As a pelvic health physiotherapist, I am constantly learning
new things in my industry. What we know from science and studies is always
changing and I want to share with you what I am learning.
A really hot topic that new moms are always interested in is
the ab separation that occurs from pregnancy. What many fitness and even
healthcare providers recommend is exercise. Rebuild those muscles and make them
stronger. This is of course one element to heal a diastasis but I am learning
that in fact it is much more than just exercise and should not be the first
thing we do.
On my fascial course last year, we started talking about the
role of fascia and how it plays a part in the function and movement of muscles.
Fascia is what lines the muscles, organs, abdominal wall and needs to move
freely. We need to consider how the fascia (or connective tissue) impacts the
muscle.
So the discussion was that not only are we looking for how
much the abs are separated but is the woman able to create or generate tension
through the fascia and is there any restriction in the fascia that is impacting
movement and function.
Listening to the ‘Birth Healing Summit’, we have to think deeper
and simpler when working to heal a diastasis. What I mean by deeper is not just
fixating on the gap. As a therapist, we need to focus on the internal/external
obliques and transverse abdominis. These three muscles are connected to the
linea alba, which is the fascia that connects the two sides of the “six pack”
muscles.
We need to asses for and poor breathing patterns, ab
gripping and posture as this can cause these muscles and thereby the fascia to
pull on the ab separation. Tension and poor contract/relax patterns promotes
the separation to stay open.
If there is tension in the abdominal fascia or muscles, it
is going to be very difficult for a new mom to get connected to the area, never
mind coordinate muscles activation properly to heal the diastasis. So if there
is tension but our focus is on more strengthening this can be problematic. So
starting your planks or other ab exercises may not be right first step.
So, here we come to the simple part. We need to get back to
basics such as proper breathing. Learning to expand the diaphragm and ribs
appropriately allows for expansion and stretch to happen in the abdominal wall
and contraction in the abdominal wall on exhale. We need to be careful not to
expand too much with belly breathing as this can create too much stretch. So a
simple exercise such as breathing begins to introduce gentle movements post
partum which can stimulate the fibroblasts (special cells that help with
collagen production) to aid in healing.
We do not give enough credit to proper breathing techniques
and remember this ladies the diaphragm is part of the core. It works
synergistically with the transverse abdominis and pelvic floor. Having a good
breathing technique sets the stage for proper core activation and proper
loading during day to day activities to reduce stress on a healing diastasis.
The other key point brought up in this summit was the
importance of touch by a professional. Not just touch to feel for the gap but
also for tension points and adhesions. Remember in the last 3 months of
pregnancy the muscles and connective tissue undergoes a lot of loading and can
cause the fascia to get stuck in that loaded position and this can impact
functionality. So yes fitness is a key but seeing someone to properly assess is
also key so that the right foundation is built.
The Pelvic Health Lady
***For more information about the 9 things you wish you knew before giving birth..and still have time to learn before birth. Check out my FREE pregnancy guide. www.ecophysio.com/pregnancy. Click on the guide picture for instant access***