How to Heal your Abdominal Wall After Birth
THIS is what women’s health experts want you to know about How to Heal your Abdominal Wall After Birth
Abdominal Separation. Those two words can bring up a lot of confusion and fear for new mums. Whilst it is a normal (yes normal!) part of pregnancy, and is the body’s way of creating space for your baby to grow and develop, abdominal separation or rectus diastasis has become a source of a lot of conflicting (and simply incorrect) information.
If you are feeling overwhelmed and unsure of how to properly heal your abdominal wall after birth, co-founders of the Empowered Motherhood Program Lyz Evans and Kimberley Smith are here to guide you through the process of healing your core after birth.
In this video, Titled Women’s Health Physiotherapist and Founder of the Empowered Motherhood Program Lyz Evans shows you three exercises you can do daily to connect to your transversus abdominis, improve your posture and breathing and help heal stomach separation.
Watch the video above for 3 exercises to help strengthen your core or read on to learn more about stomach separation.
Why do I still look pregnant? Changes to your abdominal wall in pregnancy and postpartum.
Were you surprised to see that your tummy still looked 6 months pregnant after birth? We know it’s a shock! Abdominal separation or rectus diastasis is a result of the thinning and weakening of the linea alba. The linea alba is a band of connective tissue which stretches from your breastbone to your pubic bone. All of the muscles of your abdomen, the transversus abdominis (the deepest layer of abdominal muscle), the internal and external obliques and the rectus abdominis all connect to the linea alba.
The linea alba works like an anchor point for the abdominal muscles to connect to and generate tension from.
The linea alba stretches and thins during pregnancy to allow for the growth of your baby. This stretching and thinning is what gives the appearance that the abdominal muscles have separated.
It is a natural part of pregnancy, and it can usually be healed with the right exercises and movement patterns.
How do you heal stomach separation?
This is a complex question which involves a multi-faceted approach. In the Empowered Motherhood Program, we work with you to:
#1 Improve your breathing mechanics.
The diaphragm is directly connected to the core through a complex system of fascia and connective tissue. The way that you breathe affects how your core functions. So Step #1 is learning to breathe well. As you inhale, fill up your lungs and imagine your diaphragm dropping and expanding. Allow your abdominal wall to relax and soften.
As you exhale, imagine your diaphragm lifting into your rib cage and gently draw your belly button inwards and upwards. You can practice this breath during from pregnanc and from birth.
#2 Improve your Posture.
Have you noticed that almost all of the tasks we do as mums involve an element of bending forwards. Changing nappies, feeding and even rocking our babies in our arms can result in long hours spent hunched forwards. Your core works optimally when your spine is in neutral. Being mindful of your posture throughout your day can support not only your spine, but also promote abdominal wall recovery. This is why exercises to support a strong and healthy posture are a big part of our early postnatal recovery program.
# 3 Connect to your Transversus Abdominis
The transversus abdominis (TA) is the deepest layer of abdominal muscle and wraps like a corset from the spine all the way to the front of the belly. When transversus abdominis contracts the waist narrows slightly and the lower abdomen flattens.
The role of the TA is to stabilize the low back and pelvis BEFORE you move. Because this muscle is stretched and weakened during pregnancy, we often lose this anticipatory function. This means that every time we place a load on our body, more pressure can be translated through the pelvis and lower back. To help our TvA to regain that anticipatory function, we have to ‘use it or lose it’. The ability of your body to synthesise collage and lay down new muscle is an essential part of abdominal wall recovery and is dependent on the abdominal wall being mechanically loaded.
Studies show that 4-8 weeks of non-loading (not using a muscle group) can result in a 20-30% loss of muscle mass. During the early postnatal period, the abdominal muscles can become sluggish and require gentle activations to help rebuild their strength.
One effective exercise shown in the video above is core activation is single leg toe taps and single leg and arm slides in a four-point kneel. Once you become comfortable with these exercise, it's important to incorporate it into your everyday life to ensure that you're engaging your abdominal muscles in your daily movements.
#4 Support, Support, Support
In the first 8 – 10 weeks postpartum the abdomen is still incredibly weak and distended. Whilst your body is weak and there are excess hormones are still present, it is important that we provide some rigid support to the abdominal wall to help reduce distension and also provide a form of sensory feedback for the abdominal wall.
There a number of research papers that show that core exercises combined with wearing abdominal wall support garments for an average of 8 hours per day results in:
- greater reduction of inter-recti distance;
- increased flexor strength through the abdominal wall (in a crunching movement pattern); and
- improved endurance,
compared to just doing core exercises alone.
"I am living in these tights, postnatal! They have helped my separation restore itself and made me feel more comfortable moving around." — Christella J.
"Helped with my recovery and abdominal separation making me feel really supported!" — Melissa K.
"I had 5cm ab separation during pregnancy and after wearing the tights for only one week post birth I already have noticed a narrowing of separation and feel so supported to get out of bed and feed my baby. Perfect to wear straight after labour." — Elle W.
#5 Yes! You can crunch!
We want to help you to return to the type of exercise you love. Which means progressing beyond early postnatal exercises to strong and dynamic fitness. Your core needs to support you through your daily #mumlife - not just when you are lying on your back doing toe taps!
From around 6 weeks postpartum, you need to start to load the abdominal wall. One of the key ways the abdomen is designed to move is to CRUNCH!
For a long time, there was a lot of confusion about whether crunching was safe or not. However if we want to load the connective tissue and rebuild the muscle bulk we need to crunch (safely!).
Crunching is a part of daily life, from getting up out of bed to getting out of a chair, we repeat the crunching movement pattern hundreds of times a day. In the EMP, it is really important to us that you not only heal your body safely, but that you also prepare your body for all the movements you need for daily life.
The research also backs this up. When we compare a group of women who do foundational core exercises combined with crunching, against another group that do foundational core exercises combined with planking - the group that has far greater improvements in inter-recti distance is the group that crunches.
#5 Keep Progressing
This is one mistake we see so often. Women fail to progress beyond early postnatal exercises and so they feel stuck feeling perpetually postnatal.
The abdominal wall needs to flex, stabilise, rotate and extend – and if we never get off the ground or challenge the muscles then it will never regain its full strength.
All of your body’s natural healing is finished by 8 – 10 weeks after birth, so any additional improvements are going to take a bit of work. Ensuring you are continuing to safely progress and challenge your abdominal wall will ensure you continue to heal and return to your pre-pregnancy strength (or beyond!).
In the Empowered Motherhood Program our Core Connect Program is designed to support you as you progress from toe taps and early postnatal exercises all the way to strong, functional and dynamic core exercises. This is the missing step in most core programs and is vital if you want to return to running or any other high-intensity exercise.
We hope this helps and we’d love to support you to heal your core well with the Empowered Motherhood Core Connect Program. We start with a personalised ‘Where to Start Quiz’ so that we can find the best workouts and programs for you.
Kimmy and Lyz
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Lyz Evans and Kimberley Smith are the co-founders of the the Empowered Motherhood Program (link: https://www.empoweredmother.com.au/), the award-winning online program and mobile app that combines physio-led exercise with expert education for every stage of pregnancy, birth and postpartum. Lyz is a Titled Pelvic Health Physiotherapist and mum to 3 and Kimberley is a pregnancy and postnatal exercise specialist and mum to 3.
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