SLOW AND EASY IS THE WAY TO GO

The Star Early Edition - - VERVE -

ONE morn­ing, while at­tempt­ing my first jog since the birth of my 6-week-old baby, I was taken aback by my low en­durance.

I soon dis­cov­ered this was only the be­gin­ning of the phys­i­cal chal­lenges I’d ex­pe­ri­ence as a new mom. Preg­nancy and child­birth can also weaken ab­dom­i­nal mus­cles, loosen lig­a­ments and cause struc­tural changes in the rib cage and pelvis.

All of this makes a woman prone to in­jury if she pur­sues a bikini body too quickly. Preg­nancy hor­mones stay in the body for about three months postpartum, con­tin­u­ing to loosen joints, mus­cles, ten­dons and lig­a­ments as they did in prepa­ra­tion for de­liv­ery. For those breast-feed­ing, hor­mones can have a loos­en­ing ef­fect even a few months af­ter nurs­ing stops.

Mar­i­anne Ryan, au­thor of Baby Bod: Turn Flab to Fab in 12 Weeks Flat, urges new and es­pe­cially breast-feed­ing mothers to ex­er­cise care­fully. An­other com­mon postpartum problem is di­as­ta­sis recti, a sep­a­ra­tion of the “six-pack”, or rec­tus ab­do­mi­nis, caused, in part, by loose con­nec­tive tis­sue.

It goes hand in hand with ab­dom­i­nal weak­ness and in­sta­bil­ity and is of­ten as­so­ci­ated with back pain, “mommy tummy”, uri­nary in­con­ti­nence, pelvic or­gan pro­lapse and um­bil­i­cal her­nias.

Ryan says up to 60% of new mothers have the con­di­tion, with 30% still af­fected one month postpartum.

Di­as­ta­sis recti is con­sid­ered, from a med­i­cal stand­point, a her­nia, says Joan Love­land, a gy­nae­col­o­gist and ob­ste­tri­cian in Wash­ing­ton.

Most her­nias are ig­nored un­til they be­come symp­to­matic, which is one of the rea­sons physi­cians don’t check for it in postpartum mothers. In re­cent years, phys­i­cal ther­a­pists’ in­sis­tence that di­as­ta­sis recti and pelvic floor prob­lems are treat­able has be­come more main­stream.

“Every­thing comes from the pelvis. It’s such a crit­i­cal area to en­sure strength and well­ness and fit­ness,” Love­land says, de­scrib­ing why di­as­ta­sis recti af­fects a woman’s well-be­ing. “I think (physi­cians) al­ways thought of it as more of a cos­metic thing.”

Yet af­ter an ob­ste­tri­cian gives the green light for all ac­tiv­ity at the six- to eight-week checkup, a woman is typ­i­cally left to her own de­vices. A new mother may overdo it when ex­er­cis­ing with­out re­ha­bil­i­ta­tive guid­ance, or may avoid fit­ness al­to­gether for fear of dam­age.

Women’s health ex­perts em­pha­sise re­ha­bil­i­ta­tion be­fore fit­ness. “You can work out for an hour ev­ery day, but what you do in the re­main­ing 23 hours adds up to more,” says Kelly Dean, a phys­i­cal ther­a­pist and founder of the Tummy Team, a Wash­ing­ton state clinic and on­line pro­gramme. “Birth is prob­a­bly the most phys­i­cally de­mand­ing thing many women are go­ing to do, but we ex­pect them to jump into a Zumba class right away. More is not bet­ter. Bet­ter is bet­ter.” Here’s what spe­cial­ists rec­om­mend. Ev­ery­day move­ments such as pick­ing up a baby, load­ing a pram into a car and walk­ing are op­por­tu­ni­ties to en­gage the core mus­cles, which re­fer col­lec­tively to mul­ti­ple mus­cle groups in­clud­ing the trans­verse ab­do­mi­nis (deep corset-like mus­cle), six-pack, obliques, di­aphragm, lower back and pelvic floor.

Ryan rec­om­mends get­ting up from a chair by bend­ing for­ward, press­ing the heels of your hands into your thighs to take the weight off the belly and ex­hal­ing. To get out of bed, roll on to your side, shoul­ders and hips mov­ing to­gether with knees bent, drop your legs down off the bed and push up with your arms. Avoid jack­knife move­ments. Dean says: “Vi­su­alise a cable from the crown of your head draw­ing you up. Keep arms in line with your torso and eyes on the hori­zon.” This gets the spine into a neu­tral po­si­tion with the rib cage stacked di­rectly above the pelvis and per­pen­dic­u­lar to the ground, and shoul­der blades

Re­mem­ber dur­ing any ac­tiv­ity to have the spine in a neu­tral po­si­tion, en­gage the core and belly, breathe.

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