Hi. I’m Ruth, one of Mamma with a Cuppa’s specialists. I am in fact a Registered Dietitian, but I am training to be a yoga teacher and specialist in pregnancy and post-natal yoga. I wanted to write this blog as I myself had diastasis recti (DR = separation of the abdominal muscles that run down our centre line from sternum to pubic bone) after my pregnancies. I also suffered from problems with my wrists after pushing against the side of the birthing pool repetitively during my first birth. I didn’t get any advice or even a conversation about these things with a health professional until I myself sought the advice of two separate physios for each of these problems. My eldest was about 9 months old by the time I finally sought help for DR because my lower back was taking the strain! Some simple exercises from the physio really helped me out.
Being aware that these things can be a problem is the first step to sorting them out. This video is great at explaining how to check for DR:
It’s likely that before 12 weeks post-natal every woman will still have some degree of separation, but if you still have it after 12 weeks I’d recommend asking to see physiotherapist.
The hormone relaxin produced during pregnancy causes our muscles and joints to soften. This means that they are more vulnerable to injury. This effect continues during the 4th trimester and also in breastfeeding women in whom relaxin continues to be produced.
I would like to share a few simple steps and exercises all women can take post-natally to protect themselves. This advice doesn’t replace individualised advice or the advice of a health professional, so if you are in any doubt or have a specific issue, please do seek further advice.
Avoid: any form of sit up, deep twists, and back bends
Sitting up in bed – don’t rise straight up, roll onto your side then use your hands to push yourself up. Likewise, lower down onto your side to lie down. Don’t sit or lie directly up or down with baby in your arms if you can avoid it, as the extra weight will put additional strain on muscles. The photos demonstrate what this looks like, including getting up when in bed.
Picking up baby from the floor: Come down onto your knees to place or pick baby off the floor rather than bending forward from hips. Remember to engage your core before lifting baby. (I couldn’t find my daughter’s old toy baby, so this cat teddy had to do!):
Carry a toddler: If you have a toddler alternate the side on which you carry them. Look how out of line I am:
Car seats: Be cautious carrying the car seat long distances. Use the pushchair or ask another adult if that is an option.
SAFE STRENGTHENING EXERCISES
It is important to take time to rest during the first 6 weeks, however if you feel like doing some gentle movement this first video will be safe to do as long as you haven’t been given orders to not do any exercise by your health team.
Video 1: Engaging your pelvic floor before 6 weeks
This video focuses on reconnecting to your pelvic floor
Video 2: Pelvic Floor Strengthening Exercises
After your 6 week check and when you feel ready: strengthen your core
JOINTS: due to the effects of relaxin don’t overstretch during exercise, don’t take exercises to their maximum until you’ve built strength. Exercises to build strength in glutes (bum muscle) and thighs will help protect your back and support the pelvic floor.
Try the leg raises in the video above or squat against a wall as shown in the photo below. Don’t forget to engage your core whilst doing this!
Wrist and thumb joint: Some women may need to wear wrists support or see a physio. Picking up and carrying baby, which happens repetitively in the early months, will exacerbate any wrist and thumb issues. There is such a thing as Mother’s thumb! I’ve included some modifications in the video 2 above to protect the wrists. Doing this simple wrist exercise can help and is great for anyone who works at the computer lots too:
Video 3: Releasing your wrists:
Your shoulders and upper back
Holding and feeding baby can be bad for our posture. Do these exercises as often as possible to help loosen your shoulders:
Video 4: releasing the shoulders
Whilst these are all very gentle exercises, be sure that you are not doing anything that could cause you to strain or hurt your body. Everyone's recovery after birth will be different. If you have any doubt as to whether you should be doing these exercises, please consult your doctor first.
You can also get in touch with Ruth on her specialist page and click on her Email contact for more information - or working with her more.