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.
- 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.
- 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.
- 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.
- 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:
- 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.
- 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.
- 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.
- 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@example.com 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.
Modern life is stressful. Fact. One of the questions on our screening forms is “If your life stressful?” I’m always amazed if anyone ticks no. I actually need to change that question as it does not really matter how much stress is in your life, the important thing is how you are dealing with your stress?
When we are stressed our sympathetic nervous system is working full on. This is the system that responds to a threat or when something big and scary comes along and the body needs to go into “red alert”. For example a car is hurtling towards you and you need to move, you have a huge deadline to meet or the children are shouting and you are trying to get out the door fast! It is often call the “Fight or Flight” response.
The sympathetic nerves arise from the lower and mid-upper back spinal cord. When it is switched on there can be tension all over the body. Some of the main responses that occur in the body are:
- increase in heart rate
- dilation the pupils in the eyes
- need to breath faster and more shallow breaths as the bronchioles dilate
- contraction of muscles – pumped and ready for action
- release of adrenaline from the adrenal gland causes you to feel on edge but ready to react
- conversion of glycogen to glucose to provide energy for the muscles
- decrease in saliva production: the stomach does not move for digestion, nor does it release digestive secretions.
- decrease in urinary output, no need to wee as often!
Other processes that are not critical to survival may shut down in the body, so the whole body functions differently. Now whilst this is absolutely needed in a moment of danger it is not a way we want the body to be working long term. If you are living under stress long term then it could affect your breathing, your digestive system and your muscle.
Whilst modern life is indeed stressful and you may not be able to change that… what you can do is to build in techniques to help your mind and body let go of the stress. I think this is vital to do and it’s certainly something I’m working on myself. I’m 100% lucky as I get to practise what I preach daily. Pilates is very much a way I destress. The breathing, mindful movement, the calm space and the concentration needed really calms me and grounds me.
Other great ways to activate your parasympathetic nervous are mindfulness (you can check out apps like Calm, Breathworks and Headspace), meditations (check out free ones online or try a class), a bath, massage, deep breathing and just more resting and crafting. How do you get your chillout time in?
Running is great for mental health, being outdoors provides fresh air, a new perspective and the pounding of your feet in a rhythm can help your thought processes.
However it is also known that the impact of running can elicit symptoms of stress urinary incontinence. That little bit of leaking that you get when you run, or the need to wear a pantyliner/pad is not how our bodies were designed to function and is a symptom that there is a bigger issue.
So should you run whilst you leak?
A review of 28 studies on continent and stress incontinent women showed the timing of pelvic floor activity in relation to movement was key. What does this mean? It means that co-ordinating your pelvic floor with your movement is crucial. This is something that comes with practice. Like any muscle the pelvic floor is one that needs training, but not just on it’s own via kegels. Don’t get me wrong, kegels are definitely useful and have a big role, but these need to be integrated into movement. So if your pelvic floor is not functioning properly when you run, it’s all about practicing moves to prepare for running using pelvic floor cues as well.
Does this mean you may need to stop running whilst you train your pelvic floor? Yes it may do, for a short period of time. Now whilst I completely understand that it is so hard to stop doing an exercise that you love and that is so helpful to you, there is a bigger picture to be seen. If you have the symptoms of leakage then continuing to put impact through a weak muscle can lead to it worsening. This could lead to prolapse, a condition where the pelvic organs descend… and you having to stop running for longer.
Think about it this way, if you had an injury in another muscle, such as a hamstring, then you would seek advice, possibly have some physio, work on exercises to rehabilitate and take time out from running whilst it healed. So why is the pelvic floor any different?
I’m running some brilliant courses that will help you get your pelvic floor up to speed.
Everywoman is a 12 week course with 6 weeks of in person classes and homework, then 6 weeks of online classes. Full support provided including some help with nutrition and stress regulation.
Next course starts in November
Athlete 12 is for you if your pelvic floor is already ok (no leaks) and you have already done come core work first. If you want to get stronger and fitter, it is a brilliant aid to improving your performance and having coached support without paying for a PT each week. This is a 12 week online course with workouts delivered to you and support from myself.
Want to sign up? Drop me an email firstname.lastname@example.org
Achey hips is something I’m often asked about. There are so many reasons why your hips can be hurting. If the pain is severe then you definitely want to go and seek medical advice. If it is a lower level muscular ache then check out my tips and video below.
The impact of sitting for long periods and standing out of neutral posture all adds up to extra pressure on the hips. Hip pain on the outside of your hip, upper thigh or bum is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint. Something is tight and out of balance. The body likes to be balanced and there are fascial lines that show us how it is all connected. A tightness in your hip could be related to how you sit and stand, but it could also be related to your shoulder. So it is worth making friends with your local sports massage therapist to get a good assessment and then you know what to work on. Having the area worked out in massage can then free it up for you to strengthen the surrounding areas and keep the tight part mobilised yourself.
So here are some yummy release moves that you can use to find those tight areas and start to work on them yourself. Or use these at the end of a busy day, before you get into an exercise session or between massage and pilates classes.
To book in for a sports massage do also get in touch.
Do some practice at home. Pilates is like learning a new language, the more you practice, the more you learn.
Now it is common sense that the more often you practice something the better you become at it. Therefore doing some Pilates practice between classes will help you massively. If you can practice lying in neutral and breathing, correcting your posture and a move that you enjoyed in class it will help. Check out our youtube channel for videos and sequences you can try.
Slow down and breathe, breathe, breathe. Pilates is a marathon and not a sprint.
Breathing is obviously something that we do all the time but we don’t always take the time to do properly. Focus on the breath going into your ribs, so they expand out to the side. The breath also expands your tummy and your back too.
I always talk about rib cage placement. In all posts avoid the ribs flaring out, instead bury them down towards your hipbones so the abdominals engage.
If your ribs flare up when you lift your arms or legs, concentrate on there being a heaviness on your chest and your core engaging more. It may also be you need to reduce the range of movement in your shoulders and legs.
Check in with yourself from time to time through your day. How are you standing or sitting? Are you shallow breathing? When you can only attend one class a week, it’s these daily tweaks that really help to make a difference”
A focus on your posture is so key. What you do in class is a tiny fragment of your week, so finding the posture cues you need to work on is totally crucial. Whether it is adjusting your head position or bringing your pelvis into neutral more often. It all makes a difference.
Self care is the new buzz word. Personally I love it. It is something I know I need to do more of. I work my body hard in the week running from clients to classes to clinics. I don’t always build in enough time to relax, never mind time to look after my body in the way it needs, but I’m working on it. One of my new years aims was to have a spa day this year. My older girl actually laughed when I said that… as in “that won’t happen mummy”, but thanks to a lovely friend turning 30, I’m booked on a spa day with some girls – YES. Jokes aside, I am totally lucky that I teach Pilates and can incorporate some self-care into the sessions I teach. Pilates has been shown to help with mental health conditions such as depression and anxiety – why? It centres and focuses the mind in a similar way to mindfulness. I swear Pilates keeps my body working and my mind sane. Here are some tips on how you can make self-care part of your Pilates lifestyle.
Seen by some as a luxury (including myself for many years) I’m not meaning that spa aromatherapy style massage (though bring that on too). Instead it’s the the dig deep and release the tight areas kind of massage that helps fix your body. We all get certain, recurrent tight spots in the body. Often these are due to posture or over-using the body in certain ways. Either way a decent sport massage can make a big difference. When the tight muscles are released you can move your body in a new pattern. I know I have certain areas that would benefit from a course of massage treatments (hint hint) – you only get one body.
I’ve totally fallen in love with breathing this year. A lot of time devoted to studying this deeply has impacted my practice as a teacher and my own day to day practice. I find myself pausing at points in the day to breath and reconnect. Just 10 minutes of deep breathing can help calm your mind, work your core and ground you. My personal preference is to teach people to lie down in neutral posture and breath as it helps you relax into it with good posture, however this isn’t always possible in the middle of the day! So sitting on a chair with a high back, breathing into your back, sides and tummy with a relaxation on the inhale and engagement of the core on the exhale.
We all know too much sitting is not good for us. So building movement into your day is key. This doesn’t have to be a massive workout. Move your body in the way that feels good. I don’t think there need to be any rules, the rules confine people. Instead just know that moving is good for your body, your mind, your soul. Stretching after a busy day, changing postures at work, a 15 minute walk – it all helps.
There are times my body is just too darn tired to do a teaser and thats ok. On those occasions it is good to listen. It all depends on how in tune you are with your body. Is it your head telling you not to bother moving today and to sit on the sofa or is it your body letting yoou know it is tired, it needs a rest? We all need a rest day in our week, even God took time to rest in creating the world. I have weeks as a teacher when people turn up to class and they all look tired out. Those weeks we change the pace and although there will still be plenty of core work and a sneaky teaser, there will also be plenty of stretching and release work built in too.
Not something I’ve managed to do much of over the past few years, for which I blame my children 😉 There is so much research now showing us how important sleep is. To be fair it’s pretty obvious isn’t it. When we sleep it’s the time our bodies renew, replenish and restore themselves. So it’s a time of new growth but also a time part of us gets to unplug and switch off. If you are not asleep at night then your body can’t do all its jobs, you are just making it extra hard work! So commit to getting to bed and resting.
I cannot emphasis enough how key getting good nutrition into your body and nourishing it is. I’m totally biased, confession I’m a dietitian too… which means I have seen first hand how nutrition plays a vital role in healing and in health. Simple things like ensuring you eat plenty of fruit and veggies, stay hydrated and have your cupboard/fridge stocked with nuts, seeds, dried fruit, yoghurt, oats, nut butter to keep you out of biscuit tin on some occasions. I live by the 80/20 rule which states you eat healthily 80% of the time and you relax your approach 20% of the time. There is always room for cake!
However self-care works for you, try to build it into your week, your day, your life.
How my life has changed! Once upon a time I avoided PE lessons like the plague, hated getting sweaty and would never have gone to a fitness festival for fun! I did enjoy certain types of exercise but they were not the standard ones included at school. They were not accessible and I couldn’t just pop in somewhere to try things out.
This is part of what Luke from Sweat Southsea made accessible at the Southsea Fitness Festival. Different forms of exercise were made accessible. From high impact to upside yoga, from power plates to a dualathon. It was truly fabulous and the best part, free and family friendly. Having this festival outside also meant that people could just walk by and take part, or just watch! I saw mums with newborns, pregnant ladies, gym bunnies in Lycra and older adults all soaking up the vibe.
Quote from Luke:
“We created the Festival to inspire and celebrate active and healthy lifestyles. It was apparent from the outset that it needed to be a free and fully accessible event. There are many barriers to exercise which as fitness professionals we try to break down – so why create a barrier by charging an entry fee? Our goal is to make a major difference first and foremost in our hometown which has some pretty shocking childhood obesity health related statistics. We hope to show that there is a sport or activity for everyone. The event is also an opportunity to support other local businesses and to create a network of like-minded businesses which can work together in a positive way.”
Highlights for me included taking part in the dualathon with my kids. Again, not something I would normally enter (though I am tempted) but so much fun to do this without the pressure being on.
We need to be on a mission to get children active. It’s a huge part of how we will help with their health. In my opinion (with my dietitian hat in) its no good putting everyone on strict diets. Instead it’s about making long term changes to eating patterns AND long term changes to the whole lifestyle. So finding ways for children to be active EVERYDAY is part of this. My kids loved it all. They went on gym equipment, they tried wobble boards, they loved the TRX, my girl did a body balance class, dance and some yoga. My boy spent a long time just running and playing in the fountains getting wet 😂
Thankyou Southsea for having us. We will be back. More of this please.
Let’s talk planks.
An amazing exercise for building core strength, for working the whole of your body and there is so much you can layer and add into a plank.
Also one of the exercises that therefore needs great technique or a lot can go wrong. All too often people are encouraged to dive head on into a full plank without knowing the hows, why’s and why nots. I love a challenge, but I don’t like the planking challenges. Personally I do not see the benefit to being able to hold a static plank. I have a body that rarely stays that still and so far more useful is a moving plank with levers and motion.
Many people are just not strong enough to launch into planks. These are not beginner exercises. Done incorrectly the intra-abdominal pressure will build up and it has to go somewhere, so if you have weak abdominals these may sag and bulge or the same with your pelvic floor. I remember attending a mums and babies fitness class with mums there 6 weeks after having baby – all being told to plank for 1 minute. If your core is not ready, do not do a full plank, if you have recently had a baby and you are rebuilding your strength, do not plank, if you have a weak pelvic floor, do not plank. Now that may sound harsh and rather black and white… so here is the softer version. There is a version of a plank that everyone can do, it is just finding your level and knowing which muscles to use plus ensuring you breath.
So what about if you really want to plank or if you are in a class with planks and you need a variation? Here are some plank progressions for you, including a standing version that I use with my pregnant and postnatal ladies.
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.