, but a specialised postnatal Pilates is the one you want to do FIRST. It provides you with the foundation that you need to rehabilitate your body after pregnancy and labour. If you do not strengthen your core and get your posture sorted then later along the line you could suffer set backs and problems such as leaking and abdominal separation that doesn’t heal up. If you have this issue come see me for a 1-2-1 session.

If you have pelvic floor issues then you need to be on my pelvic floor workshop.

There are a couple of ways we work on core strength in classes.

Firstly BREATHING. It is something we all do all of the time but breathing using the diaphragm will help the core work in synergy. The Diaphragm, abdominals, back muscles and pelvic floor are all involved in breathing. Try this out:

1. Place your hands around your ribcage. Inhale feeling the breath come into your ribcage. So your ribs move out to the side, your back expands, your chest expands.

2. As you exhale, breath out with pursed lips, feel the tummy come in, the lower back tense and try to get right to the end of your breath to feel an tension in your lower abdominals and a lift in your pelvic floor.

3. Practise this for 5-10 minutes and it really can help, plus it relaxes you 🙂

All the Pilates moves are layered on top of the breathing. It can take a while to get the breathing at the right time and in the right way but suddenly it will click.

It reconnects you with your body. As a mum your primary focus is on your gorgeous baby. There is less time for you to look after your own body and this can get pushed down the list of importance. However your postnatal period is an important time of recovery for you.

A postnatal class can teach you how your body feels when you do certain movements. I know I can be busy rushing around all day and then suddenly in a class I realise my shoulder is out of alignment or my hips ache. It makes you focus on your tummy and pelvic floor, an area many mums don’t want to connect with post-birth. Let’s  face it things are changed in or bodies but it is something to embrace and work to strengthen rather than to avoid. A class also means someone else also has a look at how your body is functioning, which can give you valuable insights and reassurance.

I myself go to classes so that someone who knows my body can give me feedback and push me further. We all need someone who knows us well to watch out for us.

So if you are thinking about trying a postnatal class I would highly recommend you try Pilates. Yes I am completely biased, but I am also proof that it works. Having had 3 babies, I have rehabilitated each time with Pilates. It works.

3 reasons your abdominals may not be healing up.

Saggy Tummy skin?

Mummy pouch?

Abdominal separation that hasn’t healed?

Here are 3 reasons you may not be seeing results.

1. Posture.

I can’t highlight this enough. Try this out. Place one hand on your tummy muscles. Stand up with poor posture, rounded shoulders, head jutting forward. Now what does it do to your tummy? Those muscles feel taut and strong, or saggy and loose? What changes when you lengthen up through the spine, bring the shoulder blades round and down in your back and straighten your neck? You should feel your tummy muscles are tighter and in a better position to heal up when you have good posture.

DiagramPosture-01-209x300

2. Nutrition.

If you are not giving your body good nutrition then you aren’t giving it the best chance to heal. Protein, zinc, iron and vitamin C are all important in wound healing and muscle repair. I know as a mum you need quick meals and often have to eat on the hoof, but you can eat still eat healthily. It is all in the preparation and mind set. Step away from the cake and focus on nutritious snacks that give you energy and fill you. Nuts, seeds, homemade granola bars, hummus, egg muffins are good examples. A bowl of fruit, Greek yoghurt (higher in protein) and a small handful of nuts is a fabulous snack. Make overnight oats with fruit and seeds the night before, ready for an instant breakfast. Bake a pile of sweet potato’s ready for lunches, then you can heat them in the microwave for lunch, top with tuna, pile some salad on the plate and it should keep you going. The diagram below is both relative for pelvic floor healing and diastasis recti.

Nutrition for pelvic floor

3. Breathing and Stress.

How much attention do you give to your breathing? Probably very little. Yet thoracic breathing can be a deal breaker. When you breath into the ribcage and not the belly you activate the intercostal muscles instead of forcing the tummy muscles out. As you breath out your pelvic floor lifts and you core activates. So breathing alone can work to strengthen your pelvic floor and lower abdominals. Stress leads to shallow breathing higher in the chest. It also affects hormones, posture in a lot of people and eating. A triple whammy. So taking time to relax, bring your cortisol levels down and calm down can be a factor. A bath, reading for 10 mins, a pilates class, it all helps.

Breathing Quote
I know how hard it can be. I’ve been there. But I also know this stuff works! I’ve closed 2 diastasis in my own body. Don’t delay, start with the tips above today.

If you want a 1-1 session for posture assessment and exercises you can use at home then get in touch I can even work over Skype.

What postnatal pilates can do for you.

When you are pregnant there is a lot of focus on keeping your body healthy, looking after yourself and putting you first. There is a lot more time to focus on exercising well, cooking good meals and thinking in general. The midwife and friends/family are asking how your body feels, how is the bump, what aches and pains do you have and giving plenty of advice. Then the delicious baby arrives and is totally the centre of attention. Your life is suddenly a whirlwind of feeds, sleepless nights, surviving as best you can. There is little time and energy left for exercise. Cake and chocolate can be relied to get you through the day or are part of a treat at playgroups. No-one really asks how your body is feeling or what they can do to help YOU, it is more about the baby.

The problem is that when you are postnatal your body is pretty vulnerable. It has been stretched, carried a heavy weight around and then birthed a baby. Now if you had a major operation you would lie in bed, rest, recover, have meals brought to you and be looked after for a few weeks. This is really what you need after having given birth. Instead you have a little person dependant on you, you cannot rest as much as you need and you cannot listen to your body.

Postnatal Pilates: why all mums need it

As a pre/postnatal specialist Pilates teacher this is an area I focus on and love to teach.

Postnatal Issues Pilates can help with:

POSTURE:
It is hard to maintain good posture when you are sitting up feeding, especially at night. However without good posture, those aches and pains slip in. Muscles get tight in the wrong places which can cause restrictions in your movement and cause you to compensate.

Over time poor posture can cause long term pain throughout the body, so it’s not something you want to ignore. Postnatal pilates when run by a specialised teacher will put in exercises to strengthen your upper back, talk through shoulder placement with you and use functional exercises to help with those motherhood moves that you do daily.

Sitting more will also lead to tighter hamstrings, so these need to be stretched out regularly.

The key really is to find out which part of your posture you need to focus on and which muscles need releasing. A good class and teacher will highlight this to you.

FLEXIBILITY:
There can be a lot of hormones flying around. Relaxin is a hormone that can affect the laxity of your ligaments, so this can leave you vulnerable to overstretching and potentially pulling a ligament. Learning to work within the normal range of movement for your body is the key here and not pushing yourself too hard, too soon.

PELVIC FLOOR:
Having carried a baby around your pelvic floor has taken a lot of strain. If you have then pushed baby out then that is even more damage that will have occured to the pelvic floor. Pilates will help you strengthen the whole of your core, including your pelvic floor. If you need more help in this area then check out  “Pimp Your Pelvic Floor”

ABDOMINAL SEPARATION:
Many ladies suffer from Diastasis Recti, this is a condition that is common in pregnancy and nothing to be concerned about as long as it is fixed postnatally! For some, the abdominals will naturally heal up by themselves, for others it will take more work. Exercises such as curls ups, planks and sitting up from lying on your back are not suitable and can make matters worse. A specialist pilates teacher with postnatal training will be able to help you.

PELVIC GIRDLE PAIN:
If you suffered from this in pregnancy then the likelikood is that it will disappear once baby comes along. However it is always a good idea to do some strenghtening work postnatally. If your hips and pelvis were struggling in pregnancy then some TLC for them can make all the difference in the long term.

LOWER BACK PAIN:
One of the common complaints I see in mums. Those babies get heavy when you are carrying them around a lot. Having a strong core and good posture when you lift and carry is so important. Pilates will help train your body so you are stronger and more able to manage this. The release exercises will also help mobilise and decrease any pain.

If you aren’t local to me, then check out my Postnatal Pilates DVD.

Third Time Lucky? How do you need to look after you?

Oh my days.

I can’t quite believe we are doing this again, but we are. Pregnant for the THIRD time.

It’s all feeling quite real now as there is a definite bump and lots of baby movements.

Pilates wirh Priya: Bump 3  at 20 weeks

I’m filled with a lot of excitement as I LOVE being a mummy, having the chance to nurture, feed and look after a baby again is totally amazing. With my boy I kept having sad moments of “What if this is the last time I get to do this”. Well it wasn’t  😉

However also the apprehension of how will it be having 3 small people to chase? I know I won’t have enough hands to hold theirs all at once. How long will it take to get out of the house? How many bags of snacks, clothes, nappies, toys and random items will I have to carry with me? How on earth will my poor body fare?

After baby 1 I definitely bounced back pretty quickly.

Baby 2 I had diastasis Recti, just a small one but it took 6 months to heal. I went back to normal life too quickly and didn’t spend long enough thinking about myself, my posture and fixing me.

Baby 3 I know my former abdominal separation has softened up already and I am now teaching more classes than I was before but will also have to be extra careful with myself.

Good Nutrition, hydration, sensible exercise and some rest are my plans for the next few months.

So here is my thought for you….

Pilates with Priya: Take time to look after you

What do you need to do to look after you this week, this month, this year? If you don’t look after you then no-one else will.

3 Moves to think about with Diastasis

 If you have abdominal separation, or are pregnant, here are 3 moves to stay clear of…
1. Sitting up from Lying
It’s such a simple everyday move but sitting up in bed is something to modify. Why? It puts pressure on your rectus abdominus or “six-pack” muscles. These muscles you want to look after. They have to stretch and make room for your growing bump and can separate. This can be a normal part of pregnancy but also something you can help lessen the risk of. Avoid any exercises like sit ups or curl ups or sitting up from lying on your back will help with this.
2. Lifting heavy weights which puts strain on your back, core and can affect your posture.
This can be hard to avoid if you have another young child. Try training them to walk or use a scooter more. Bring in the idea of sitting down for a cuddle rather than walking around holding them. I still have to carry my toddler but he now goes in a sling on my back which helps my posture and distributes the weight more evenly.
Lifting also puts extra pressure on your pelvic floor which is already working harder than normal.
3. Sitting in a bucket seat in the later stages of pregnancy.
Sitting on a sofa or almost any comfy chair can lead to your pelvis being tilted so you are not seated in the best position for either your lower back or to allow your baby to descend into your pelvis. Sitting on an exercise ball or a high backed chair will help you sit up tall so that baby can get into position easier.
Diastasis Recti

Abdominal Separation #ppnchat from 9/9/14

Myself and the fabulous Claire Mockridge hosted the second twitter #ppnchat on 9/9/14, the topic was abdominal separation. Personally I’ve found these chats not only a chance to meet new people who work in the same field as me….but a chance to share knowledge, ask questions, be stimulated, be made to think about my practise and to learn. All of that in an hour, whilst sat at home. Pretty amazing networking and learning huh.

So if you work in the pre/postnatal field make sure you come along to our next #ppnchat on 7th October at 2.30pm.

If you missed the chat or want to catch up on some of the tweets and links (I know I do) then you can find a transcript of our chat here.

Say NO to Sit Ups

 Sit-ups are one of those exercises that I’m really not keen on. Many people perform them incorrectly, they are not safe in pregnancy or post-birth… and yet they are often one of the main exercises people will be doing.

A sit up or any variation of this movement where you go into forward flexion , bringing your upper body towards your knees, is not a good thing for postnatal women.  In fact it can cause more harm than good as it works the tummy muscles in the wrong way.  So, if you’ve recently had a baby and you’re doing sit ups, STOP them immediately.

Pilates with Priya: Why not to Curl up after having baby

Sit ups work the tummy muscles that run vetically down the tummy, called the Rectus Abdominis but commonly known as the six-pack muscle. These lengthen in pregnancy and as your baby grows and your bump gets bigger, this muscle my start to separate around your belly button.  The abdominals can take time to come back to normal after your baby has been born, so for several weeks and indeed months after birth, these muscle remains in a lengthened, separated state.

The danger of doing sit ups in this state is that you can widen any separation you may have of the abdominals and you can actually strengthen the muscles to stay in this separated state. The long term problems with separation include the risk of a hernia (the intestines poke out as there are no tummy muscles covering them), pelvic floor weakness and it also means you won’t get a flat tummy back again.

Instead of doing sit ups, you need to focus on strengthening the pelvic floor and the Transversus Abdominis, which runs like a corset around your lower tummy. By strenghtening these muscle that are deep inside you will strengthen the body from the outside in. These muscles are your foundation, once they are working then they will help realign any abdominal separation you may have and will knit you together again.

Our specialist Postnatal Pilates class and our DVD focuses on strengthening these muscles in the correct order. So we find the lower tummy (transversus abdominus) muscle first, along with the pelvic floor. We then shorten the rectus abdominus  muscles running down the tummy. When this is strong enough and any abdominal separation has been realigned, then the other tummy muscles can be worked.