There are many do’s and don’ts out there when it comes to exercising after pregnancy. So how do you get a stronger tummy?
There is lots of talk about the best way to ‘close the gap’, if you have experienced abdominal muscle separation (Diastasis of Rectus Abdominis).
We know from research that the abdominal muscles show the most recovery in the first two months after the birth of your baby (Coldron, Stokes, Newham and Cook 2008), so it is important to know what exercises to do in these early weeks to help the recovery process.
It is equally as important to know which exercises to avoid!
Firstly, if you have had a caesarean section it is important to offload the abdominal wall for around 6 weeks to allow the stitches and wound to heal.
In this case, only very gentle abdominal exercises should be undertaken.
More about this in a moment….
Sometimes physiotherapists and fitness instructors may suggest avoiding abdominal crunches (sit-up style exercises) and sticking to the ‘drawing in’ or ‘abdominal bracing’ of the transversus abdominis instead because it’s gentler.
This is good advice for the early weeks postnatal, however some interesting research demonstrates that supported crunch style exercises may be more effective in closing the gap in the first 6 months postnatal than using transverse abdominis exercises alone (Bo et al 2015).
Now, this doesn’t mean that straining to do strong planks or crunch-style exercises in the first few weeks postpartum is necessarily the best idea, especially because we know that these exercises can place more strain on the pelvic organs and pelvic floor, which are particularly vulnerable in the early postnatal period.
However, versions of the crunch, especially those that are semi-supported shouldn’t be discounted in their effect on “closing the gap”, but they do need to be introduced into your exercise regime at the right time for you.
The Women’s Health Physiotherapists at myPhysioSA for her suggest the following the tips if you have noticed a widening of the abdominal muscles after having your baby:
- Use a support garment such as tubigrip or SRC recovery shorts in the first 4-6 weeks to help the muscles stay closer together during the healing phase and make you feel more comfortable.
- If you have had a caesarean section; avoid sitting straight up out of bed or undertaking any ‘crunch’ or sit-up type exercises in the first 6 weeks. Instead, learn to roll onto your side and push up out of bed using your arm as you let your legs lower off the bed. This type of transfer puts less strain on your pelvic floor so it can also be used following a vaginal delivery.
- Check with a Women’s Health Physiotherapist to make sure you are working your pelvic floor properly & start these exercises as soon as you can after birth
- Minimize any strong movements or exercises that cause a bulging, doming or peaking at the abdominal wall, or that require you to hold your breath – these actions place extra strain through the site of separation
- Commence some gentle exercises such as a posterior pelvic tilt, ensuring you are breathing throughout. Your physiotherapist can show you how to do these correctly.
- See your Women’s Health Physiotherapist! Everyone is different so an individual assessment is needed to determine which type of abdominal exercises will work best for you. This will take into account the health and function of your pelvic organs, your pelvic floor, your breathing habits, your posture, previous injury or surgery and of course what works best for you in practice!
If you have any concerns about pregnancy or postnatal exercise, you can book an appointment before or after giving birth to talk to one of our Women’s Health Physiotherapists.
We encourage all women to book in for a comprehensive assessment at around 6 – 8 weeks postpartum so we can help you return to exercise safely.
Jane Rothe, myPhysioSA Associate Sports Physiotherapist and Women’s Health Physiotherapist
References:
Coldron, Y., Stokes, M.J., Newham, D.J. and Cook, K., 2008. Postpartum characteristics of rectus abdominis on ultrasound imaging. Manual therapy, 13(2), pp.112-121.
Mota, P., Pascoal, A.G., Carita, A.I. and Bø, K., 2015. The immediate effects on inter-rectus distance of abdominal crunch and drawing-in exercises during pregnancy and the postpartum period. journal of orthopaedic & sports physical therapy, 45(10), pp.781-788.
