Work It Out: The key to conquering abdominal separation for pregnant women.

Childbirth is truly a beautiful time in the life of a woman. A time of joy and happiness, in which you bring another, very beautiful life into the world. Of course, pregnancy can come or be associated with a multitude of health challenges; many of which you can do something about while you are pregnant {back pain, sciatic discomfort, pelvic floor dysfunction, poor posture, diastasis recti, round ligament – to name a few) and more that you can do to heal after baby arrives. Abdominal separation (diastasis recti) is one of these later conditions, in that it actually involves a gap of 2.7 cm or more between the dual sides of the rectus abdominis muscle. And while this condition has no serious or life-threatening consequences, it can actually result in the visibility of the uterus and/or intestines through the abdominal wall—so that it seems to protrude through the skin – resulting in a hernia (typically an umbilical hernia).

 

Not to worry; through a very basic and—believe it or not—actually enjoyable series of exercises, you can correct abdominal separation and even begin to heal during pregnancy. Yet before we delve into these virtual aerobic ‘tummy tucks’ and how you can ‘exercise’ them to the very best effect, let’s take a look at diastasis recti—its causes, effects and what you can do to ‘save the stomach.’

The whole and holistic experience of childbirth is truly a transformative experience; one that leaves a woman forever changed as she grows and delivers a beautiful new life—both into her family and into the world. Yet for all of the positive effects that accompany this major life change (a positive outlook to the future, an increased feeling of spiritual oneness with your child, your family, and the universe in general, a healthy and bountiful glow that shines forth from the woman’s skin, an increased enjoyment of food, and a more voluptuous physique), the physically challenging pregnancy procedure can be one of the most trying and even traumatic experiences of a woman’s existence. And if you happen to be reading this at the beginning of your first trimester of pregnancy or anytime during your pregnancy really, head on over to Erica’s Knocked-Up Fitness Membership and learn how to safely and properly strengthen your core to help minimize and even begin healing abdominal separation during your pregnancy (Yes it really is possible to begin healing diastasis recti even while pregnant!).

 

 

 

Seriously though, most new mothers realize that this isn’t precisely going to be a walk in the park. Most have heard about the substantial weight gain, aches and pains, the contractions, and of course the intense labor pains that come as part and parcel of the pregnancy experience for every woman. And, depending on the individual, others also experience mood swings and depression bouts both during and after the experience; some may have trouble sleeping, experiencing mood swings and limited movement, and even dealing with odd food cravings (pickles and ice cream, anyone?) Some even go so far as to say that, if men could get pregnant, the species would likely die outright!

Among the many maladies and discomforts associated with pregnancy, abdominal separation does not rank among the most frequently discussed. The fact remains, however, that nearly every woman experiences this phenomenon to a certain extent, some more severely than others.  It is certainly nothing to be ashamed of, and—while inevitable in many cases—abdominal separation can be minimized and corrected.

 

First, though, one must develop an understanding of this all too common maternal malady. And basically, diastasis recti indicates a separation of the rectus abdominis muscle—or, in other words, the abs. Now while everyone would love to see the appearance of ‘ripped’ abs on their bodies, few actually desire ripped abs—ah, but when a gap of almost 3 cm or more develops between the left and right regions of the rectus abdominis, this is precisely what happens.

If it makes you feel any better, Ladies, please allow us to assure you that the singular phenomenon of abdominal separation happens to males as well. As tends to be customary in everyday life, the condition affects the females far more frequently; yet males do contract diastasis recti from time to time, and for wildly varying reasons.

 

Gents who practice improper weightlifting techniques or who do excessive abdominal crunches in a decidedly incorrect fashion are particularly susceptible to diastasis recti. At the other end of the spectrum, men who gain excessive amounts of weight are more susceptible to abdominal separation, as masculine weight gain is most generally expressed in the outward swelling of the abdomen (aka the rise of the good ol’ beer belly). And some people of both genders and various ages are genetically predisposed to contract this condition.

Even the adorable little babies that result from those much discussed pregnancies can suffer from abdominal separation; this owing to the fact that their little abdominal areas are not fully developed and may not be properly sealed at the center. The condition, as might be expected, is particularly prevalent in the instance of premature births and for many will naturally heal with time.

Ah, but let’s get it back to no. 1 and talk about the ladies. Abdominal separation most frequently occurs in pregnant women, although the condition can strike new moms as well—particularly during the course of the postpartum period.

During pregnancy in particular, the growth of the uterus results in a marked stretching of the abdominal muscles; thus creating the not so great divide between the dual sides of the abs.

Women who have had more than one child, who give birth over the age of 35, who experience multiple births, or who have particularly robust and bouncing infants (translation: the kid is BIG, possessing of a high birth weight), or do inappropriate abdominal exercises during pregnancy, are more likely to suffer from diastasis recti. Yet as previously mentioned, some degree of abdominal separation can be expected throughout the course of virtually any pregnancy.

How does someone know that they are suffering from abdominal separation?The indicators for this condition are quite varied and do not express themselves in the same way for every person afflicted (Annoying, we know). In general, though, abdominal separation makes its presence known in the form of subtle physical differences and abnormalities. You might experience an onset of nausea or notice redness and inflammation in the abdominal area. You might suffer from unusual pain in the hip, the back, or the belly button. You might suffer from urinary incontinence or constipation as a result of this condition. And in more severe cases, you even might find it challenging to move or breathe with the usual ease. You even may develop a hernia—never a pleasant experience, to be sure. Yet this is a manageable condition and there is hope; and by improving and enhancing your deep core strength, you can empower yourself–not only to deal with this condition–but to conquer it.

Test to see if you have abdominal separation:

 

 

Or, by contrast, you may feel no adverse effects at all—still, perhaps you notice that certain, inexplicable physical changes have begun to overtake your body; subtle but highly visible changes that do not necessarily come as part and parcel of the pregnancy experience.

Perhaps your belly button begins to protrude outward (we’re talkin’ a major outie here). This same belly button may feel looser, wider, or substantially less taut.  Or you even might note the presence of a line that develops down the center of the stomach. In its most visible and apparent instances, diastasis recti can create a bulge or protrusion in your midsection, with the outline of the uterus protruding through the abdominal wall beneath the skin.

 

“Ok, good to know!” you might be thinking at this point. “So how do I prevent this from happening to me? And if it happens, how do I correct it?”

 

Well, the answer to the dilemma of how to deal with abdominal separation is just as complex as the condition itself. For example; these days a person actually can purchase foundation garments to help manage any given instance of diastasis recti. Indeed, you can wear a garment to help hold your abs together…but it can actually make your core weaker if you use it to just bind – the proper way to use a binder or belt or belly band is to use it to remind yourself to engage your deep core (correctly)!

Surgery is the remedy of choice for some sufferers, with diastasis recti surgery and ‘tummy tucks’ ranking high as procedures of choice for those who wish to cure this all too common phenomena. And while they may indeed prove very effective, it is truly only a band-aid solution and does not fix the underlying weak fascia / connective tissue and deep core. Those who wish to avoid many of the pratfalls associated with surgical procedures (i.e., high financial cost, time away from work, pain and discomfort, and perhaps an emotional fear of going under the knife) might want to try an altogether different route.

picture of a woman with an Abdominal Separation Pregnancy

Abdominal Separation Pregnancy

 

Indeed, some choose to do nothing; a remedy that works best if your instance of abdominal separation goes away on its own, leaving no visible effects or anything in the way of lasting pain or discomfort.

 

Also along the same lines of doing absolutely nothing (always good work if you can get it), rest and relaxation are seen as viable coping mechanisms when it comes to preventing and/or coping with abdominal separation.

 

Often pregnant women are advised to take it easy for the duration of and immediately following their nine months of pregnancy. Although a limited and very specific regimen of exercise is recommended to maintain the strength of the mother to be (while also preparing her body for the rigors of childbirth), she is also frequently advised to get plenty of sleep, lighten her workload, and limit physical activity.

Sure, new moms and moms to be want to stay active (especially in this modern age, when many of them work outside the home, are fitness enthusiasts, and play sports as well), but even they must regard and follow a designated list of don’ts during this challenging time of significant life change and substantial body transformation. Don’t drink, for example. Don’t smoke. Don’t eat too much unhealthful food. And don’t participate in excessive and prolonged periods of vigorous physical activity.

picture of a woman with Kinesiology tape for pregnancy discomfort

Kinesiology tape for pregnancy discomfort in abdominal separation

The same holds true when it comes to the prevention and treatment of abdominal separation. Those who avoid doing excessive abdominal crunches during their first trimester of pregnancy, for instance, might stand a better chance of avoiding a severe case of abdominal separation. And once the condition already has developed, a sustained rest period will not help to sustain and hasten the healing process. Keep moving, keep active, Stick to your exercise regimen and build those muscles to the very best effect; while taking your rest sessions as you need them. As is the case with the vast majority of diseases, injuries, and maladies that afflict the human body on a regular basis, rest and sleep can do much to heal the body. In this instance in particular, to mend the abdominal muscles and restore them to their original state.

 

Try to get a full 8 hours sleep during and after your pregnancy (or as close as a new mom can get to that amount), and lay down for a nap or rest period whenever needed. Take note of any strain or pain that may strike you, and inform your doctor if said discomfort persists. And never be afraid to reject the performance of any physical work- or recreation-related tasks that you feel might cause or exacerbate this or other pregnancy related conditions.  

 

In some, very rare cases, doctors may prescribe bed rest to help sustain a healthful pregnancy, and/or to combat related conditions such as abdominal separation. In the vast majority of cases, however, this extreme treatment is not needed or even recommended. And you will want to remain as wisely and healthfully active as possible before, during and after your pregnancy.

When movement is required, just make a concerted effort not to overdo it, so to speak. Don’t bend over swiftly or at sharp angles, and refrain from heavy lifting; and yes, new moms, you even must be cautious as to how much you bend over to lift that hefty—oh, but we shall hasten to add, oh so adorable—bundle of joy that inadvertently brought about this condition in the first place.  

 

And please do not believe that—in the vast majority of cases—abstinence from any and all forms of exercise is required. If anything, pregnancy can—under a doctor’s supervision and with the greatest of care—be a time to strengthen the body in preparation for one of its greatest challenges. This is the perfect opportunity to strengthen your abdominals and indeed all of your deep core muscles.

 

During the first trimester in particular, strengthen your abs to both avoid and remedy instances of diastasis recti, while also enhancing posture and pelvic floor strength, increasing energy, alleviating aches and pains, etc. So for best results, exercise for a half hour to an hour each day, all the while staying hydrated, dressing in layers, wearing stable shoes, and exercising in temperate conditions inside and outside.

 

Always start slowly during these exercises, limiting your sessions to 10 or fewer minutes if needed. Discuss any and all exercises that you plan to do with your physician, and obey any limits that they set on your behalf. Also, limit the amount of time that you spend reclining on your back during exercise, to minimize decreased blood flow to the baby.

picture of hip press to decrease abdominal separation pregnancy

hip press to decrease abdominal separation pregnancy

A few more items on that ever pesky don’t list that every expectant mama simply must obey. You should avoid exercises, for example, that require you to change direction swiftly; even deep, intense yoga poses should be avoided at this time, although overall the relaxing, time honored and ever therapeutic practice of yoga is highly recommended for new and expectant moms. And as opposed to holding a stretch, elect for a more active—while still gentle—approach to stretching. Be active with your stretches, while still showing restraint—especially after the birth, while your body is recovering. And avoid twisting the exercise session away, as excessive twisting of the waist and hips is not recommended at this time. Also, by all means, avoid any coning of the belly; to put it simply, if you see a ridge or bulge popping forth from your mid drift, chances are you are doing an exercise incorrectly. And, yes, coning is an all too common sign of abdominal separation. This is why we avoid traditional crunches during pregnancy, and also take great care in rising from the floor after the completion of your exercise—rolling to your side before you rise.

 

As far as a to do list regarding ‘partum pregnancy’ (that would make a mighty weird title for an exercise video, would it not?), well the good news is that the do’s far outnumber the do not’s. In addition to your physician, you may want to seek out the services of a personal trainer, coach, trained fitness instructor, or other fitness professional. Dress in accordance with the temperature of the workout area, and maintain a controlled range of motion at all times.

picture of Erica Ziel explaining abdominal separation symptoms

Ah, enough with all of those pesky do’s and don’ts, right? Let’s get to work! Here are some suggested exercises for all stages and trimesters of pregnancy; ones particularly geared toward the treatment and management of abdominal separation. They are pelvic tilts, hip rolls, foam rolling, squats with rotation, forward rolls, and the cat cow exercise.

 

These exercises are derivatives of fairly common exercise maneuvers, and they benefit people of all genders, ages and physical conditions. Yet they were preselected for you during this specific time of your life, according to some very specific criteria. All of these exercises, for example, are relatively low impact and easy to complete. All are aimed toward both relaxing and strengthening your body, especially those pivotal parts (i.e., the hips, the stomach, the thighs, etc.) integral to the childbirth process. These exercises are beneficial to both you and your baby, as they help you to maneuver the pregnancy experience and better prepare for childbirth. And, perhaps best of all, all of them have been proven to work; perhaps even serving to ease and facilitate the pregnancy and childbirth experience.

 

Moreover, these exercises are custom made for those who suffer from abdominal separation, in that they serve to work and strengthen the abs while also relaxing and toning them as well. And as they strengthen these all important tummy muscles, they even may help to prevent further instances ofdiastasis recti.

 

Foam rolling is perhaps the most popular, effective and easy to complete exercise available for today’s moms, moms to be, or anyone who wishes to ease hip and lower back pain. It is particularly beneficial for the first trimester of pregnancy. Here’s how it works, in just a few simple steps:

  1. 1. Place your foam roller (among the cutest and cushiest of workout instruments—get one today!) atop your exercise mat, and just beneath your hip.
  2. 2. Sit atop the foam roller, just as you would a (wobbly and moving) seat.
  3. 3. Walk outward in a sitting position.
  4. 4. Roll to your right hip and hold your head up high (Yes, Sister!)
  5. 5. Keep your hip relaxed and roll down the length of your hip and glute.
  6. 6. Shift back and forth across the roller, changing your position to address any sensitive or pain stricken areas.
  7. 7. Repeat the same process with the other hip.

Continue until you feel a substantial alleviation of any pain or discomfort. And as you complete the foam rolling exercises, please observe a few basic suggestions to optimize the experience of the foam rolling exercise and its effects:

  1. 1. Use your deep core muscles throughout the exercise.
  2. 2. Angle up tall from the floor.
  3. 3. Exercise in a slow and deliberate manner.
  4. 4. Breathe deeply and slowly throughout the exercise.
  5. 5. Relax your muscles, particularly the tension wrought shoulders and hips

 

Squats with Rotation is a particularly beneficial exercise for the second trimester of pregnancy. Take the squat (which is, for all intents and purposes, a common and even classic exercise staple) and most literally bend it to meet your adjusted fitness needs as your pregnancy progresses. Follow these simple steps to do the Squats with Rotation:

 

  1. 1. Part your feet to equal or exceed your shoulder width, then rotate the legs outward from your hips.
  2. 2. Squat downward toward the floor, all the while keeping your head up. Do not overexert your back, instead concentrating on the mobility of your hips and the derriere. And this will become more and more true as your pregnancy advances and your range of motion curtails. Hey, Girl; even a superwoman has to slow down and pace herself once in awhile.
  3. 3. Stand erect and rotate toward one side. Keep your front leg still, so that your back leg rotates and you pivot on your toe (You go, Twinkle Toes! Put those ballet lessons to work!). Extend your arms upward and away from you.
  4. 4. Stand and lift tall, and from your very core.
  5. 5. Rotate back toward the center and repeat the exercise on alternating sides.
  6. 6. Complete 10-20 sets of the exercise, or as many as feel comfortable or prudent at any stage of the pregnancy.

Forward rolls are another excellent pregnancy exercise that is particularly effective throughout the course of the second trimester. Get on a roll as you relieve any and all back pain, strengthen your core muscles, and stretch your tight back and abdominal muscles. So with that in mind, let’s roll!

  1. 1. Kneel with your knees shoulder width apart and keep the ball close to your body.
  2. 2. Articulate the spine in a forward motion by first tucking your chin, then roll the ball outward.
  3. 3. Roll the ball outward and ‘hug your baby,’ so you can work your deep core muscles.
  4. 4. Once you work your way outward, arch your back and press your arms into the sides of the exercise ball.
  5. 5. Breathe deeply into your belly, all while gently stretching your ab muscles.
  6. 6. Work your abs, scoop your belly inward and outward, straighten your spine, and stretch your lower back throughout the exercise.

 

As you come in to your third trimester—and, indeed, throughout your pregnancy—the cat cow exercise can prove a beneficial (if admittedly very oddly named) move. These simple but essential moves can be done every day, or as recommended by your doctor and a personal trainer or exercise instructor. They are not overly exerting, and—in truth—feel far more like stretches than they do strenuous exercise moves.

 

  1. 1. Go down onto your exercise mat on your hands and knees, squaring your shoulders and widening your hips while lifting your chin.
  2. 2. Angle your shoulders back and arch your back upward in a rolling motion, just as a feline would, all the while lifting your back and belly in a smooth rolling motion.
  3. 3. Repeat as you feel comfortable, feeling the slow arching motion in your back, behind and belly in particular.
  4. 4. Complete the exercise move by arching backward, again much like a cat would—and, hey, who knows? Cows might do it too. What is certain is that this exercise move is relaxing, invigorating and easy to do. But again….
  5. 5. Stop if the exercise feels uncomfortable. Be careful, and have fun with the good ol’ cat cow!

Have fun, in fact, with any and all aspects of your pregnancy workout. This is a very special time of your life; one bound to come complete with feelings of intense joy, hope and anticipation for the future. It is also a time, of course, for intense pain, discomfort and fatigue in some instances. And yes, it can for many be a time of abdominal separation. Yet if you remain active and energetic throughout your pregnancy, then you can take the power of your pregnancy into your own hands; just as any strong woman would! And with the help of these basic but highly empowering exercises, you very well may find that you can maintain high energy levels during these trying months; avoiding some of the excessive aches and fatigue that typically come as part and parcel of this life changing experience.

 

These exercises, in fact, might ease and facilitate the delivery process, as they will strengthen your hip, stomach and thigh muscles in particular and your body overall. They should help you combat and alleviate any issues of abdominal separation. And after the delivery, you very well might find that you are stronger and better able to carry out the basic duties that come with motherhood—from carrying the baby to carrying all of the burdens and responsibilities that come as part and parcel of this very special experience. You got this, Girl! And we are truly honored to be along for the ride.

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  • Fraddy Roy
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    Hii, Erica Ziel! Amazing post I never saw like this post, I have read your all posts all are awesome keep write
    Thanks for sharing

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