Pregnant and post-partum moms...You need to know about abdominal wall separation!

MamaBirdBoss

You may see videos of super fit moms lifting weights all through their pregnancy. But this is a REALLY, REALLY bad idea because it can dramatically increase your chances of abdominal wall separation and can cause even permanent damage to your core.

Starting a core program that's too aggressive too soon after birth or if you have remaining separation can also cause permanent damage.

This is one of the foremost experts on diastasis in the pregnancy/post partum period:

https://diastasisrehab.com/

For people without a serious existing issue, a program like this can be helpful:

http://www.nataliejillfitness.com/diastasis-recti-abdominal-separation/

Due to my genetic muscle disorder, I got diastasis with my FIRST pregnancy. I eventually got back to a flat stomach (a friend called it "concave"), so know that improvement is very possible if it does happen!

kgeyser

Do you have a source for your claim that lifting weights during pregnancy increases the chance of diastasis recti and can permanently damage the core?

MamaBirdBoss

The current health guidelines for pregnancy simply say don't do any weightlifting after the first trimester because of the possibility of diastasis recti and injury from loose ligaments.

This is oversimplifying things (as many pregnancy guides do) but there's a good discussion of VERY SPECIFIC exercises to avoid in pregnancy on this page from experienced trainers who do a lot of pregnancy/post-partup training in the discussion section:

http://www.thehealthyhomeeconomist.com/pregnancy-and-postpartum-fitness-dos-and-donts/

The article itself is actually crap. It's the discussion you want to delve into.

MamaBirdBoss

As for permanent damage:

https://en.wikipedia.org/wiki/Diastasis_recti

If you look into the specific surgical treatments (if rehab fails), you'll find that they are mostly cosmetic and don't restore full function.

http://www.ncbi.nlm.nih.gov/pubmed/21688021

MamaBirdBoss

Oh, and diastasis recti is known to occur in non-pregnant individuals who do intense "traditional" ab work (as well as a birth defect, BTW). You can see it on some MALE body builders.

http://breakingmuscle.com/womens-fitness/can-your-abs-split-in-two-5-important-facts-about-diastasis-recti

The little kid who was turned into a bodybuilder by his dad had the most ridiculous case of it in a man.


Anyway, minimal separation is no big deal, but if you're doing exercises that are known to cause diastasis recti in men who DON'T have a huge amount of pressure on their abs in a pregnant woman is a very, very bad idea.

Here's a (partial) list of exercises that are especially straining:

http://www.theptdc.com/2013/10/the-personal-trainers-guide-to-diastasis-recti/

Anyway, the "direct abs" exercises that are most likely to cause diastasis recti (by working the rectis abdominis without working the transversus abdominis, as well) are probably not a great idea for anyone, pregnant or not. They won't strengthen the muscles that give you a flat tummy--and they aren't even as good for your abs as most lifts that require more muscles.

The BEST way to know if you're getting diastasis recti is if your stomach starts to burn right down the midline when doing things that mostly engage the dominis rectis. If this happens...don't do those things. That includes sitting up without turning on your side first. The more the linea alba is stretched, the harder it is to get it back. Start doing as many exercises for your transverse muscles, too, to help minimize the separation, and you might need a stomach splint.

It can get to the point where even standing up can make you want to cry because of the pressure on the damaged linea alba. Don't get to that point if you possible can!

kgeyser

I'm not seeing anything stating not to use weights in any of the links you posted. There are recommendations to avoid certain abdominal exercises during pregnancy which have been around for some time, and modifications for other exercises, but I do not see anything stating that lifting weights causes or even increases chances of diastasis recti.

MamaBirdBoss

kgeyser wrote: »

I'm not seeing anything stating not to use weights in any of the links you posted. There are recommendations to avoid certain abdominal exercises during pregnancy which have been around for some time, and modifications for other exercises, but I do not see anything stating that lifting weights causes or even increases chances of diastasis recti.

Any weight-bearing exercise that uses the rectis heavily and doesn't demand at least as much from the transverse can cause or worsen it, including body weight.

The deadlift is among those that are recommended for avoidance for that reason (it's listed among the exercises). Pulldowns are another. Bench press is contraindicated because of that lying-on-your-back position already, but it would be out, too, until you've had a chance to heal.

If you're postpartum and you do something that makes the center of your abs bulge and the sides go concave, it's wrong. Don't do that.

If you're pregnant, it might be harder to see the signs, but if it makes the center of your stomach burn, don't do that thing. There are no muscles on that line to work. That's your linea alba being pulled apart.

You can see the visible diastasis recti in several of the women who have done "look at me lifting while pregnant!" videos. For most of them, it was a first pregnancy, and diastasis is USUALLY pretty rare in first pregnancies, and if you get it, your body typically bounces back pretty fast. But many times in their "after" recovery videos, taken after they triumphantly show that they made the right choices in the video, you can see a very classic and obvious diastasis. Some of them remain quite significant. They apparently took the "shark fin" shape of their abs in a crunch as just a sign that their bodies have changed with pregnancy. It's not just a change. It's destabilizing damage.

I wrote this post after seeing a video of the "seven-year-old body builder"--who had developed a TERRIBLE diastasis because of his father's abuse and still have a very visible one as a non-body building adult as a result. That reminded me of the other videos that I've seen of women who have messed themselves up by causing/worsening diastasis during and after their pregnancy. When I find one, I'll show you.

Some of the women have it so severely that I know that their smiling faces are a lie. It hurts likes a @#$#@ to have your linea alba that damaged and then to put more stress on it. And the pain is more damage, not their muscles getting stronger. It's not something you can "work through." Wou can also have a visibly flat stomach while standing and still have diastasis severe enough to be destabilizing and causing pain.

Do every move you can to strengthen the transverse muscles while pregnant. But the rectis shouldn't be given serious strain during or within 3 months (if you have very little to no detectable diastasis) to a year (with large diastasis) after pregnancy.

blobby10

Surely the key to all exercise when pregnant is not to start anything NEW!! I drew gasps of horror from my friends when I confessed to still riding every day when pregnant with my first child but the midwife said that because I had been doing that for many years it would be no problem. (had to stop at 20 weeks because I was so big my bump kept hitting the front of the saddle ) Same with the media stories about super fit mums - they are CONTINUING their exercise regime so their muscles will be used to whatever they are doing - how can this be bad? Pregnancy isn't an illness or an excuse to lose shape any more than you absolutely have to!

allergictodiets

My OB actually encouraged me to continue with my fitness program when I was pregnant and I am glad I did. I had NO back pain, NO hip pain and almost no problems with water retention. I biked to work every day and did strength training and / or yoga in the evening ( DVDs by Tracey Mallet and Erin O'Brien ). As far as I know planks, crunches and twists are not recommended because of diastasis, but other exercises are fine.