Core Strengthening Following Pregnancy and Delivery

Spring is in the air! Flowers are blooming, birds are singing, and baby shower invitations keep showing up in my mailbox. I am at the time in my life when all my friends and cousins are starting their own little families and announcing expectations for little “bundles of joy.” Due to our clinic location, here in Kailua and facilities, I also have the privilege of working with a lot of expectant mothers as well as those who have just given birth. A lot of changes occur to a woman’s body and her core as she goes through the process of pregnancy and delivery and even as she transitions to caring for an infant. Hormones cause a loosening of joints, the growing baby causes a shift in the center of balance, and increased strain is put on many structures.

Many of the changes that occur during pregnancy resolve following delivery and return to physical activity as the body returns to homeostasis, heals, and strengthens. But one area that is often overlooked and sometimes does not return to normal function involves the core muscles and connective tissues of the abdomen. A lot of women notice an increased separation in the abdominal muscles after the delivery. The long, latin, medical term for this is “Diastasis Recti” and it indicates an increase in the distance between the two bellies of the Rectus Abdominus (the “6-pack”) muscle. There has been a lot of mixed information given over the years about how it is best to be treated or even if it needs to be or can be treated at all. I have heard from patients that they have been told it will naturally grow back together, that it will never grow back together and has to be fixed surgically, that abdominal strengthening exercises will make it worse and they should avoid them for the rest of their lives, or that abdominal strengthening exercises will cause the muscle to grow back together but they must only do/avoid certain ones. While there are no muscles that wrap across the whole front of the abdomen and so the separation will not “grow back” together, surgery for your core is not often necessary.

By performing certain exercises aimed at progressively strengthening the deeper core muscles, tension in the non-muscular layers (made up of fascia or connective tissue) can be increased which not only decreases the appearance and feeling of a “gap” but also restores the normal function of these layers which is to hold all the organs snugly inside the abdomen. No exercises are to be forever avoided, but rather, all abdominal strengthening exercises can be returned to if done in a progression to avoid overloading these tissues. Our physical therapists here at OSR can give you more information on how to help strengthen your core safely and appropriately during and after pregnancy. If you are pregnant and looking for more information or know someone who is, call us today at 488-5555 to set up your complimentary consultation!

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