A few years ago I used to write the “Ask the over 100 dollar an hour Tacoma Personal Trainer” articles. It’s been a few years later and I have greatly expanded my skills and the rate has increased accordingly to match the value. With the demand of the skills came less time to write, I took some time out today to answer a question about a splitting of the abdominal wall.
Here’s a question that client asked me following the birth of her first child. Let’s start with her question:
“For weeks I was wondering why in the world my stomach still looks like I am pregnant. At first I was thinking it was not a big deal until I noticed that working out and eating well did not make one change in my stomach area when that is actually the first place that goes…
After speanding hours of research and feeling just weak in the mid-section I noticed a gap….a pretty large one to be honest which in turn lead to more research. I did a few test and low and behold I have Diastasis Recti/Abdominus. A diastasis recti is a separation of your outer most abdominal muscles. The job of these muscles (called rectus abdominis), is to support your back and your organs.The cause of a diastasis is from continuous stretching of, and intra-abdominal force and pressure on, this connective tissue that joins your outer most abdominal muscles. Which because I had such a LARGE pregnancy I think it damaged it. Right smack in the middle of this connective tissue is your belly button which is a weak spot. That is why when the connective tissue stretches sideways your belly button will become an “outie”. Pregnancy and doing crunches are examples of intra-abdominal “force” on the connective tissue. Wearing a front loading baby carrier or being in a hands and knees position are examples of “pressure” on the connective tissue. Movements where you arch your back will flare your ribs (which I do already because of my scoliosis) This flaring will stretch your connective tissue.
Your six pack looks pretty but it actually helps keep your organs from pushing out against your abdominal wall. In the event of a separation like this one you lose the support of your abs to keep your organs from pooching out.
The immediate concern is to restore the form of the structure as soon as possible, minimize the current damage and work on supporting the structure. The good news is abdominal diastasis is generally non hamrful in terms of organ health. A bigger problem that people encounter is how do they get their old belly button and flat stomach back.
The key lies in “core training” but not any core training. Most people don’t break core training down into as many segments as they need to. In core training we have many planes of movement and we have different ways to train the core for example if I hold a plank compared to do something popular like a crunch.
The two biggest concerns are bringing the ribs or the pelvis away from the attachments of these two points like if you were to lean back to press a weight overhead instead of bracing your core giving up your back and stretching your abs this would be terrible for your linea alba.
Lifting heavy weights that usually require a brace aren’t ideal at this time either because they require you to PUSH out against a force which if your abs don’t have good structure could increase the amount of stretch.
Exercises where you don’t move as much but rather pull in and stabilize your spine are ideal exercises for this. Let me give you an example of how we would treat this abdominal diastasis.
In A Perfect World
As a note, the reason you’re seeing my write about this on my blog is because I tend to do more fitness and therapy related personal training, much of this very basic abdominal training is done with a physical therapists while trainer normally push clients through higher level core exercises. As a trainer I see many back pain patients, moms and clients of all levels so I find the progressions and regressions that work for my clients, not to say that a well qualified therapist wouldn’t be able to do these either. In my session I would address the therapy and then move on to getting my client stronger, fitter and happier so you’ll see my approach is based off that.
2. Track Pelvic Floor Control.
During birth a pelvic floor gets traumatized which simply means you have a harder time keeping your legs together and also keeping your bladder stable. This is one reason in general I don’t prefer my clients who have had children to lift in a wider stance. Sumo deadlifts are great for people without pelvic floor problems but developing that kind of strength in “abduction” is not a good idea for someone who has problems in “adduction”.
Tracking Pelvic Floor progress is pretty simple, my clients will do a few bounces and pretty soon they will need to use the bathroom, count bounces or pogos. I have a pogo video for you here so you can count reps until your have to use the bathroom.
We avoid lifting max effort training until we see improvements in either measurements or pelvic floor movements. A key note the hip bridge is NOT the best exercise for abdominal diastasis. Because of the lack of abdominal support from the splitting most people get back pain from not being able to support their spine but it doesn’t mean the only exercise you can do is a hip bridge.
An exercise on all four will enable you to feel the contents drop down and then you will “PULL” the abs back, if this is difficult on all fours you can always change your angle to make it easier. This is a much better exercise than your hip bridge, nothing is wrong with the hip bridge it’s just far away from the best pelvic floor exercise or feed back for bracing your abs.
Starting on all fours, practicing “vacuums” and then moving to make the exercise more dynamic while maintaining control of your abs is what we would focus on here.
4. Get Some Good Manual Work Done To Speed Healing
Let’s Put Together A Session
As you can see there is plenty to do here. I don’t have time in this post to explain why I pick all these exercise for this client but I can tell you this is a good workout for strength, stabilization and fat loss at the end.
Any questions email me at email@example.com, if this article helped you please share and like on facebook because, “sharing is carin and likin is excitin!”