Splitting of abdominals and weak pelvic floor

lora-kate

Active Member
Hi Cathe - I am in my 13th week and have such conflicting information about ab work that I don't know what to do. I have been told by a fitness professional not to do any flexion of the spine as it may result in my abdominals splitting. I saw that you said that you did it on an incline. Is that to minimize cutting off the bloodflow to the fetus and does it also take into account the splitting of the abs?

Completely unrelated but a huge concern is that I have also had week pelvic floor muscles (when I was little my siblings would try to make me laugh so hard that I would pee my pants). With pregnacy it is horrible anytime I jump. I have also had conflicting information here. My obstatrician said kegels are a waste of time unless you do hundreds everyday for the rest of your life. Other woman say they are great. Any thoughts? I do not want to be wearing "Depends" as an older woman! Help!
 
Hi Lora-Kate! It sounds to me like what you are referring to when you say splitting abdominals is "diastis recti". Sheila, our prenatal expert here on the forum has addressed this question in the past. I will post her reply here. I also want to say that some people get this separation and some do not. I did not get this and neither did the other woman that all delivered babies around the time I had my first. We all did ab work through most of our pregnancies. By the way, I do abs on an incline soley to promote good circulation to the baby.


Sheila responds:

A very good reference for this is "Essential Exercises for the Childbearing Year" by Elizabeth Noble. I would highly recommend this book.

Also, here is an exerpt from my "Healthy Moms Perinatal Fitness Instructor Training Manual"

Diastasis Recti

As a quick review, the rectus abdominis is the outermost abdominal muscle, which attaches from the top of the ribs to the pubic bone. It is composed of two halves called recti that are normally about a half an inch apart. The two recti are joined by a fibrous band of connective tissue or central seam known as the linea alba. The hormones of pregnancy cause the linea alba to soften. This is why women notice a “thicker” waistline early in their pregnancies. This softening coupled with the increased pressure from the growing baby may actually cause the two recti to separate around the area of the navel, somewhat like a zipper separating under stress. The onset of diastasis recti may be gradual or sudden (Ex. During a bout of coughing or during labor). During pregnancy, a gap or bulge is often noticed in the seam when the head and shoulders are raised. This is the “telltale” sign of a diastasis. Women sometimes find their diastases when they are rising out of bed and notice the bulge.


Implications

Pregnant women should be checked for separation after the 20th week of pregnancy or when they begin to “show.” They should be checked every one to two weeks after their initial assessment. Clients should also be checked after they return to class postpartum since they may have separated during labor and delivery.

The oblique muscles, which are involved with trunk rotation, insert into the linea alba. If a mom has a separated rectus muscle, she should not be doing rotational oblique work as this could encourage further separation. It is necessary to “splint” the seam (i.e. the “corrective” exercise) by crossing the hands over the lower abdomen when doing abdominal work.

Separation Check

POSITION: Supine, knees bent. Press fingers of one hand (horizontally) firmly into area around navel (perpendicular to the linea alba)

ACTION: Client slowly raises head and shoulders about 8 inches off the floor while reaching for her knees.

CHECK: How many fingers remain in gap?
- A slight gap (~ ½ - 1 finger) is normal.
- ~ 2 or more finger separation: Client should do the corrective exercise below.


"Corrective Exercise"

POSITION: Supine with knees bent(first trimester) or on a slight incline (after first trimester). Cross hands over the abdominal area and guide the recti muscles toward the midline to stabilize them.

ACTION: Inhale deeply. Slowly exhale and pull in abdominal muscles (“pull navel to spine”) while simultaneously pulling the underlying muscles together with your hands. Only raise your head, not your shoulders. Return to starting position.

This exercise should be done a few times in the morning and evening while lying in bed to keep the recti muscles in maximum tone and to discourage further separation." (end of response)


As far as kegels are concerned, I strongly recommend them to strengthen your pelvic floor muscles. This will not only help to keep you from leaking urine when you sneeze, cough, or jump (since the baby puts more pressure on your bladder as he/she grows), but will keep your pelvic floor stronger overall(a big plus) since your pelvic floor will become stressed from holding the weight of the baby. Since you are already leaking urine, you should focus on kegels and not do any jumping in your workouts until the leaking no longer occurs. If you find after time that the leaking is still occuring, eliminate all impact from your workouts. Good Luck!
 
Hi Cathe - Thanks for your response - alot of good information. I think I will keep up with my ab work (on an incline) and just watch for separation.

Take care.
 
I don't want to dispel anything your OB says... and, yes, hundreds of kegels might be what you need... (no big deal! Do 10 every time you start or stop your car... do 10 after you pee but before you get off of the toilet... do 10 before you get out of bed in the morning and 10 more before you go to bed at night... it all adds up!) but, really, since when can you not strengthen a muscle if you work it? If you had a completely unused bicep muscle, and you started lifting a 3 lbs. weight with that same muscle every day (or even every other day), you'd expect to see progress, right? The kegel is simply a muscle that does a figure 8 around your urethra and vaginal area in the front and your rectum in the back. It acts like a hammock holding up all of your major pelvic organs including your bladder & uterus. During pregnancy the excess weight of the baby and placenta as well as the increased relaxin in your system can allow the hammock to sag. This is the cause of the incontinence so many women experience during and after pregancy. Labor also puts tremendous strain on the kegel muscles, and so sometimes women will have problems later even if they haven't had problems during pregnancy.

My personal experience is that kegels work... and that what Sheila preaches in her classes is absolutely true... all muscles have memory, including your kegels, and if you work them now, you'll be able to get them back sooner after pregnancy. Sure, you'll need to keep up the kegels later on... but in order to maintain strength in any other muslce, you need to do the same, right?

BTW, I found that doing kegels while I was nursing was an easy way to get them in during the day.

As for exercising -- if you find yourself leaking urine when you go to high impact, then you shouldn't go high impact -- this true during and after pregnancy. You don't want to further stress a muscle that is already compromised.

Susan
Healthy Moms Certified Prenatal Instructor
p.s. - Sheila, can you tell story of the prolapsed bladder? I don't want to get it wrong!
 

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