Wednesday, January 6, 2016

What Every Mom Needs to Know About Diastasis Recti AKA "Mommy Tummy"

Did you know that 1 in 3 moms who have had 2 or more pregnancies may have some type of abdominal separation? Have you have tried planks and sit-ups to help strengthen your core only to find that it does not help?  Did you know that certain abdominal exercises could make it worse?

This week I am blessed to have guest blogger, Carey Adam, Physiotherapist, Health Coach, mamma,  runner, and founder of RunningMoms; to cover a topic many moms suffer from, but do not know about. She has also had first hand experience with "mommy tummy" herself and has learned to heal hers overtime.


I am a runner, a physiotherapist, a health and running coach, and a mom of two boys. I had two very uneventful pregnancies. I ran for 26 weeks the first and about the same with the second two years later. I was back up and running within 5 weeks of both natural births on a slow and progressive program.

 I also have Diastasis Recti.

In my training as a physiotherapist, I was never taught much about pregnancy issues. As a practicing physiotherapist I worked with an aging population, joint replacement surgery and rehab after strokes, heart attacks, amputations, cancer, and any other chronic disease you can think of. So of course I thought I knew everything I needed for pregnancy, labor and recovery to get back up and running afterwards. I was a rehab specialist! Was I ever wrong.

During training for my first half marathon about 8 months post baby number one, I remember a sprint interval training session. I made it through the first 3 sprint sessions and on the last one, I peed my pants. I was mortified and shocked. We talked in the group about it and I was not the only one. So I just accepted this was my reality now and kept on training, no sprints. It was unfair but I was a runner, I needed to run and this was what I had to work with.

With age comes wisdom, so fast forward another baby and 4 years later. I have learned so much since that day, including all the other warning signs of an abnormal recovery. These included my new and growing outtie belly button and the weird bulge my abs took with every plank, mountain climber and crunch I did (and it was getting worse). Please know that none of this is normal. Even with all my training and education, it took me a long time to clue in, accept it and make changes to my exercise and activities.

Women’s health is a specialty, and I am shocked and appalled that all women are not taught more about this in every pre and post natal course and check in with their specialist. If I was not unable to identify the signs as abnormal and know to seek appropriate care (and who the heck that even would be), how is anyone else supposed to?

So finally now, 5 years after my first baby, do I finally feel like I have this under control.  When I did give into the signs and symptoms, acknowledge my fears and stop to really listen to my body, I started doing some serious research. I learned about Diastasis Recti, mommy tummy”, what exercises I should avoid and what exercises I should be doing. I am now well on my way to recovery and getting stronger with every smart workout I do. This is how I train my RunningMoms and this is what I now want to share with you.

Do You Have Diastasis Recti?
Photo from www.bellies.inc


Diastasis Recti (DR) aka "Mommy Tummy", is a fairly common condition in post partum women whether you have had natural birth or a cesarean. It is a condition not often talked about or recognized in the general fitness and mom community. Once you learn a bit about it, how it happens and how it manifests within your own body, you can start to address your own issues.

Briefly, DR is a condition where the connective tissue on your abdomen (think 6-pack abdominal muscles) becomes stretched, loosened and then separate at your midline. This is a great article to explain it. Please have a read to learn more.

It is important to understand that some amount of stretching and separation of this connective tissue is normal during pregnancy. You need to accommodate that growing baby somehow and this is what your body is designed to do. Unfortunately, when your health, daily activities and participation in your favorite activities is compromised, you have crossed the boundary of normal and need to seek professional guidance.
Here is a quick test you can easily self administer.

Photo credit goes to www.bikinibodymommy.com
What Are the Signs and Symptoms?

Diastasic Recti and pelvic floor weakness often go together. These are the signs and symptoms to watch out for:

  an outtie belly button (during and after pregnancy)
  urinary incontinence or increased frequency
  stretched and lax connective tissue after birth (see the pictures in the article above)
  unexplained low back pain
  unexplained pelvic pain
  a protruding belly despite crunches”, other exercise and diet to get rid of it
  just feeling off” or like something is going to fall out” when you are running, jumping or  lifting

Most women don't even know they have DR or think it is just a part of pregnancy/motherhood that they will have to live with for the rest of their lives. The good news is that they are wrong and there are ways to work at correcting it.

What Exercises Should I Avoid?

I know losing weight and getting back to a flat tummy is on every woman’s mind after baby. The reality of getting there is in rebuilding a strong, stable and supportive core. It is on reconnecting to that core for your life and not just your bathing suit. Getting back to exercise that is too much and incorrect will only prolong the struggle or make it worse.

If you are experiencing any of the signs or symptoms discussed above or you have not spent the time reconnecting with your core, this will apply to you despite how long ago you had your baby.

Here is list of exercises that should be avoided for the first 8 weeks post baby at least (possibly longer depending on the work you have put in to re-connecting to your core):

1.    Crunches and Sit Ups. This is a great link to why you should not being doing crunches. Will you ever do crunches again? The question should really be, why would you want to? There are so many better ways to strengthen your core and flatten your tummy. You do not need crunches.

2.    Planks - These are great but only when you have the strength to do them in good alignment and with good form. If you attempt a plank, you have a DR and you are not strong, this is where you will see your abdomen take that dome shape or start to bulge. That is your clue the variation is too tough for you. Always think quality before quantity. There are many variations you can begin with like the bird dog, plank from your knees or on an incline.
Other variations of plank type exercises are push ups, burpees and mountain climbers.
Continuing these types of exercises will only exaggerate your symptoms and make your “mummy tummy” worse over time.

Photo taken from http://www.belliesinc.com
What Exercises Can I Do?

The good news is there is so much you can do. Once you decide to address your issues, you will become more mindful of your body alignment, stronger for good, fitter and maybe even get  a flatter tummy.

By re-connecting with your core, I mean learning how to get your deep core system of muscles functioning and firing together - your transverses abdomens,  pelvic floor and  multifidus. The function of these muscles is to work together in anticipation of every move we make. They really can be trained during any exercise you do and it all starts with the breath.

It is a whole other post to teach you what you can do. If this is really an issue for you, I encourage you to seek advice form a professional or have a look at this program. It is online and teaches you the basic sequence of exercises you need to work through to start to re-connect. Check out the Online Core Confidence Exercise Program here.

So to put his all together, I have put together a 4 part videoseries on DR to help you learn more about your post pregnancy body. Please watch them in order. They are the basics. I give you a few exercises you can be doing to get started. Please don't be afraid of what you may find!

Be empowered to seek professional guidance. I strongly encourage you to seek professional one on one advice with a women’s health physiotherapist if you are symptomatic, concerned or needing more directed guidance about your own body. I want you to learn more about your postpartum body and appreciate what it is trying to tell you. I want to to then make changes to your workouts to get stronger correctly.

It can be done and it needs to be done because you need to keep moving whether you love hitting the gym, running, yoga, chasing your kids and being in your swim suit on the beach. Your body and mind need movement and exercise and it is possible to continue to do the things you love, you just need to be educated and learn how to do them safely for the long term health of your body.

My intention here is to appreciate that, respect that and make you more aware of your body. I want to teach you how to strengthen it appropriately, when to seek further medical advice and how to be smarter about your training. If I (as a physiotherapist, health and running coach) was oblivious to the signs, I know so many of you are.

All my RunningMoms.com programs are "Mummy Tummy" friendly. I am proud to be listening to my mamma's concerns out there and improving the quality of all my running and workout programs to reflect the unique needs of all moms post baby (even when you really may not want to hear it!).

Here are some great resources to help you out:

1. For more info on diastatic rect and online resources to help you while you are pregnant and guidance in those first weeks to recovery after, browse the e-books and courses with Bellies Inc.They offer a great 8 week e-course via email that progressively helps to restore your core. They also have great e-books for pregnancy and motherhood.

2. Become a Member of RunningMoms. We are a community of moms who runs and support one another in our running and motherhood journeys. You have great access to me to ask questions and get real answers quickly. Once you have restored your core, join one of our training programs to get you up and running again, safe and strong!

You can also find the Running Moms community on Facebook.






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