7 key steps to healing abdominal separation
Updated: Jul 7, 2018
7 key fundamental steps to healing your tummy separation
➡️ Do no harm
Protect tissue healing by making sure that nothing in your day to day life with regards exercises, movement patterns or daily activities increases the load and hence strain on the middle. A bit like don’t pick a scab and expect it to heal!
Certain movements or positions can place an increased pressure on the already over-loaded abdominal wall, which won’t be doing you any favours. As a general rule of thumb I would avoid sit-ups, planks and standard ‘abs’ exercises.
Day to day movements for example getting in/out of bed by lying straight back/sitting straight up can increase pressure on the tummy gap, as can getting up from a reclined position on the sofa.
Daily tasks for example lifting heavy shopping bags/car seats/toddlers also increase load on the tummy gap, and we should ‘use our breath’ (see below) during these tasks to protect the tummy.
If you see your tummy start to bulge outwards or look a bit pointy, try to avoid that position/movement or do things differently, so as not to observe that bulge. It’s an indication of further strain on the abdominal muscles.
➡️ Correct your alignment
Pregnancy causes massive changes to our postural alignment and centre of gravity, which doesn’t spontaneously resolve the moment we deliver our babies! It’s worth making some effort to restore the natural curves of our spines to give our bodies a chance at correcting what’s gone on the past 9 months. If we can align ourselves well, muscles are more able to work optimally and generate the tension they need to in order to work efficiently.
Here's a technique I use in my Pilates classes each week....try standing in the mirror (just underwear on at home!) and observe your side profile, or have some side photos taken of you. Are you standing tall, or slouching? Belly protruding or sucked in under the ribs? Rib cage shifted back relative to pelvis? Try tipping the pelvis back and forth, then shifting body weight side to side/forwards-backwards over again every day until you feel you’ve ‘re-learnt’ how to stand well, and are happier with the side profile alignment.
➡️ Breathe effectively, and ‘use your breath’
When pregnant, our rib cage expands fully to allow abdominal expansion and stays there. Afterwards, new Mums can find it helpful to ‘practice’ thoracic breathing - when the ribs expand sideways with the inhale and then re-coil with an exhale. This helps to restore motion of the rib cage.
Using your breath refers to the practise of ‘exhaling on exertion’ ie every time you perform a movement that increases pressure in the tummy (a lift/push/pull) - co-ordinate that task with an out breath. This helps manage or control the abdominal rise in pressure, avoiding any excessive strain on the pelvic floor and abdominal wall.
➡️ Avoid ‘sucking your belly in’ all day
No muscle will be in good health when it’s under a constant state of contraction, our bodies aren’t designed to work like that! Added to this, pulling in your belly all the time can contribute to muscle imbalances, when some muscles are stronger/tighter than they should be and also pelvic floor hypertonicity, where the pelvic floor is working too hard and will therefore tire quickly in times of need.
A better option would be to consider a medical support garment such as EVB Shorts. These can be worn as underwear or you can buy sports gear by EVB which are designed by medical engineers and are built to offer support to your perineum (undercarriage) and abdominal wall. A great option for ladies with abdominal separation or any type of pelvic floor dysfunction (urinary leaking, pelvic organ prolapse)
➡️ Stay well hydrated
The midline of our tummies is made of a fibrous connective tissue called collagen....which is 70% water. It’s not rocket science....if you want to build collagen, drink enough water!
➡️ Look after yourself
Early motherhood is not a time well known for nurturing oneself and feeling well rested. But take whatever steps you can to maximise sleep/rest and minimise stress as this influences the hormone cortisol, which in turn will influence our body’s ability to repair and regenerate itself. Too much cortisol (produced by lack of sleep and stress) can impair our healing.
➡️ Pelvic floor problem too? SEEK TREATMENT
We know from research that many people with abdominal separation also have some form of pelvic floor problem - leaking urine or perhaps pelvic organ prolapse. If you suspect you have a problem downstairs, know that it’s all connected, it’s not just a coincidence! You won’t do well at fixing your tummy while trying to ignore the issue going on with your undercarriage!
Your pelvic floor and tummy are part of the ‘core unit’ and it all needs to be working well in harmony....if there’s a problem, get it sorted! I offer women’s health (pelvic floor) assessment and treatment at St Judes Clinic in Leighton Buzzard.
Haven’t even mentioned postnatal exercise or Pilates yet...there is so much that can potentially contribute to healing a separation before even thinking about that. Hopefully you will have begun to see why exercise is just a small part of it!
Look out for my next blog 'Abdominal Separation - Do we really need to mind the gap?'..........Follow my Facebook page to be sure you don’t miss it.
Mother Nurture Pilates | Physiotherapist led Postnatal Pilates classes | Leighton Buzzard, Bedfordshire