abdominal separation

Running Postpartum

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Your 4th Trimester is your recovery phase.  A time to restore your strength and endurance.  Think of your postpartum recovery more like a marathon vs a sprint.  If it were a sprint, you would see your OB at your 6th week check up and get released to resume exercise AND you would head home to go for a jog.  If this sounds like you, you will likely increase your risk for pelvic floor dysfunction (leaking urine, pelvic organ prolapse, low back pain, hip pain, pelvic pain...I could go on and on and on...). 

Retraining your pelvic floor and core muscles how to work for you is very important and should take time to get them back functioning properly.  I mean, the pelvic floor and abdominal muscles have been stretched for 9+ months and forgot how to work properly.   It is our job, as smart moms, to make sure they are functioning before running/ jumping with 10-12 times our body weight thru those muscles.  That's a lot of stress on those muscles.  Think about your life down the road with your pelvic floor, abdominal muscles and your organs...you want them working in the correct way when you are in your 60s, 70s and so on, right?!  I do!

For my friends and patients who love running, I advise waiting 4-6 months postpartum to begin running.  I really think closer to the 6 months would be best for our lovely pelvic floors.  4 months seems to be early when you think about life as a mom of 1, 2 or more children.  It is a challenge to train your muscles prior to that time consistently.  AND then we throw in breastfeeding (hormones), lack of sleep (increased cortisol-stress hormone-effects how our body heals and recovers) and then 6 months sounds a little early.  Especially with the hormones that are still heightened in our bodies.  If my patients are breastfeeding, we may push back running past 6 months, depending on how the body is functioning with movement and what the pelvic floor strength, endurance and tone is looking like.  

Before my patients are advised to begin running, they have completed certain pelvic floor/ core strengthening exercises and home exercise programs for a period of 8-12 weeks to set them up for good outcome when they go out for their run for the first time. 

Things to think about prior to going out for a run at 4-6 months postpartum:

1. Have you had an evaluation with a pelvic floor physical therapist to assess your pelvic floor function? core strength? function with posture and alignment?  You should!  All of us should postpartum!

2. If you pee your pants with coughing, sneezing, laughing, lifting, bending over etc you are not ready to run yet. 

3. Feeling of pressure or heaviness in the vagina? Worse after lifting? Or while on your cycle?  If you answered "yes", you are not ready to run yet. 

4. Do you have an abdominal separation in your midline that is weak (Diastasis Recti)?  If so, I would wait to go out and run. 

"So...what can I do instead?"

I love having patients find hills in their neighborhoods to walk up and down.  Prior to doing this, patients have been walking on a flat surface (for a long time) with no increased symptoms from above.   Patients are to practice proper alignment while walking to promote proper core recruitment.  I cue patients to rotate their upper body arm swing while ascending and descending hills. 

   

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

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Abdominal separation (Diastasis Recti) of your mid line of six-pack muscles is all the chat right now in social media.  So...I want to give you the low down on what the hype is all about.

When I first started my training with pelvic floor physical therapy, I was under the impression that a 2 finger split was considered normal.  With time, more research and growing knowledge about this topic, we now know that not to be true.  

After you read this I hope you feel more comfortable about this topic.  

5 Important Pieces of Information About Diastasis Recti (Abdominal Separation)

Fact 1 :I feel like a see 3 new sponsored posts daily on this topic.  An abdominal separation can happen to the linea alba, the connective tissue within your mid line, due to the laxity that happens from growing uterus and baby.  Try not to stress out about an abdominal separation.  It is very common among pregnant and postpartum women and very possible to heal a diastasis recti (men can have Diastasis Recti too).  A study by Diane Lee, found 100% of women have abdominal separation at 35 weeks gestation (pregnancy).  Your body is smart one and knows what it is doing.  Your belly stretches to accommodate your growing uterus and baby. The study found that by 6 months postpartum, diastasis had decreased to 35-39%.  So it is important to check in with belly every now and then to see if yours has gotten stronger.  

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Copied from Bing images

Fact 2: Posture and alignment are important with strengthening the gap.  Pay attention to how you are standing, lifting and carrying baby. Make sure your shoulders and ribs are stacked over pelvis to keep your torso in good alignment, which decreases pressure in your abdomen (less pressure pushing on linea alba-midline of abdomen).  Try to be mindful of how you are lifting/ carrying baby, especially when in the car seat or baby wearing. This is also a great place to start seeing a pelvic floor physical therapist so they can help you with your alignment with activities and assist you on your road to recovery.

Fact 3: Another way you can decrease the pressure in your belly is by breathing out (exhaling) when you are lifting baby.  This is great to remember when lifting baby into car, crib, picking toys up from the ground, lifting holiday decorations etc.  

Fact 4: There is NOT one exercise that will heal your abdominal separation.  There is also NOT one exercise that will ruin your abdomen.  There may be exercises that you need to avoid while you are working on strengthening your separation, but you can get back to those exercises when your body is ready.  For instance, if you are seeing a pelvic floor physical therapist, they may ask you to avoid certain core strengthening exercises, like a plank, but that doesn’t mean you will have to avoid them forever.

Fact 5:  The internet gets us caught up in the separation of our abdomen.  Is it 2 fingers wide, 3 fingers wide or more.  I tend to not get caught up on the separation split width and try to not get my patients too excited on this either.  I am more interested in the tension created between the 6 pack muscles that run from the breast bone to the pubic bone. I want my patients to improve in their “bridge” between their mid line, meaning more “taut” with activities of lifting, carrying, exercise etc.  When your tension improves, you are getting stronger!