Post-baby a crunch time
It took seven years for a personal trainer to realise doing the wrong exercises after the birth of her baby had caused a tummy separation. Emily Brookes reports.
If you’ve ever had a baby, no matter how long ago, popular abdominal exercises such as crunches, burpees and planks could be putting you at risk of injury, according to a personal trainer specialised in postpartum women. Kirstyn Campbell began a mission to make the unique risks faced by women part of all personal trainers’ studies after she suffered a diastasis recti, sometimes referred to as a tummy separation or stomach separation, in 2016 – seven years after she had her last baby.
The Auckland mother-of-two had recently completed a challenge where she did 100 burpees a day for 100 days.
Campbell had noticed some stomach pain when exercising but put it down to the irritable bowel syndrome she suffers from.
Then one night when lying on her back she touched her stomach and felt a telltale dip in the centre. ‘‘My heart sank.’’
A diastasis recti occurs when the rectus abdominis – your six-pack muscles – that meet in the middle of your stomach, separate.
It’s common during pregnancy as muscles relax and internal organs shift to accommodate a growing baby, and if left alone it will usually heal by itself, either at about three months postpartum, or three months after ceasing to breastfeed.
But when women rush back to burpees or crunches before that point – as many do – they run a high risk of instigating or worsening a separation, Campbell said.
If a woman continues to exacerbate a diastasis recti, the tear will likely get worse. It certainly won’t heal. Hernias are a common side effect and surgery is sometimes necessary to correct them. If not addressed, back pain can become chronic and internal organs may shift.
And Campbell said having given birth puts women at greater risk of diastasis recti.
She compared muscles, ligaments and tissues that are stretched during pregnancy to chewing gum or hair ties: They don’t go back to the way they were.
Campbell’s muscles separated because she did exercises inappropriate for her postpartum body.
By the time she discovered it, the tear extended from just below her ribcage to her pubic bone. Campbell managed to avoid surgery but required extensive physiotherapy, including having her stomach strapped with kinesiology tape for two weeks.
At the time of her injury, Campbell was working with a personal trainer who was studying for his masters. She had questioned him during workouts about the doming she could see in her stomach, which she now knows to be a sign of a diastasis recti, but he had waved it away, saying just that ‘‘it happens to most women’’.
‘‘He wasn’t like a rookie or a cowboy,’’ said Campbell. ‘‘He cared about what he was doing, but he didn’t know what it was because we’re not taught this stuff when we study. It’s a specialised topic, and that is what I really want to change.’’
Christchurch gynaecologist Olivia Smart said the high levels of the hormones progesterone and relaxin that remained in a woman’s body after giving birth meant there would be less stability in the pelvic girdle and weight-bearing joints.
Over exertion could cause damage to the ligaments supporting these joints or damage to nerves travelling close by.
Women who had any kind of stitches were also at particular risk, she said.
‘‘At six weeks, the tensile strength of the wound reaches about 80 per cent, and it could take a full year for scar remodelling to be complete.’’
That meant women who exercised without taking necessary precautions could risk the muscles and skin not knitting properly, leading to further injury down the line.
‘‘It takes 40 weeks to form a fully pregnant body,’’ Smart added. ‘‘Don’t expect it to return immediately, regardless of how you have birthed. There are lots of people with expertise in these areas who can guide you when re-introducing exercise.’’
Campbell is one of those people. She now specialises in working with postpartum mums, helping them to function in ways that strengthen their deep core abdominal muscles – that includes not just exercises but also posture and how they pick up and carry their children – as well as with rebuilding pelvic floors weakened by pregnancy, which can lead to leaking and discomfort.
But she says as a trained personal trainer, she shouldn’t have to be a specialist.
‘‘I was mortified that I studied and I learned nothing, and I was mortified not just that I’d injured myself from it, but what have I done to my clients unknowingly,’’ she said.
‘‘Exercise is supposed to heal us – it’s mentally and physically amazing – and for that to be causing an injury due to lack of education was awful.’’
Mums, Campbell pointed out, make up an outsized proportion of the people who attend gyms and seek out personal training services.
But many of the people working with them don’t know that some of the most common exercises, the ones women hope will flatten their post-baby tummies, could be doing them harm.
That includes such common exercises as pressups, planking, burpees, mountain climbers, crunches, and star jumps.
Campbell believes trainers should assess their women clients, especially those who have given birth, to ensure their abdominals are strong enough for these types of exercises. If not, the moves should be modified and other strengthening exercises employed.
She says women shouldn’t have to seek a specialised trainer to get workout programmes that are safe for their bodies.
‘‘The system’s just broken at the moment,’’ she said. ‘‘I shouldn’t be a specialised trainer. What I’m doing should be normal.’’
‘‘Exercise is supposed to heal us – it’s mentally and physically amazing – and for that to be causing an injury due to lack of education was awful.’’
Kirstyn Campbell