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What happened to my stomach?

30/5/2017

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​Wow what happened to my tummy? It looks like it's torn in half and not working. 
This is very common after pregnancy, It's called Diastasis Rectus Abdominis (DRA).  Where the tummy muscles have stretched and separated during and after pregnancy leaving you feeling weak and flabby. What can you do about it?

DRA: This is where the fascia ( I like to think of it as a piece of glad wrap over the top and in between the muscles holding them all together) and connective tissue between your Rectus Abdominis (6 pack muscles) has stretched and weakened leaving a gap between your muscles. 

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So why is this a problem?
  • It can lead to weakness in the stomach muscles leaving you at risk of back pain and postural related pain.
  • It disrupts the lumbo-sacral support and muscle system.
  • DRA and Pelvic Floor issues often go together.
  • A thinner lining of the abdominal wall creates less support for your inner organs and can leave you at risk of a hernia of your bowels.
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Alarming Facts:
  • 100% of women have some level of diastasis of the rectus abdominis in the third trimester. (Hilliard and Brown 1996, Diane Lee 2013)
  • For a lot of women with DRA their gap closes significantly between day 1 and 8 weeks post baby. However their gap remains widened at 8 weeks and if left untreated the gap at 8 weeks remains the same at 1 year post baby. (Cauldron et al 2008, Liaw et al 2011)
  • 66% of women with DRA were also found to have a pelvic floor dysfucntion Eg Incontinence, pelvic organ prolapse. (Spitznagle et al 2007)

What NOT to do!
  • Crunches!! This is a no no as it increases your intra-abdominal pressure and your stomach muscles and pelvic floor aren't ready to cope with that.
  • Planks without sufficient Pelvic Floor and TA strengthening first.
  • Brace your tummy muscles - this can increase the bulge from within.
  • High impact sport without inner core and pelvic floor strengthening first.

So what can you do about it?
  • ​An exercise called a head lift which aims to ensure your pelvic floor muscles are switched on, your TA (deeper core muscle)  is switched on and a slight head tilt to allow the outer abdominals to contract. Adding extra hand pressure to your muscles to push them closer together and down towards your spine. There is no bulging or doming from the tummy outwards! This is a key exercise of our Post Baby Pelvic Floor Program which is so important given your best chance of recovery of these muscles is within the first 8 weeks post partum.
  • ​Be careful with getting up from the chair or bed, use compression with a towel or your hands around your tummy.
  • Be careful lifting your baby - try to use your pelvic floor muscles and TA as best you can
  • Wear recovery support shorts  - we love the SRC recovery shorts to give you that extra compression and support in your early post partum phase. 
  • Ease back into exercise with gentle walking and a pelvic floor program first.

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​If you have any questions or comments please leave them below.

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    I'm Melanie, a Pelvic Floor Physiotherapist. 
    I founded Perfect Pelvic Floor to be able to share my years of experience and knowledge with you to help you feel empowered to live the life you want to.

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Melanie Platt M.Phty, APAM
Women's Health Physiotherapist

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