Healing Your Abs Postpartum

Postpartum Body

Of course, I am biased, but I believe that every person that gets pregnant and gestates a baby for 9 months and then goes through the intense experience of delivery, should go see a Pelvic Health Physical Therapist (or Occupational Therapist) in the postpartum period (even if it has been many years since the last delivery).

At the Postpartum evaluation I can assess the integrity of the pelvic floor and the abdominal wall.  When I assess the abdominal wall, besides checking for diastasis recti,  I like to observe posture, breathing patterns and recruitment patterns of the core with different loads:

• standing:  resisting the arms to movement in flexion, extension and rotation, forced expiration
• lying on the back: lifting a straight leg, lifting both straight legs, resistance to the arms, forced expiration

A Common Core Pattern: Overactive upper abs and rib gripping

In a previous post I addressed how increased internal pressure contributes to prolapse and urinary incontinence.  Increased internal pressure can effect the healing of DR and the abdominal wall as well.  In the post mentioned above, I discuss and provide an example of what a non postpartum body looks like with overactive abs.  The tension created by the over activation of the upper abs and gripping with the diaphragm and muscles of the ribcage creates downward pressure into the lower abdomen and the pelvic bowl.  People who have this pattern also tend to over activate their neck, rib, diaphragm, and spinal extensor muscles.  In order to heal the DR and abdominal wall there needs to be better balance with all the muscles of the core.  In this post, I will share some moves to help you connect to your lower abs without recruiting your upper abs first.  

Are you an overactive upper ab and rib gripper?  How can you tell?

• Your lower abs stick out compared to upper abs or despite working out, your lower abs still don't get toned.
• When you engage your core you can see a crease across your ab above your belly button.  You can see a demonstration of this in the blog mentioned above.
• Blow out really hard on your exhale like you are going to blow out 50 candle.  Do your lower abs push out?
• When you lie on your back and lift both straight legs does your back arch, your neck tense, your ribs grip and your abs push out?

Even if you don't grip your upper abs, these moves can still be helpful for you!

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.