Postpartum Workout: Diastasis Recti, Pelvic Floor and Core Strength
Having a baby is hard on your body, but being pregnant for months and months is even harder! The baby pushes up into your diaphragm and down into your pelvic floor. Your ribs spread, your pelvis spreads — okay, I’m going to stop now, because elaborating is just not needed.
In this article I’m going to cover 3 easy exercises that can help your body bounce back from baby as well as some common patient questions that might interest you.
*Q&A about diastasis is at the bottom of the article.
Your body is supposed to bounce back after the baby, right? Well, not so fast. A couple key factors go into bouncing back naturally and one of them is chairs. That’s right, we sit too much in chairs instead of squatting. In the upcoming workout series, you will learn a safe progression for building deep squat strength. Deep squatting activates the glute max, which is not only your powerhouse for strength but also helps kick your pelvic floor back into action. A strong glute max also prevents mom butt! I say this in a distressing way because mom butt is associated with knee, hip and low back pain. It’s an issue that is best prevented before nagging orthopedic issues like back pain follow. Who would have thought looking great in a pair of jeans could be a health bonus?!
Everything we do as a mom is hunching forward. It’s terrible for our backs! Changing tables are low, cribs are low, car seats are low — everything with kids requires bending over. Most new moms are not crazy bodybuilders, so learning how to do a proper hip hinge is not on the radar.
#1 Strengthen Your Glutes to Bounce Back from Baby
The angle our pelvis takes on to accommodate the baby makes it difficult for the glutes to fire. Most new mom patients I see lack glute strength. To get your glutes back you need to start using them every time you bend over to pick up that little precious one or just all the toys scattered across the floor. That’s why you need to learn a hip hinge now and build deadlift strength.
After deep squatting and learning a hip hinge, my 3rd tip for building glute strength is to:
Quick Back Saving Tip:
Alternate the side you carry the baby or carrier on as much as possible. Always carrying on one side can cause muscle imbalances that can lead to future neck, shoulder and back pain, as well as pelvic floor dysfunction. The same goes for your heavy purse, too!
#2 Build Pelvic Floor Strength to Bounce Back from Baby
You do not need a vaginal delivery for your pelvic floor strength to be affected by pregnancy. The extra weight of the baby pushing down on the pelvic floor can cause issues without having to push that baby out. As your body spreads to accommodate the baby, the bones of your pelvis move. This change can affect the function of the pelvic floor. Proper diaphragm function, as well as correct posture and deep squatting, go a long way toward strengthening the pelvic floor. It’s more than just doing kegels. Alignment issues, diaphragm function, hip and core strength all play a role in having a strong pelvic floor. Don’t want to pee when you laugh? Then get your pelvic floor firing today!
#3 Deep Breathing (Diaphragm Function) to Bounce Back from Baby
Deep breathing with proper diaphragm expansion makes your whole body happy. It relieves neck and back tension, but most importantly, it turns on the pelvic floor and helps close your diastasis.
When you take a deep inhale, focus on the ribs expanding out- 360 – around your entire ribcage. As they expand out, feel the pressure from the diaphragm push down into your pelvic floor. (Try sitting on an exercise ball for added feedback.) This pressure down says: “Hey, pelvic floor! You need to turn on and work!”
When you exhale your ribs should come back down and in. In most of my patients with diastasis their ribs are stuck in a flared out position. Check out this video below to see how to get stubborn ribs to come down. This will help close your diastasis.
- Start with your hands directly under your shoulders and knees directly under hips.
- Ground your toes, creating a dynamic feel to your position
- Keep your head up in line with your body and your chin tucked
- Tuck your butt under slightly from your lower abdominals, not your glutes and hamstrings (do not tuck if you have a disc herniation- see Low Back article)
- Keep your glutes and hamstrings completely relaxed
- Inhale expanding into your midback area (if it won’t expand, it just means you are really tight and need more work)
- Exhale from your ribs- you should really feel your ribs come down and in! You are not drawing in yoru belly button.
- Do not let your back or head drop down on the exhale
- Inhale through your nose and then exhale again continuing to fill the balloon- Only add a balloon once this exercise is easy without it and you are getting great rib movement!
- Try for 4-5 breaths, maintaining the exhale for 5 seconds
(Exercise credit: Postural Restoration Institute)
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Frequently Asked Questions from Postpartum Patients
What exercises postpartum that prevent my body from healing?
- Too much too soon. It’s important to listen to your body.
- Front Planks, crunches, sit ups, leg lifts, push ups, Pilates 100s, v-sits. Basically, anything that puts too much pressure on the front abdominal muscle (rectus abdominis) can cause your diastasis recti to get worse.
- Anything too dynamic before your pelvic floor heals: jumping jacks, running, etc. Dynamic activity before the pelvic floor fully heads can increase risk of a prolapse and nobody wants that!
- Being too strong without balance. Women can have an imbalance where their core is too strong (crazy right) and their pelvic floor is not strong enough to handle the intra-abdominal pressure that the strong core muscles exert. Example: peeing a little when you lift something really heavy or exert max effort. You see this in your Olympic lifting crowd. Balance has a lot to do with breathing. Every part of your body has a role and it must work together. (Other things that cause pelvic floor dysfuntion: Being disconnected from your pelvic floor – diaphragm system. That natural support system needs to be tapped into for proper function. Clenching your pelvic floor can also lead to leaks. The pelvic floor will compensate for other areas of weakness in the body.)
Why do I need to do anything special or different from a normal exercise routine postpartum?
Pregnancy is a dramatic event on your muscles, joints and ligaments, not to mention your uterus. Your body has just been through some incredible changes. I see women in my office every day who are suffering from hip, low back and neck pain caused by changes during pregnancy that were never fixed properly postpartum. (Flared rib cages, pelvic floor dysfunction, pelvic angle changes, poor posture, increased kyphosis, etc.) I want to help women get back their bodies to prevent aches and pains later in life. Plus we all want to go have fun with our kids! The ability to run, jump and play without worry should be a part of life. So, yes! The answer is yes! Women need to do special exercises to get their body back to 100%.
I had a C-Section. Doesn’t that mean I’m spared from those dreaded pelvic floor issues?
Well, not so fast. The pelvic floor is a dynamic set of muscles that are responding to the surrounding tissues. It’s not just the babies head coming out that does the damage. The baby pushing up into your diaphragm (remember that foot kicking your rib) and out on the abdominal wall also cause a problem.
Can’t I just do kegels at stop lights and call it day?
First off, good for you for knowing what a kegel is. A quarter of my clients have never heard of that exercise. (It’s the drawing up of the pelvic floor muscles. It feels like you are trying to prevent the passing gas or urine.) The answer is no, you can’t just do kegels. They are good exercises and you need a strong pelvic floor, but sometimes the issue has more to do with timing. Someone may have a strong pelvic floor but when they jump up and down or sneeze, the pelvic floor does not respond automatically. Sneezes do not wait for you to hold in your pelvic floor consciously, nor does that spontaneous laugh that feels so good. Thus, pelvic floor firing is dynamic and interactive with the body, so there is more to it than just strengthening the pelvic floor. Lastly, I also see an issue with women doing kegels incorrectly. Sometimes exercises are not as simple as they seem.
What is a diastasis recti?
A diastasis recti is when the center abdominal muscle, the rectus abdominis, seperates. The condition is measured by lying on your back, knees bent and doing a curl up. If you have more than a two finger width gap above or below the bellow button on the linea alba it is indicative of a positive diastasis recti.
How does it happen and can it be prevented?
The risk increases with multiple babies, multiple births, or large weight babies. Think of it as a capacity issue. Your abdominal wall is a canister and there is just no more room for a big baby, so something has to give. The thing you can do is avoid forward pressure exercises after your belly starts to grow in size and immediately postpartum. So, no front planks, push ups, leg lifts lying on your back, or hanging leg lifts. Also try to always roll on your side when you get up instead of sitting straight up. Basically you are trying not to stress the front abdominal muscle while it has so much pressure on it. Once it heals postpartum (which most naturally do) you can do all the front planking your heart desires.
The other thing you can do is perfect your posture. The way you carry yourself and load your system changes the forces on your abdominal wall. Correct loading will protect a diastasis and prevent it from occuring, incorrect loading will cause it to get worse or never heal. Just the other day I saw a woman that was 20 yrears postpartum and she still had a diastasis. Within a couple sesions we got it to start closing. Crazy right!?! You can correct something that long after it happened. It’s like her body was just waiting for the right movement pattern.
What can I do to help my diastasis heal?
Some professionals recommend wrapping or supporting the diastasis for the first few weeks postpartum, which can help, but the biggest one is fixing your posture and getting your diaphragm working properly. With correct, supportive posture, your deep core muscles will take all the stress off the diastasis and allow it to heal properly. You also need to be careful with abdominal work postpartum. Exercises like front planks, crunches, and leg lifts can make a diastasis recti worse. Don’t rush into a difficult exercise program too soon, your body just went through a huge change and it needs time to heal properly.
My mission is to get every woman’s body back after baby! Reconnecting the core prevents back, hip and neck pain as well as other ailments. If I can get the right information out to postpartum women, then I will be less likely to see those women later for related orthopedic issues. Life is beautiful, and we should all be able to run, jump and play with our kids.
All My Best –