Home » Looking after your core in pregnancy – Diastasis Recti with Nicky Ryder

Looking after your core in pregnancy – Diastasis Recti with Nicky Ryder

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WE get many messages on which types of workouts are safe/not safe during pregnancy. Here, pregnancy and postpartum specialist PT Nicky Ryder has written an article covering all the things to consider regarding fitness in pregnancy. She covers it all, from diastasis recti to breathing when exercising.

To answer a very important and common question first:

Am I able to start strength training for the first time, whilst pregnant?

Often we are told not to take up a new sport, whilst pregnant but this is a bit of a myth. There is no reason why you shouldn’t take up strength training during pregnancy. I’ve had pregnant clients start with me, that have never stepped in a gym before. BUT (and it really is a huge BUT), my advice would be to go to a specialist PT, even if only to get you started. I recommend a specialist PT as not all PTs are qualified in pregnancy fitness.

Whether you are pregnant or not, if your PT is not talking to you about how you breathe during working out and vitally, if you are pregnant or postpartum, how to engage your TVA, then to put this bluntly, you need to find a new PT. That’s not to say your PT isn’t good but their strengths may lie elsewhere. Just as I wouldn’t train an athlete or prep someone for a physique competition, as that’s not where may strengths lie. My strengths lie in pregnancy, postpartum and menopause support. I am passionate about helping all women throughout these various stages of our lives.

I digress. If you are pregnant, don’t just copy instagram or youtube videos, speak to a specialist that can write you a programme and explain the fundamentals to you. Most gyms will have a PT that will be able to get you started safely.

Ok, here are my TOP 5 areas for you to focus on, should you start or continue to strength train during pregnancy. NOTE: With the exception of the first one, Relaxin, you should be doing these anyway, regardless of whether you are pregnant or not.

RELAXIN

Relaxin starts coursing through your body early on in pregnancy and while at the end of pregnancy, it is there to help prepare your joints, tendons and ligaments for birth, it may affect some women earlier or more intensely. Even if you feel strong and sturdy, you don’t really know what’s going on inside of you. Be kind to your body – don’t over do it. Lower your weights and increase your reps instead of trying to go heavier. The last thing you want to be doing is throwing your back out or worse, suffering from SPD.

BREATHING

It’s imperative with training anyway but even more important during pregnancy, that you EXHALE (breathe out) on exertion, i.e. the hardest part of the exercise = the part of the exercise that goes against gravity. E.g. with squats, breathe out on your way up; with bicep curls, breathe out as you curl up and with deadlifts, breathe out as your drive up. Long breaths out through your mouth and deep inhale through your nose on the eccentric part of the movement. It is the opposite to normal breathing so pay attention and ensure that you’re doing it right.

TVA – LOCK IT IN! 

The transverse abdominis (TVA) helps with the process of breathing, by assisting in exhalation and compressing the internal organs. However, its main function is to activate the core muscles and stabilise the pelvis and lower back, prior to any movement of the body. So, it’s pretty important! Therefore, on the exhale mentioned above, you want to ensure that your TVA is switched on when you’re exhaling too. This engages your core and pelvic floor and keeps them protected and strong. To lock in your TVA, squeeze below as if you are  stopping yourself from weeing and pooing (sorry :)), then immediately after that, zip up from your pubic bone pulling your belly button into your spine. Your TVA is now on. Relax it as you inhale, switch it back on as you exhale.

DIASTASIS RECTI 

diastasis-recti-signsDiastasis recti is commonly referred to as ‘ab separation.’ Everyone will have diastasis recti during pregnancy. How much will differ from woman to woman. We are told that it should “go away” or “return back to normal” by the time we are 8 weeks postpartum but this really isn’t always the case.

The first thing that I want to say about diastasis recti is that I don’t believe that it is purely based on doing things right or wrong during pregnancy. I say that because I know super fit mums, with rock solid abs, that have adhered to all the advice to avoid diastasis recti and have still had it quite badly, even at 3 months postpartum (but have gone on to repair them). I’m not an expert on the effects on the anatomy during pregnancy but this is what I’ve witnessed for myself.

I do think your body type plays a part in how much your abs separate during pregnancy. For example, I didn’t have much ab separation at all, even during pregnancy, because I have a super long torso. Add to that a wide hip canal and there is plenty of room for baby to grow and nest lengthways, without having to push out width ways. I am all body! In contrast, someone with a short torso is more likely to have ab separation as there isn’t much room for baby to spread out length ways so mama has to grow width ways. In this instance, you can do as much as you can to mitigate the negative impact of diastasis recti but you are still likely to get it.

If you’ve already had a baby and already have diastasic recti, please do not panic. It is a vicious rumour that your abs should come back together completely. In fact, you may have had some separation before you were even pregnant. Contrary to what we are told, 1 to 2 cms of diastasis recti is actually ok to live with. What matters is a little thing called ‘tensegrity’ or ‘tension integrity’ – I promise I’m not making these words up. If the gap is firm, then that is actually fine. When you’re pregnant, it’s not just your abs that separate, it’s your organs, fascia and everything else swimming around inside of you.

Therefore, it seems crazy that we should expect everything to go completely back to how it was pre-kids, doesn’t it? And the more children that you have, particularly close together, the more likely you are to suffer. If the gap is more than 2cms and/or loose to touch, i.e. your fingers sink in, then you’re more at risk of problems such as lower back and pelvic floor issues to more serious issues such as prolapse or hernias. Should you have any concerns about diastasis recti, get in touch with a Women’s Health Physio. If you are local to Cheltenham, Louise Rahmanou is your lady and the top of her field. You couldn’t be in better hands.

So, what can we do to minimise the risk of diastasis recti ? 

  • Breathing correctly, as mentioned a lot already. Breathing correctly during exercise ensures that you don’t put any unnecessary pressure on your intra-abdominal wall.
  • When you wake up in the morning, roll on to your side and push yourself up to get up . Don’t use your abs to sit up.
  • Avoid exercises that put unnecessary pressure on your intra-abdominal wall. For example, planks, crunches, sit ups, double leg raises, hanging knee raises and high impact jumping. Particularly jumps where both feet come off the floor and land at force at the same time. Jumps also put unnecessary pressure on your already compromised pelvic floor. Which brings me nicely on to…

PELVIC FLOOR

I’ve left this to the end on purpose, even though you may feel it’s your biggest area of concern. The reason for this is because, if you follow all the guidelines above, you’ll have been taking care of your pelvic floor without even realising it. Woo hoo!

  • Breathing: the quality of your breathing mechanics doesn’t just affect your lungs. It travels past your lungs and down into your diaphragm. Therefore, it has the potential to improve your pelvic floor, bowel and bladder function.
  • TVA: lock it in and you are working your pelvic floor before you even start an exercise
  • Diastasis recti : Minimal diastasis recti means less risk of pelvic floor issues

Regarding fitness, what I would add to the above is this:

PRIORITISE YOUR GLUTES!

Modern studies show that you cannot have a strong core or pelvic floor without strong glutes. FACT. Our glutes are set up to be idle, despite being our biggest muscle group, because we mostly sit on them all day and stretch the muscles. Therefore, work them! Activate them with bands as a priority and make hip thrusters your best friend. For inspo, check out these videos on my youtube channel.


So, there you have it! My top tips for training throughout pregnancy! I hope you’ve found this useful. If you know anyone else that would benefit from reading this article, please use the share button to pop it on your facebook. 

Please note, this article is written by Nicky Ryder from Fit Inside Out, based on experience, evidence and training from Burrell Education. There is no one size fits all when it comes to our anatomy and physiology. Some women continue to do marathons, crossfit, HIIT and other high impact exercise during pregnancy and do just fine. It’s unlikely that they are doing these things for the first time though and many of them will have professional support and guidance. If in doubt, follow my guidelines above and listen to your body. Our Baby Chapter Course includes a section on Top-to-Toe you postnatally, as looking after yourself as well as your babu is an important factor we often overlook! 

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