Emily teaches our Thursday evening Pilates classes and is our expert Women’s Health Physiotherapist. Here she gives a guide to dealing with ‘mum tum’:
‘I stand with the wardrobe open, pondering how socially acceptable my black joggers are for the school run. Despite the wardrobe being full, none are really ‘options’ for my post c-section tum. Whilst some friends seem to slip back into their skinny jeans with barely a stretch mark in sight- The Pouch, Mum-tum, Baby belly (clinically know as Diastasis Recti Abdominus or DRA) can be more embarrassing and long lasting for others.
What is DRA?
The muscles of the trunk are multi layered, attaching to the spine at the back and Linear Alba (connective tissue sheath between your six-pack muscles) at the front then bordering onto the ribs and pelvis. These ‘anchor’ points interact with the muscles to create the body’s movement and posture. The spinal bones won’t move under the changes of pregnancy, so the muscles and connective tissue sheath adapt, creating a stretching effect. Imagine a tent’s guy ropes that have been pulled and stretched. Even though they are still intact the tent moves much more in the wind and loses its shape. The body’s ‘tent poles’, ‘sheet’ and ‘ropes’ no longer have the same coordination if left like that.
DRA is the gap created in these muscles. Some ladies won’t notice the gap when they are pregnant as their tummy is pulled tight under the pressure of a growing baby. Commonly it’s seen as a peak or ridge with movement e.g. getting out of bed. Postnatally women report a small rounded tummy, bloating and loose skin. Women with a DRA experience higher rate of incontinence, back pain and prolapse.
I’ve seen lots of ladies in clinic eager to know how to make it smaller but the gap itself is not the only issue.
Here’s a guide to protecting, stabilising, and restoring your DRA.
Yummy Tummy: If you’re recovering from a diastasis you need to eat and drink like you want to heal. I’m not here to give you the perfect plan but instead to ask you how your body feels? If you are feeling sluggish, suffer episodes of constipation or bloating, then you may be ignoring one of the most powerful influences you have on your body. Your diet is not only the nutrient supply to the very parts you are trying to mend but the digestive process can influence the pressures on you DRA. Straining to open your bowels can undo all your pelvic floor exercises, as can having an elevated body weight or repeated heavy lifting.
Strong to the core: The muscles I described work as part of a core muscles system called the primary sling. The 4 muscles coordinate in a cylinder piston to respond to changing postures and loads. Recovering a DRA is about the strength AND coordination of these muscles. Learning to switch on your pelvic floor with your diaphragm and deep abdominal/spinal muscles is essential to recovery as this helps use rather than pull the separation. Start with daily pelvic floor exercises and progress to Pilates based workouts. These will help to improve your posture and balance the load on your tummy. The APPI Health Group have an excellent series of post-natal online videos you can stream from their website that will safely guide you through foundational core exercises.
The Knack: When you have established your pelvic and core exercises begin to introduce these to your daily habits. When you pick your baby up, hold a loaded bag or squat down, use your core as you move and if you can’t feel it don’t do it! You may well be compromising your function.
The compensated core: A weak core adapts to enable everyday activities to continue. Often, a tightening of the outer abdominals around the waist (Obliques) happens creating a clamping effect at the trunk. Over active Oblique muscles can worsen the body’s ability to create stability and restricting the inner core. You can help with stretches, as shown below, but I would highly recommended seeing a specialist physiotherapist to help release the restrictions and ensure your core exercises are being performed properly.
Sleep like a baby: The irony of having children is that you need more rest whilst juggling a longer ‘to do’ list. No matter how much I do there is always something still be done! I want to set you a challenge to find 3 things you do in a week that you do out of obligation or habit. Write out how you are going to stop or change them. For example, you cook every evening meal so ask your partner to pick a night where they reign over the kitchen whilst you read or take a bath. Not only is this a great self-care practice but an overloaded body will be running on empty and healing a DRA will get deprioritised.’
Emily teaches our Thursday evening Pilates classes and is our expert Women’s Health Physiotherapist. Contact the Client Care Team on 0114 327 2080 or firstname.lastname@example.org to book a free women’s health consultation session.