Healing Diastasis Recti
The term “working out” is appropriate for exercising because it really is work! Being a new mom is also a demanding workout, and your exercise program must adjust to these big changes in your body and your life.
Needless to say, pregnancy takes its toll on the body, especially on your abdominal and pelvic floor muscles. Your abdomninal muscles stretch and seperate (diastasis recti) as the growing uterus weakens the support system for both your back and your organs, causing lower back problems and the “mummy tummy.” The pelvic floor musicales are weakened during pregnancy by the combined weight of you uterus and fetus on them. Although you will want to wait at least six weeks after giving birth before resuming any high impact aerobic exercise or running, you can begin to strengthen your pelvic floor muscles within days of giving birth. In fact, a great time to do these exercises is while you are feeding your baby.
Abdominals
My suggested technique for abdominal exercise focuses on the innermost abdominal muscles called the transverse abdominals. This muscle is attached to the outermost abdominal muscle called the rectus abdominis. The action of the transverse muscles is forwards and backwards. It’s the muscle used in beathing. So every time the transverse muscle goes back towards the spine it brings the recti muscle back with it, shortening and strengthening the recti muscle at the middle of the muscle and making the separation of the recti muscle smaller. Bringing the transverse muscle back towards the spine is the foundation of a series of exercises I’ve dubbed the “Tupler Technique,” one of which, is the Elevator.
The Elevator
If you are doing this exercise while feeding your baby, sit in a chair with a seat that is the length of your thighs and buttocks. The seat cushion should be firm but comfortable. If there are armrests, they should be slightly higher than the bottoms of your bent elbows so your shoulders don’t droop. Sit with your buttocks touching the back of the chair, which, ideally, should support your spine. If your chair doesn’t fit just right, you might want to place a pillow at your lowers back. A low footstool can also be used to maintain that comfortable L-position. Also, place enough cushions on your lap so that your baby is high enough that you don’t have to bend forward to feed her. If you are doing these exercises without your baby, sit cross-legged on the floor, with your back against the wall and your shoulders lined up with your hips.
First, imagine the transverse muscle moving out and in, forward and backward, as if it were a sideways elevator. Think of your belly button as the engine that moves that elevator. Put both hands on your belly. Take a “belly breath” by taking air in through the nose and expanding your belly as far as it can go. At this position your belly button is at the “first floor.” Exhale slowly and power your elevator to your spine. As your belly moves back toward your spine, imagine your ribs coming together. Hold there for 30 counts. Count out loud so you don’t stop breathing. This is the fifth floor. Now, bring your belly button even further back: Imagine you are bringing it out the back of your spine (sixth floor). Think of it as just a little squeeze or tightening. Count as you do five of these squeezes. End with a full belly breath. Do 10 sets every day. It may sound like a lot, but keep in mind that you can do a set in a minute or two, even while you’re breast or bottle feeding.
Pelvic Floor Muscles
After you do an Elevator for your abdominals, you can do a Kegel exercise for your pelvic floor muscles. To begin, sit comfortably with your legs apart and your back supported against a wall or chair. Bring your transverse to the fifth floor and hold it there as you engage your pelvic floor muscles (called the PC muscle, it’s what you engage to stop flow of urine mid-stream). Hold both the PC muscle and the transverse muscle as tight as you can while you count to 10. Then relax both muscles. A good way to relax the pelvic floor muscles is to imagine it opening up like a flower. After each 10-second hold, do 10 quick squeezes/releases. Work up to doing 20 of these 10-second hold-and-squeeze releases five times per day. If you are having difficulty holding in your PC muscle for 10 seconds at a time, start with a five-second hold, or do the Kegel exercise with your legs up on the wall and your back on the floor.
— Julie Tupler, RN, is a certified fitness instructor and childbirth educator. She is the author of “Lose Your Mummy Tummy” “Perseus, 2005) and “Maternal Fitness” (Simon & Schuster, 1996; new edition this year). She offers prenatal & postpartum workouts at her New York City Maternal Fitness Center. Contact Julie at: info@diastasisrehab.com