Nest Physical Therapy

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#15 DRA- A new recovery framework that makes it less scary

During pregnancy, your growing belly puts quite a strain on all your abdominal tissues, especially the connective band down the center of your belly, the linea alba.  You may have heard that the abdominals “split” in order to make room for the baby.  You my have heard about or seen the widening gap between the abdominal muscles.  You may have been alarmed by seeing a doming lump pop up from your belly when you sat up postpartum.  These can all be scary things describing a DR/DRA/DRAM (diastasis of rectus abdominis muscle.)  Thankfully, research is catching up and we are learning that the width of the gap is not such a big deal.  The tissue tension and integrity of connective tissue bridging the gap is what is more important. An it’s totally possible to get back to advanced Pilates or kickboxing or whatever activity you’re into after baby!

During pregnancy, the linea alba widens and thins.  All the abdominal muscles are on stretch but the muscle does not split. After childbirth, this thinner tissue makes it easier for abdominal contents to push outward when you have a rise in intraabdominal pressure, like when you do a sit up.  By generating tension throughout the abdominal cavity (your core), you can minimize the doming and gain strength.  In terms of management, we are moving away from the long list of “don’t” exercises and instead starting at an individual’s baseline and progressing up to doing nearly any exercise with proper form and the use of core pressure strategies.  We don’t want to foster a fear of movement in our postpartum clients.  We want to educate you in the proper progression of exercise, control the doming while progressively overloading the tissues to build strength, and thereby shrink the mummy tummy postpartum.  And give yourself time to bounce back after baby.  Women tend to put a lot of pressure on themselves to get back to their pre-pregnancy stature.  But rebuilding these muscles and connective tissue takes 6 months to a year, sometimes two.  That sounds like an unfair amount of time but it’s worth putting in the effort to get back into shape before carrying another baby to minimize future pregnancy aches and pains.

Pregnancy affects the whole abdominal wall circumferentially, not just the linea alba so recovery needs to address the whole abdominal wall and take into account other body systems.  At Nest PT, you’ll be evaluated and started on the right level of exercises for you and progressed at your pace with all your activities and goals in mind.  Core recovery can begin anytime, even years after your last childbirth. Contact for a consultation.