March 14, 2016

Exercise in Pregnancy and Postpartum PART 1

My passion for helping women understand what happens in their bodies during pregnancy and postpartum started over a decade ago.  I was taking an “Exercise through Pregnancy” workshop in NYC with Debra Goodman MSPT, and I discovered I had a three-finger diastasis. I learned movement contraindications and the potential worst outcomes if you use your abdominals incorrectly during pregnancy and the first year postpartum. I was so afraid of making it worse that I avoided all abdominal work.  I would teach Pilates and show nothing, as so much of the repretoire was contraindicated.  I became excellent at verbal cuing and did nothing to rehab my own abdominal separation. Fast forward to “The Postpartum Client” workshop. Here, we again used my diastasis as an example as students learned to palpate the split. Debra told me I needed to start strengthening. There is a fine line between the damage of incorrect movement and doing nothing at all. I wish I had had that information before I was pregnant, or at least at the beginning of the first trimester.

As I started my journey to heal my own body, I began to educate others how to heal theirs correctly and efficiently. When I opened Local Motion Studio, I became passionate about teaching my instructors how to do the same. I wanted woman to understand in the simplist terms what is happening and why they should not do crunches, planks and other exercises that put too much load on the abdominals.  Integrity of the abdominal muscles is compromised during pregnancy because of hormonal and musculoskeletal changes,  and these changes are present postpartum. You can rehab correctly, but you  need to know how. It is important to educate yourself if you are going into a group exercise class. Many instructors  will not tell you this, either because it is difficult to modify during their classes, they do not realize you are pregnant or postpartum, or they simply do not have the knowledge. Additionally, there are different opinions and it is up to you to arm yourself with knowledge and make the best choice for you. I do take a conservative approach.  I have seen both the worst case scenarios, and also great success with this protocol.

What is Diastasis Recti? It is a separation of the two halves of the rectus along the linea alba. This happens to most women during pregnancy due to hormonal softening. This is not the problem on its own typically. It is during pregnancy and postpartum that you want to learn about this, learn what not to do so you do not worsen it, and what you can do to rehab it.  A trained instructor should be able to palpate this split.

Diastasis-Recti | MuTu System | COPYRIGHTED IMAGE

 

What can worsen it? Doing exercises that put too much load on the rectus before regaining the integrity of all the abdominal muscles. You need to be able to engage the TVA (Transvers Abdominis) and keep the rectus from bulging out. A professional trained in this work can evaluate if you are engaging correctly, and  let you know when you are ready to move toward more challenging core exercises. Exercises that can worsen the split include, but are not limited to, crunches, leg lowers while lying on back, double leg lifts, planks, and push-ups on floor. Do not jack knife up from the floor ; roll to one side and push yourself to seated.

How can you safely rehab your abs? My recommendation is to start with seated and quadruped (on all fours) abdominal exercises. These enable you to engage correctly, build back the strength and integrity of the core muscles, and train the body to stabilize before mobilizing. This muscle memory helps you properly engage the abdominals before moving or adding load. The video here is of the seated 10 second holds. I will post more in coming weeks.

These holds can be done anywhere. I used to do them driving, walking, at home and in class.

If you have any questions about this or if would like to schedule a session with me to learn more, comment below or email me at sara@localmotionstudio.com

 

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