What do the pre & postnatal challenges of Diastasis Recti, low back pain, hip pain, and sciatica pain all have in common?
They are often symptoms of chronic core weakness that has been exacerbated by pregnancy. One simple solution, that you can incorporate as easily as you breath is the Core Breathing Belly Pump™ (CBBP) exercise. It incorporates the primary muscles of the Core’s Inner Unit, including Diaphragm (DPH), Transverse Abdominis (TVA), and Pelvic Floor (PF) muscles.
IMAGE: The Inner Unit of the Core, including Diaphragm, Transverse Abdominis, and Pelvic Floor Muscles: http://www.cityedgephysio.com.au/core-stability.html
This chart highlights common prenatal Symptoms, Causes and Solutions. Although not every perinatal mom will receive immediate symptom relief from the Foundational Exercise solutions listed here, nearly everyone will benefit from them. Inner unit harmony is a foundational component missing in so many perinatal women. As always, this should not replace the advice of your doctor or physical therapist; please visit a specialist if you are in pain.
CORRECTIVE EXERCISES
Exercises that Strengthen your DPH, TVA, PF, & CBBP
Activating your DPH means that when you INHALE, your body will physically be able to “fill” or move your belly and lungs, rather than your chest and shoulders. Activating your TVA means that you will be able to draw your navel inwards as you EXHALE. Using your CBBP means that you’ll be able to both inhale and exhale with some core activation, every time you breathe.
IMAGE: Standing Big Belly / Standing Small Belly
Lying Supine DPH Activations-
While lying on your back, INHALE attempting to “fill” or move your belly and lungs as you bring air in, not your chest and shoulders. Extend the inhalation for several seconds if you notice that diaphragmatic breathing in this manner is challenging for you.
Lying Supine TVA Activations-
While lying on your back, EXHALE attempting draw in the area of your navel, just below the belly button. Extend the exhalation for several seconds if you notice that drawing in this area of your navel is challenging for you. Feeling a slight abdominal burn is totally acceptable.
Lying Supine PF Activations-
While lying on your back, EXHALE and engage your pelvic floor muscles (the Kegel exercises that you use when you hold yourself from urinating). Extend the exhalation and the pelvic floor activation for several seconds if you notice that activating the Kegel is challenging for you. Creating a fatigue in the pelvic floor muscles is totally acceptable.
Lying Supine CBBP-
Activating your DPH breathing as you INHALE and activating your lower TVA and PF as you EXHALE each time you breath naturally is how you turn on your Core Breathing Belly Pump™. Keeping the CBBP active throughout your day is the foundational way to make sure that the aches and pains of pregnancy don’t happen to you.
Add an Alternating Leg Lift -
Any one of the above exercises can be performed while simultaneously practicing a slight leg lift, as demonstrated in this photo. The slight leg lift represents walking, and is there fore more likely to carry over to other activities of daily life. It’s important to understand that your primary objective is to teach Breathing Centered Movement. In other words, make sure that your inhale and/or exhale generates the slight leg movement, rather than vice versa. And keep your foot rising only barely from the floor, the height of a piece of paper.
IMAGE: Lying Supine: CBBP with Alternating Leg Lifts
IMAGE: Lying Supine on FOAM ROLLER: CBBP with Alternating Leg Lifts. This exercise is more balance challenging than lying on the floor.
Horse Stance: DPH, TVA, PF, or CBBP (with Alternating Leg Lifts) –
In a hands-and-knees position, with middle fingers forward, elbows slightly bend and turned in, hold yourself using your chest and triceps muscles, without upper traps / neck activation. Like the supine lying exercises, you will practice either Diaphragmatic Inhalations, TVA Exhalations, PF Exhalations, or combining them all into the CBBP. Once ready, you can add Alternating Leg Lifts to any of the breath activations. As you do, make sure that you hold your spine and body so firmly in place that you could balance a wine glass on your back as you lift your leg.
IMAGE: Horse Stance with Alternating Leg Lifts. This photo was taken with a dowel rod signaling the stability, but is not necessary to do the exercise.)
Apply CBBP to daily life, by using your Core Breathing for two Functional Exercises:
(Exercises that Strengthen your Glutes)
IMAGE: The Bend pattern is an activity of daily life. As pregnant woman, or new mom, you naturally bend to pick things up all the time. Each bend is an opportunity to activate the right muscles; in this case, your Glutes (Butt muscles).
1 Leg Deadlift
The important part to any therapy or exercise is that it carries over to help you in your daily life activities, so that your body progresses to higher levels of function. One example of a great functional exercise is the 1 Leg Deadlift, which also serves as an incredible glute activation exercise. Stand on one leg and hinge your hip back so that you bend forward, making sure to feel that your glutes (butt) muscles are holding you and moving you every inch of the exercise. You should not feel this in your lower back or knees. Use your CBBP to repeat the motion anywhere from 5 to 30 times, until you feel a strong burn in your glutes.
IMAGE: The 1 Leg Deadlift is a great exercise for activating your glutes. Use this exercise to train your body for the activities of daily life, including bending.
Glute Squats
Our “Glute Squat” is really the same as any squat, but we’ve added “glute” to the name in order to emphasize the muscle that you should be feeling when performing a squat, and the muscle that should be sore the next day. This is the critical missing link for most fitness enthusiasts. If you find yourself doing squats and feeling the burn in your thighs, oops! From now on, make sure you literally feel your glutes (butt muscles). That’s the difference between corrective exercise and general fitness. That’s also the difference between your strong body and your back pain.
IMAGE: Glute Squats
Exercises like these amount to so much more than standard prenatal fitness. These are corrective exercises that specifically activate some of the most under-active muscles in the prenatal body, namely your true Core and Glutes. Do these exercises daily for a couple weeks and feel the difference in your alignment, the bounce in your step, the strength and longevity of your physical output in the day. Then take these exercises with you to labor and delivery. Let your new awareness of Core Breathing help you focus on the most challenging physical event of your life: birth. And feel how your Core Breathing affects your ability to guide your baby in the pushing stage of labor. Then experience the power of a post-partum bounce back that you’ve not imagined possible.
For more exercise progressions, or help applying these foundational exercises to your daily life, please visit GetFitForBirthMiami.com, the daughter site to the Continuing Education site dedicated to fitness professionals, GetFitForBirth.com
REFERENCED SOLUTIONS FROM THE EXPERTS…
HIP PAINS:
Pelvic Girdle Pain: Strengthen “stomach, back, hip and pelvic floor muscles to help realign joints.”[1]
Pelvic Girdle Pain: “Remain active within the limits of pain. Avoid activities which she knows make the pain worse. Avoid activities that involve asymmetrical positions of the pelvis.”[2]
Symphysis Pubis Dysfunction: “Exercises that focus on strengthening the pelvic floor muscles are particularly useful for this purpose.”[3]
Symphysis Pubis Dysfunction: “It would seem beneficial in the long term for women to use their muscles to provide stability to the pelvis rather than to rely on an external device.”[4]
IMAGE of Symphysis Pubis Dysfunction (SPD): http://anterior-hip-surgery.com/pelvic-injuries/pubic-symphysis-diastasis/
LOWER BACK PAINS / SCIATICA:
Herniated Disc/Disk / Sciatica: “There is little evidence to suggest that drug treatments are effective in treating herniated disc...Neither bed rest nor traction seem effective in treating people with sciatica caused by disc herniation.” [5]
Herniated Disc/Disk: “Most people who have a herniated disk don't need surgery to correct the problem.” [6]
Sacroiliac Joint Dysfunction: “In this author's opinion, the treatments with the most potential for reductions in pain and disability are exercises aimed at improvement in lumbopelvic stability and intra-articular steroid injections.” [7]
Sciatica: “Design a rehabilitation program to help you prevent future injuries. This typically includes exercises to correct your posture, strengthen the muscles supporting your back and improve your flexibility.” [8]
Sciatica: “Specific stretches and exercises are the best solution to all of the kinds of sciatica.” [9]
IMAGE of where Sacroiliac Joint (SIJ) Dysfunction occurs: http://www.necksolutions.com/sacroiliac-joint-pain.html https://en.wikipedia.org/wiki/Sacroiliac_joint
IMAGE of Sciatica (and Disc/Disk Herniation): http://steamspoils.com/sciatica-sos-review
DIASTASIS RECTI:
DR was found to be “Much greater in non-exercising pregnant women than in exercising pregnant women.” [10]
“The two primary solutions are (1) Corrective Exercise: Learning proper core mechanics that ensure the diastasis-causing pressures are not chronically stressing the [connective tissue] fibers and thereby worsening the separation, and (2) Nutrition: Some foods and topical treatments may strengthen the fibers on a cellular level. It is worth noting that a third healing factor exists: (3) Thoughts: Belief is a powerful factor in healing. Coaching a client from pessimism and disbelief into optimism and belief is a critical component in any healing process.” [11]
IMAGE of Diastasis Recti: TheBloomMethod.com
[1] http://www.webmd.boots.com/pregnancy/guide/pelvic-girdle-pain-pgp-spd?page=2
[2] 2015. “Pregnancy-related Pelvic Girdle Pain.” Pelvic Obstetric & Gynaecological Physiotherapy (POGP).
[3] http://www.pregmed.org/symphysis-pubis-dysfunction-spd.htm
[4] Management of Symphysis Pubis Dysfunction During Pregnancy Using Exercise and Pelvic Support Belts. Physical Therapy December 2005 vol. 85 no. 12 1290-1300. http://ptjournal.apta.org/content/85/12/1290.full
[5] Jordon, Jo. BMJ Clin Evid. 2009; 2009: 1118.Herniated Lumbar Disc. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907819/
[6] http://www.mayoclinic.org/diseases-conditions/herniated-disk/basics/definition/con-20029957
[7] J Man Manip Ther. 2008; 16(3): 142–152. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582421/
[8] http://www.mayoclinic.org/diseases-conditions/sciatica/basics/treatment/con-20026478
[9] http://sciaticainstitute.org/sciatica-exercises-how-to-cure-sciatica/
[10] http://journals.lww.com/jwhpt/Abstract/2005/29010/The_Effects_of_an_Exercise_Program_on_Diastasis.3.aspx Journal of Women’s Health Physical Therapy. Spring 2005-Volume 29-Issue 1-pg 11-16. https://www.diastasisrehab.com/research
[11] 2016. Pre & Post Natal Diastasis and Core Consultant. Fit For Birth Course Curriculum. Section 6: The Notable Nine Core Challenges.