I remember talking with a fellow trainer friend late in our pregnancies about the lack of information about not only exercise during pregnancy, but the even single mention of Diastasis Recti (DA) or health of the pelvic floor from health practitioners.
Both of us delivered healthy babes but couldn’t believe we make it almost 40 weeks without even a handout?
I was told to exercise most days of the week, not to lift more than 10 pounds, and at every appointment was asked how many days a week I was exercising and for how long. That’s it.
Post baby I was told I could resume normal activity and do lots of abdominal work. Seems innocent enough but read on to learn why this advice just doesn’t cut it.
What is Diastasis Recti and why should I care?
Diastasis Recti (DR) is likely to occur in almost all women during pregnancy.
The connective tissue (linea alba) that runs down the midline of your tummy (think between the 6 pack muscles, the rectus abdominis) from the sternum to the pubic bone holding your abs together becomes stretched as baby grows. This can cause separation between the abdominals leading to instability in the midsection.
While this is natural and very common it can be made worse with poor posture, poor exercise selection and poor movement during pregnancy and after.
What exercises can make it worse?
As your belly grows and once baby is born it is best to initially avoid exercises such as front planks, push-ups, sit-ups, crunches, leg raises.
Avoid using heavy weight that forces you to hold your breath.
These exercises put unnecessary stress on the abdomen and can put the belly in a bulging position, contributing even more to DA and pelvic floor dysfunction.
Focus on the pelvic floor connection and the breath.
Kegels are often recommend to keep the pelvic floor strong but a more effective way goes beyond just clenching the pelvic region repeatedly. It is a controlled engagement that matches a specific breath pattern. Your pelvic floor should relax on your inhale and lift on your exhale. This is a gentle movement that should not be used at full force.
When applied to an exercise such as a squat lets say, typically you inhale on the way down, engage your pelvic floor and exhale on the way up.
This breath and movement pattern is important for keeping a strong pelvic floor during and after pregnancy. It will very from person to person and the absolute best thing you can do is to see a women’s health physical therapist during and after pregnancy, especially if you are experiencing any pain or symptoms.
Diastasis and pelvic floor dysfunction are often associated with incontinence, back or pelvic pain, hernias and prolapse.
Aesthetically it can look or feel like a poochy tummy.
But how do I strengthen my core?
There are far more effective and safe ways to strengthen the core than sit-ups and crunches. Pregnant women do not need direct abdominal work as it is not the only way to create stability throughout the midsection.
The latest research shows that is not AS much about choosing the perfect exercises but the approach you take, focusing on connecting your breath to your pelvic floor to the particular movement.
During pregnancy you can choose dead bugs (as long as you can lay on your back) and modified side planks.
Focus on the glutes as they are as much a part of the core as the abs, with exercises like hip thrusts off the bench, side lying clams, side steps with the mini band.
Use unilateral upper and lower body exercises like standing one arms cable rows, single arm shoulder presses, single arm incline bench presses. Use exercises like trx rows, inclined rows on the smiths machine with the body is proper alignment and breath patterns.
Avoid any back bending exercises or exercises like pull ups that can overstretch the midsection.
What else should I avoid during pregnancy?
Be cautious of when you might do sit up like movement in your everyday routine. Getting out of bed, sitting up of the ground, etc.
Always be conscious of rolling on to your side first and then using your upper body to press yourself up.
This creates unnecessary pressure on the tummy and the pelvic floor.
I have attached several additional resources below.