The Role of Physical Therapy Postpartum

Concerned about post-pregnancy recovery?

 

 

During and after pregnancy, many women experience abdominal muscle seperation caused by stretching and thinning of the inter-abdominal connective tissue. This condition is known as Diastasis recti and is characterized by a >2cm separation of the rectus abdominis muscles at the level of the umbilicus. Many women will describe that they are able to feel a 2-finger width separation in their central abdominal muscles.

What causes abdominal muscle separation?

The most obvious contributor to this condition is increased abdominal pressure due to a small human growing inside you. This is compounded by pregnancy related changes in hormones that increase ligament laxity throughout the body. Weak abdominal muscles and insufficient tension in the network of connective tissue will increase the risk for developing diastasis recti.

  • intra-abdominal pressure
  • hormonal changes
  • weak abdominal muscles
  • strained fascial tissue

How do you treat abdominal muscle separation?

Do not be alarmed! This condition is relatively common and usually resolves on it own. For some women, separation of the abdominal muscles can last for months and even years postpartum. In rare instances invasive medical procedures are required to resolve the condition. The good news is, physical therapy before and after pregnancy can greatly improve patient outcomes.

  • nothing
  • breathing exercises
  • physical therapy
  • pre-pregancy exercise

I will let you in on one important exercise that is easy to perform in the privacy of your own home. This exercise is known as belly breathing. While keeping the rib cage down, push the belly button out as you inhale. This is done by contracting the parachute-like muscle known as the diaphragm.  This muscle pulls the lungs down and allows them to expand. Feel free to pause for a moment at the peak of your inhale and notice the fullness of the lungs. Next, draw the belly button in towards the spine as you exhale. Place one hand on your chest and one on your stomach so you can feel your belly rise and fall with each breath.

As you continue to expand and contract your abdominal cavity you will start to exercise the inner muscular layers of the torso. By repeatedly activating these deep abdominal muscles the connective tissue will begin to retract and close the gap in the outer abdominal wall. As always these are only recommendation and a proper in-person assessment from a qualified health care professional should be completed before starting a physical rehabilitation program.

Dr. Laura: 21 Reasons You Might be Constipated

Bowels that move slow or are difficult to pass are not only uncomfortable, they are unhealthy. It is important we eliminate from our bowels at least once, and up to three times per day. Constipation is an issue affecting up to 20% of the population(1).

When the stool stays in the colon for extending lengths of time, toxins and hormones that have been packaged and processed for elimination are at risk for re-absorption back into the body. Not passing stool frequently enough will lead to a feeling of toxic overload.

What is constipation?

  1. Irregular bowel movements
    1. Pass less than 3-5 stools per week.
  2. Difficulty passing stool.
    1. Hard stool, requires straining,
    2. Insufficient, unsatisfactory, incomplete stool

21 Reasons You Might be Constipated

  1. Diet lacks fibre and vegetables
  2. Diet too high in proteins and carbs, especially in sugar & starch
  3. Dairy or wheat sensitivity
  4. Too much dairy (cheese)
  5. Other food sensitivities
  6. Insufficient microflora
  7. Dysbiosis (overgrowth of the wrong kinds of bacteria in the intestines)
  8. Small Intestinal Bacterial Overgrowth (SIBO) (root cause may be hypothyroid and migrating motor complex)
  9. Hypothyroid affecting the migrating motor complex
  10. Lack of regular daily exercise
  11. Insufficient water intake
  12. Supplements such as iron, calcium
  13. Overuse of laxatives
  14. Side effects of prescription drugs- painkillers (opioids), anti-depressants
  15. Irritable bowel syndrome or diseases
  16. Colon cancer
  17. Stress
  18. Pregnancy
  19. Diabetes mellitus
  20. Hemorrhoids
  21. Nervous system disruption as in spinal cord lesions, MS & Parkinson’s.

Best ways to “get moving” –> relieve your constipation

Laxatives are okay occasionally. Too much use will lead to dependence, which is not how nature intended and don’t fix what’s really happening. Have a look at some of the possibilities of what may cause constipation and see what you can correct. Dr. Laura M. Brown, ND can help you access and interpret many different types of testing.

References:

  1. Portalatin M, Winstead N. Medical Management of Constipation. Clinics in Colon and Rectal Surgery. 2012;25(1):12-19. doi:10.1055/s-0032-1301754.