Healing Abdominal Muscles After Pregnancy

One component of the six-week postpartum visit is the assessment of the rectus abdominis muscles. Separation of these muscles is normal during pregnancy as the muscles and connective tissue stretch and thin to accommodate your baby. It can take several months for these muscles to begin to heal and move closer together after giving birth. For some individuals, the separation can remain significant, a condition called diastasis recti. This condition can lead to a weak core, back pain, and a stubborn postpartum belly. Fortunately, diastasis recti can be greatly improved or healed all together with the slow implementation of certain core stabilizing exercises.diastasis-recti-check-yourself-before-you-wreck-yourself-b8a4c

First, it is helpful to
check for the degree of muscle separation. Lying on your back, lift your head and shoulders slightly off of the floor (like doing a mini crunch) and push your fingers down into your belly button. If your fingers sink into your abdomen, you have a separation of your rectus abdominis muscles. You can then move your fingers above and below your belly button to feel the different degrees of separation in different areas. Becoming familiar with your degree of separation is helpful when beginning exercises in order to track your healing progress. Here is a demonstration on how to check for diastasis recti.

 

Before we talk about exercises we that should be doing to premote diastasis closure, lets quickly review what we shouldn’t bdiastasis-recti-1e doing. Abdominal exercises like crunches, sit-ups and planks are counterproductive when dealing with diastasis recti and can, in fact, make the condition worse. Any exercises that cause the abdominal muscle to bulge away from the body (put your hand on your stomach while doing a crunch to feel it for yourself) put additional pressure on those already weak abdominal muscles. Planks force the abdominal muscles to support the internal organs, also increasing abdominal pressure and outward force. Once your diastasis is healed, these exercises can be added back into your routine, but it is important to avoid them while rebuilding your foundational core.

One of the first exercises to begin with after your 6-week postpartum visit is a simple breathing exercise that can help to isolate your core abdominal muscles. Lay on your back, knees bent, with the arch of your back pressed against the ground (you want a flat spine). Place your hand on your belly and take a deep breath, trying to expand your abdominal muscles to push your hand up and away from the floor. As you exhaled, contract your abdominal muscles and pull your belly button towards your spine. This “pulling your belly button towards the ground” action is the foundation for all of the other exercises to follow. You can do this simple exercise in repetitions of ten several times throughout the day until you feel that you have a good grasp on the technique.

Next add the “pelvic tilt” to your practice. Here, start in the same position on your back with your knees bent. This time curl your hips towards your ribcage while engaging your abs and pressing your lower back into the ground. This is a very subtle movement, which works both the core abdominal muscles and the pelvic floor muscles. Check this out for visual examples of the pelvic tilt.
As you progress in your strength and technique, you can add other exercises into your routine. Here is a great guide to 6 exercises for healing diastasis recti (some oabdominal-muscles-diagramf which we already discussed above).

Lastly, here are some other gentle, beginning exercises to work with…
Ultimately, a physical therapist is going to be able to best asses your muscular weaknesses and tailor individual exercises. If you feel that you would benefit from professional physical therapy, please speak to your provider about a referral.

Here are a few physical therapy resources for the local Philadelphia, PA area (**note that we do not endorse any of these providers. This list is simply a place for you to start your own research).

Action Physical Therapy

Central Bucks Physical Therapy LLC

Select Physical Therapy diastasis_recti_illustration3

Image Property of Fit2B https://fit2b.us/how-to-check-for-diastasis-hd/

We know how busy families are with life, children, and especially new babies. I am sure that you are laughing at the idea of exercising with a 6-week-old infant at home. Fortunately, these exercises are really quick and simple and can be broken up throughout the day or even integrated into floor play with little ones. The sooner that you implement gentle core exercise (after getting the go ahead from your provider of course), the better your body will heal. Even if you had your babies many years ago, it is never too late to strengthen these important abdominal muscles! Glute-bridge

For those of you planning on having more babies, check out this post on healthy musculature/pelvic structure and their important role in optimal fetal position for delivery.

Next time we will address pelvic floor dysfunction and how to regain strength in your pelvic floor. To kegel or not to kegel? That is the question! Best wishes for your self care endeavors!

 

 

 

Copyright © Midwifery Traditions 2015 all rights reserved

THIS BLOG claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please E-mail with a link to said image and it will be promptly removed.

45 thoughts on “Healing Abdominal Muscles After Pregnancy

  1. do you recommend this for a certain window of time post labor? I’m afraid mine hasn’t healed almost 3 years after giving birth, yikes. Thanks!

    Like

    1. Hi Kate! What kind of exercises have you been doing thus far to work on the separation? For some women, it may never close completely. It is more about the degree of separation (how many finger widths apart) and how you feel it is affecting your abdominal tone/core strength. A physical therapist would probably be your best bet for assessing your particular diastasis and they may be able to present you with realistic goals for healing. Most providers recommend waiting until 6 weeks after delivery to begin gentle abdominal exercises (starting slow is key) and building up from there, but you can start a program aimed at healing a separation at any point in life. Thank so much for your comment and best wishes!

      Like

  2. Will this help with c section stomach? I have had multiple c sections and after 8 years I still trying to figure out how to get a flat belly. Thank you!

    Like

    1. Hi Lady J,

      Yes these exercises also apply to women who have had C-sections. In an ideal world, all mothers would be referred to physical therapy immediately after having a C-section (after all we send people to physical therapy after almost every other kind of surgery, most of which are far less invasive than a C-section), but unfortunately that is not the standard of care here in America. Physical therapists and Pilates instructors who work with postpartum mothers agree that gentle core stabilizing exercises, such as the breathing exercise and pelvic tilt mentioned above, are great ways to start. Finding those deep core muscles and re-learning how to use them properly is the first step in building stability and strength. I would recommend finding an awesome physical therapist or postpartum Pilates instructor to work with. They would be able to asses your individual abdominal needs. While muscles are not severed during C-sections, the connective tissue between the rectus abdominis is and the muscles are stretched, leading to scar tissue, nerve damage, and decreased circulation to the area. Some physical therapists can also work on these issues by breaking down existing scar tissue in order to access the muscles more effectively. Ultimately, a surgeon may best correct some of the cosmetic issues that you have experienced after your surgeries. Thank you so much for your comment and I hope that you can find some great local support!

      Like

      1. I was wondering if these exercises can be done even aftet 4 months of postpartum-c sec…..i ccould hardley find time earlier so please suggest few more effective exercises that would help me get bake in shape..thankyou

        Like

  3. Hi i was wondering if there was any other excerises that can help get the flat tummy after have a stage 3c tear.

    Like

    1. Hi Tanisha!

      A stage three perineal tear affects the muscles of your pelvic floor. While the exercises listed above do also engage the pelvic floor muscles (the pelvic floor and abdominal core are interconnected in function), you may want to consult with a physical therapist that specializes in pelvic floor dysfunction. They would be able to use techniques such as pelvic massage, myofascial release, and craniosacral therapy to breakdown scar tissue and restore balance to your pelvic floor muscles. All muscles heal better if they are free of imbalances and restrictions! There are also additional pelvic floor exercises and stretches that you can do to regain strength, function, and mobility, which I will be discussing soon in my next post. Thanks so much for your question!

      Like

  4. Are there any exercises that you can do prior to delivery to help it not get so bad or to help assist in recovery after? Can these exercises be done during pregnancy?

    Like

    1. Hi Stacy!

      These exercises are not recommended in pregnancy for several reasons. One, they require laying flat on your back, which compresses the inferior vena cava, thereby decreasing circulation to your body and your baby. Secondly, the natural stretching of the abdominal muscles during pregnancy causes the muscles to function differently. Preforming targeted abdominal exercises adds excess strain to them, which puts you at risk for injury (potently making the separation worse postpartum). Lastly, the hormone relaxin works during pregnancy to soften the abdominal and pelvic floor muscles (along with all other soft tissue in the body) to help accommodate the growth and birth of your baby. This hormone can also increase the risk of muscle/connective tissue injury. That said, there are exercises that you can do while pregnant to keep your body active and engaged. The biggest is walking and gentle stretching (such as prenatal yoga with a well trained instructor). You can also practice several pelvic floor exercises, which I will be discussing shortly in my next blog post ☺. Thanks so much for the great question!

      Like

  5. I had this problem with my first and now due with my second. I plan on using these exercises after 6 weeks. Would you recommend a girdle during the first 6 weeks?

    Liked by 1 person

    1. Hi Peaceloveorganic,

      There are some mixed feelings on the use and extent of use for adnominal binders. Immediately postpartum and during the first few weeks, a binder can be helpful with stabilization and to reduce stress on the abdominal muscles while they begin to recover from their distended state. Many traditional cultures around the word practice belly binding as a routine part of the postpartum period. Some abdominal programs recommend continuous use of binders for months postpartum (even during sleep), while others only recommend it for the first few weeks. Personally I feel that long-term use of binders or girdles work as a crutch, not truly allowing your body to regain its own core support, but that they may be beneficial during the immediate postpartum period. I recommend consulting with a local women’s health physical therapist on this one to get a better understanding of what is best for your body. Thank you very much for your comment!

      Like

  6. Just wondering if you know of any exercises that would help after prolapsing? My doctor says to keep doing kegels. But, it’s not helping. Thanks!

    Like

    1. Hi Daniela! I am in the process of writing another post specifically about pelvic floor dysfunction and pelvic floor exercise. I am hoping to get it up this week, so check back in for more information about prolapse and extending our knowledge base beyond the kegel 🙂 A lot of women are suffering from pelvic floor dysfunction, so thank you for bringing this question to the discussion!

      Like

      1. Was the pelvic floor post ever published? I’ve been hoping to read it and have checked back regularly to no avail.

        Like

      2. Hi Nichole,
        I am finishing it up right now. Please feel free to check back in later this evening 🙂 Thank you very much for following up!

        Like

      3. Hi midwifekara – is there a link to the pelvic floor post? I’ve developed a prolapse after a fantastic birth and I’m struggling with a lot of conflicting information. Looking forward to any insight you might have 🙂

        Like

      4. Hi Jess,
        I am finishing up the post right now. Please feel free to check back in later this evening 🙂 Thank you for following up!

        Like

  7. Will the bulging be apparent? I’m almost 3 months postpartum and I tried feeling for separation in between and I think I can feel a little bit, maybe about one finger width, but when I tried it in sort of a crappy plank position lol I didn’t feel anything “falling out” or bulging. The only thing that falls is my yucky tummy skin.

    Like

    1. If you don’t feel anything while laying down and doing a crunch, you probably don’t have a dramatic separation. That is a good thing! Our bodies go through tremendous changes to bring our children into the world and they will never quite be the same, but making sure we have a solid core can help with many other discomforts down the line. Here’s to being as kind and gentle to ourselves as possible through life’s many physical and emotional blossomings:)

      Like

  8. What about muscles around the breastbone area. Mine are so sore it hurts to lift the baby from his crib?

    Like

    1. Hi Cathy,
      I recommend finding an awesome Osteopath who specializes in manipulations or perhaps a chiropractor. It sounds like you may have other structural things going on. Many people find relief with adjustments. An osteopath (look for one who practices in the “cranial field” may also be able to recommend ways to modify your movements to reduce the pain.

      Like

  9. Oh, I wish I had known this when my boys were born (15 and 17 years ago). I have had two mid-line hernia repairs, and should probably have a third. It makes sense that the musculature stretched out during pregnancy and may have weakened the wall between the muscles and intestinal wall. So all of the new moms out there, this may be the solution. I’m going to start doing these exercises today!

    Like

    1. Thank you for the comment, Keren!

      Like

  10. This was the best written post on diastasis recti I’ve ever seen. Thank you! Do you know anything about getting the ribcage back into position postpartum? My ribs expanded outward during pregnancy to make room for the baby and now none of my shirts or dresses fit even after losing all the weight because my rib size has changed so much. Is there anything known about how to get it to shift back into position?

    Like

    1. Thank you very much for the kind words! Some of the structural changes that we experience during pregnancy may never quite return to our pre-pregnancy form (for example my shoe size increased half a size with each baby…probably from hormones relaxing the ligaments, causing my arches to drop). The soft tissue in-between the ribs are also influenced by pregnancy hormones, which may leave residual expansion after baby is born. You could try seeing a chiropractor or an osteopath who specializes in manipulations. They can help with alignment of the ribs, which may encourage them to shift back towards their original structure. Still, your ribs may never quite return to their pre-pregnancy size…they just accommodated an amazing transformation and may just require a little self-love for their new form. Treating ourselves to some new clothes/shoes is one way to help embrace the changes. :-)Thanks again and take care!

      Like

  11. This is the best post on this I’ve ever seen- there is so much conflicting information about this out there. I’ve got a question about what is considered ‘back to normal.’ I had a 4/5 finger gap straight after my first baby (I asked them to check for me in hospital) and using similar exercises that you’ve discussed brought that down to 2.5 fingers. I kept doing the excercises for months after but nothing changed and the gap remained at this. After my second baby the gap has gone back to 2.5 fingers (she’s 15 weeks.) is this now how my muscles will stay or do I have to aim to bring the muscles totally back together (in some way? I could do better with excercises this time around to be honest) If 2.5 fingers width will be my ‘normal,’ can I restart excercises like the plank? I’ve not done any since having the first baby as I’ve been too scared to damage my muscles further. Any advice on this would be great! Thanks again for the post.

    Like

    1. Hi Hannah,

      For many of us, some degree of separation will always be there, but we can still aim to protect these muscles by doing exercises that do not make the separation worse. I recommend consulting with a physical therapist to see how your abdominals hold up against planks and other exercise that cause an outward exertion of pressure on this muscle group. Congrats on seeing such a dramatic improvement in your separation thus far and thank
      you very much for your comment!

      Like

  12. Thanks for the write up Kara, I’m 6 months postpartum and my diastasis before I started doing these exercises was really bad, Its been 2 months of constantly doing these exercises and its helped a lot. You’re a life saver! Thank you.

    Like

    1. Hi Maria! Thank you so much for checking back in and keeping us posted on your progress! I am very glad that you are seeing results 🙂

      Like

  13. Hi. It’s been a year and a month since I gave birth by CS to a lovely little boy, and I only found out my muscles are like this now, through your blog. My back aches and my belly still protrudes I am often mistaken to be pregnant again. will the healing exercise still work on me? It’s been sometime, though.

    Like

  14. Hi, am a mother of 4 the last baby is 13months now while the first was 9 years and I have opening in my belly its make my stomach pendulous is there any help of exercise , and there are excess skin below my tummy

    Like

  15. I am a mom of six great kids, born at home, ages 9 mo to 8 years old. As you can see they all came very close together and I have no reason to think we are finished. I say that to say, I have diastasis recti pretty bad and did not realize the type of condition that it was and how I needed to work on healing it after my last 4 labors. After my 3 rd child. A 11 lbs 15 oz baby it began. He is now 5. Each pregnancy it has gotten worse, more than 4 fingers now,
    What can I do? It is very uncomfortable and my stomached and back muscles are constantly over working and hurt feeling like they have to pull my stomach in.
    I need help. Do you have any advice?

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this:
search previous next tag category expand menu location phone mail time cart zoom edit close