Diastasis recti is the separation of the abdomen muscles (aka our six pack), It’s totally normal to occur during pregnancy as our bodies have to make space for the growing baby. 

The trouble is that this separation can weaken our core and, left unchecked, this can lead to back pain and contribute to poor posture and alignment. Whether you are a new mum or seasoned parent, dealing with back pain is difficult and can cause all sorts of disruptions to life. 

 

How can I reduce my back pain?

The first step to alleviating the pain is to get to the core of the problem…our core! By ‘closing the gap’ and addressing our abdominal function, we can relieve the pressure on our spinal muscles and ensure that our back is not doing all the work. 

 

Exercises To Help Diastasis Recti

For anyone who DOES have time to exercise, here are some useful exercises to kick start your movement practice but in an ideal world I would find a local pregnancy and postnatal specialist trained by Carolyne Anthony or Jenny Burrell as there is no substitute for good teaching! Or come and work with me in my online membership! 

These exercises should only be performed after you have had clearance from your GP to exercise again. I would recommend that you also see a Women’s Health Physio before starting any exercise postnatally.

 

 

Sidelying Ribcage Rock

• Lie on your side with both arms extended forwards at chest level with the palms together
• Inhale to rock the ribcage forward while at the same time rocking the pelvis back
• Exhale to rock the ribcage back as you rock the pelvis forward
• Repeat then change sides

This is really helpful as it will mobilise the tissues around your ribcage and torso that could be causing tension that is preventing good function in your abdominals.

 

Double Knee Openings

• Lie in neutral spine with your feet together. 
• Exhale to allow your abdominals to flatten
• Draw your hip bones towards each other and open both knees out to the side – focus on keeping the pelvis still as the legs move
• Inhale to hold the legs there, exhale to connect to your abdominals again and pull the legs back together again. 
• Think of the legs being heavy and using your abdominals to pull them back to the middle.

When working in neutral spine many postnatal women benefit from a higher head position (cushion/ block) to allow the back of the ribcage to stay released into the mat whilst the lower back can maintain its neutral curve. If neutral spine is uncomfortable for you, look at the positioning of the head.

This exercise will help to connect you to your deep core muscles. 

 

Single Knee Openings

• Lie in semi-supine
• Exhale to allow your abdominals to relax then draw your sit bones, hip bones and rib cage together
• Open one leg out to the side
• Inhale and hold it
• Exhale to bring it back to parallel
• Repeat with the other leg. 

Focus on keeping the pelvis and especially the supporting leg still and releasing as the other leg moves.

 

Pelvic Tilts

• Lie on your back with your knees bent up and feet flat on the floor
• Make sure that the feet are parallel to each other and be aware of the big toe joint connecting into the floor. 
• Exhale to gently flatten your lower back so that your lower spine softens into the floor (rolling your pelvis under and thinking of bringing your pubic bone and your rib cage towards each other). 
• Inhale and release back into neutral, allowing your hip flexors to release, the pelvic floor to open. 

 

As a variation:

• Hold the pelvis in the tilt (if you can, try not to fully release on the in breath, keeping some connection)
• Exhale to connect again
• Visualising the abdominals drawing back into the middle
• Have an awareness of your pelvic floor connecting as your ribcage is softening and the pelvic floor connecting the sit bones into the inner thighs and big toe joints with every out breath. 
• Repeat the breathing 5 times.
• Release the pelvis back to the floor.

 

Postnatal Classes with Centred Mums

All of our postnatal classes can help with your abdominal separation. We have designed each class to ensure it only contains exercises that will assist your recovery, and we will always encourage you to work at your own pace and listen to your body.

When it comes to dysfunctions like Diastasis Recti, you are often warned against exercises such as sit-ups, but we will teach you that it isn’t about the exercise but about the level of control you have. If your abdominals ‘dome’ and push out when you do a sit-up, then this isn’t a good exercise for you. But plenty of people who don’t have a diastasis also dome, and it’s not a good exercise for them either.

We’re here to assure you that you don’t be scared to move and to use your body, you simply need to learn how to use it better.

With a better understanding of what your postnatal body needs, you can avoid pushing yourself into exercises and movements that won’t serve you well in the long term. And, as experts in this, we can confidently support you through making these important changes and bring you great results with our postnatal classes or our online membership!

A pelvic organ prolapse, or POP for short, happens when one or more organs in the pelvis move downwards from their normal position and bulge into the vagina. There are three main types:

• Anterior – This happens when the bladder drops from its normal position
• Posterior – This happens when the bowels bulge into or out of the vagina.
• Uterine – This happens when the uterus drops from its normal position

Unfortunately, there is still a lot of shame around this subject and conditions, causing a lot of women to receive misinformation or terrible to little advice. 

 

So what are the symptoms?

It’s important to note that it is not life-threatening but can cause a huge amount of distress and discomfort. The most commonly reported symptoms are:

• Leaking a small amount of urine when coughing, sneezing or exercising. 
• Going to the toilet more 
• Feeling a heaviness or ‘dragging’ feeling in your lower tummy 
• Feeling like there is something moving down your vagina 
• Seeing a bulge coming out of your vagina 
• A numb feeling or pain during sex

Because of the stigma, it’s unclear exactly how many women are affected but it’s thought that nearly 50% of women experience some form of POP[1]. Many women can experience POP as a result of difficult or multiple childbirths, transitioning into the menopause. 

 

 

What treatments are available?

Before considering surgery, there are several treatment options which could help to alleviate symptoms.

Some lifestyle changes such as losing weight, not lifting heavy objects and eating a diet high in fibre could prevent prolapse symptoms from getting worse. 

Pelvic floor exercises or kegels can be a helpful way to make sure that the pelvic floor is able to contract and release effectively but they are just a piece of the puzzle and shouldn’t be considered the only way to support your prolapse better. There are also a number of additional exercises you can do to support your recovery journey, including: 

• Arm circles
• Rib Cage Release
• Hip release
• Ball Squeeze
• Bridges

You may feel like some of these are unrelated to prolapse symptoms but addressing things like your breathing, your posture and tightness around the pelvis are all vital to alleviate prolapse symptoms. 

For information on how to carry out these exercises, have a read of my ‘Will pelvic floor exercises help prolapse?’ blog. 

Other treatments that could be tried are hormone treatments and vaginal pessaries. You can get advice about these from your GP but ideally, get a referral to a women’s health physio. 

 

 

What if I need surgery?

If your quality of life is being affected, you may decide to have surgery to repair your prolapse. It is important to address the issues that contributed to the prolapse in the first place as otherwise, your symptoms are more likely to return. 

Here are some examples of things that should be addressed before having surgery: 

• If your posture causes you to put downward pressure onto your pelvic floor, you need to find ways to reduce that pressure, possibly by strengthening your spinal muscles to create more length in your body. 
• If your breathing tends to move down into your belly, rather than spreading equally throughout your torso, you need to create new breathing patterns. 
• If you find it hard to control intra-abdominal pressure due to lack of strength, you need to strengthen your pelvic floor muscles, your abdominal muscles and your whole body globally to reduce the pressure going into your pelvic floor day to day. 
• If you are constipated, you need to address this to ensure that the pressure created by straining is not continuing post-surgery. 

Without these kinds of holistic changes, your pelvic floor surgery is more likely to be unsuccessful. 

 

Anterior repair 

The procedure will focus on reinforcing the weakened layers between the bladder and the vagina to improve overall bladder function and reduce any vagina bulging. 

It’s thought that this procedure is around 70-90% successful (Source: Bladder & Bowel).

I believe this figure could be improved if information about pelvic floor health and a more holistic approach (as outlined above) was discussed with the post-surgery team. 

 

Posterior Repair 

The procedure will focus on reinforcing the weakened layers between the rectum and the vagina to improve overall bowel function and reduce any vagina bulging. 

It’s thought that this procedure is around 80-90% successful (Source: Bladder & Bowel).

 

Vaginal Hystorectomy 

When the uterus drops a vaginal hysterectomy to surgically remove the uterus may be advised. It’s thought that this procedure is around 85% successful  (Source: Bladder & Bowel) but it is possible that some women will develop a further prolapse of the vaginal vault further down the line. 

It is important to remember that a prolapse can recur or another part of the vaginal wall may prolapse. This may be inevitable in some circumstances but I believe it is less likely when a holistic approach is taken and when people are better informed and empowered about their pelvic floor health. Healing post-surgery takes around 3 months and any heavy lifting and strenuous exercises should be avoided. You should consider a full rehab programme post-surgery which is not generally provided. You need to learn to control intra-abdominal pressure, improve breathing patterns, improve posture and gain better mobility and strength to improve pelvic floor function. 

 

 

Is there anything you should consider before having surgery? 

 

Any type of surgery is a huge decision so here are a couple of things you may want to consider:

Age – if you are young, you may need further treatments down the line. The type of surgery you can have when you are older may be dictated by other health conditions and your overall health history. 

If you want more children – if you are looking to grow your family, surgery may not be the right option for you.

Health conditions – there may be other risks to consider if you are living with conditions such as diabetes or heart disease. 

If you haven’t already seen a Women’s Health Physio, make sure you go and get some advice from someone in person. Get your pelvic floor checked for as much support as possible. You can look for a local physio here.

You might be interested in The Pelvic Floor Project if you are interested in improving prolapse symptoms in a holistic and sustainable way.

 

As the festive season approaches, what better way to express love and care than by giving gifts that contribute to the well-being and vitality of your loved ones?

This year, consider presents that not only celebrate the joy of the holiday season but also set the stage for a revitalized start to the New Year. Here are five Christmas gifts designed to bring back the spark in 2024!

Also, remember there is no shame in asking for presents for yourself, that you truly want and need, so why not send this list on, or drop some subtle hints to Santa! 😉

1. The Glucose Goddess Method: A 4-Week Guide to Energy, Craving Reduction, and Feeling Amazing

In a world filled with hectic schedules and constant demands, energy levels can easily plummet. Gift yourself or your loved ones ‘The Glucose Goddess Method’, a comprehensive 4-week guide that promises to rejuvenate and revitalize.

This program focuses on cutting cravings, boosting energy, and promoting an overall sense of well-being. It’s the perfect gift for those seeking a transformative start to the New Year.

2. Centred Mums Pilates Retreat Day

A day of self-care and rejuvenation can make a world of difference. My Centred Mums Pilates Retreat Day offers the perfect escape. This retreat combines the benefits of Pilates with a focus on centring the mind and body. A thoughtful and invigorating experience, it’s a gift that promotes both physical and mental well-being.

3. Treat Yourself to a Massage from Fernwood Remedies

Indulge in the gift of relaxation and tranquillity with a massage from Fernwood Remedies. Their professional and rejuvenating massage services provide a holistic approach to well-being. This gift is an excellent way to unwind and relieve the stresses of the holiday season, setting the stage for a calm and collected entry into the New Year.

4. The Gift of Sleep from Clare McDonald @creative.sleep

Ease into the New Year with Sleepy Sundays, A 3 part playful, calming and nurturing experience for parent and child. Using breath work, imagination and fun activities. This intuitive approach to tackling worries and wired minds is back again in January. Enjoy the whole course for £49!

For adult adults seeking better sleep, there’s also the ‘Help For Sleep’ online course, for £39!

Clare herself suffered from insomnia from childhood into her late 30s but eventually found a combination of the Coherent Breathing technique, guided imagination, a lot of reframing around her beliefs about sleep and an overall intuitive approach worked wonders.

5. The Pelvic Floor Project: Ongoing Wellbeing

Invest in long-term well-being with my Centred Mums Pelvic Floor Project. This initiative offers continuous support for pelvic health, promoting overall vitality.

By gifting a membership to The Pelvic Floor Project, to either a loved one or yourself, you provide a resource that focuses on an often-overlooked aspect of well-being, contributing to a healthier and more energised lifestyle.

Making this commitment to your wellbeing will set up your pelvic floor health for the rest of your life. Get rid of those pelvic floor issues like wetting yourself that you’ve been putting off for too long!

Conclusion:

This holiday season, go beyond traditional gifts and give the present of well-being.

Each of these gifts is carefully curated to not only celebrate the joy of Christmas but also to lay the foundation for a revitalized and spirited start to the New Year.

Whether it’s promoting energy, relaxation, better sleep, or ongoing well-being, these gifts show that your love and care extend to the overall health and happiness of your friends and family.

Wishing you a very Merry Christmas and a Sparkly New Year!

Grace – Founder, Centred Mums