SLOW AND EASY IS THE WAY TO GO
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