Modifying Pilates in Pregnancy to Prevent Diastasis Recti
With Jess Kostos, also known as 'The Mama Physio'. Jess is a Pelvic Health and Musculoskeletal Physiotherapist, Clinical Pilates Instructor, and Course Educator at Unite Health. Her signature course is “Ante and Postnatal Pilates” which she has taught internationally to allied health and fitness professionals.
Did you know that 100% of women who have had a baby will have a diastasis recti (also known as abdominal muscles separation)?
A diastasis recti is a weakening and stretching of the connective tissue that runs between the recti muscles, known as the linea alba. This is a normal process that happens when your baby grows, to allow it to fit in your tummy.
For most women this separation closes spontaneously within the first six weeks after their baby is born.
However in 60% of women, especially those with a large separation, this remains stretched and weak causing reduced core stability, which contributes to pelvic and back pain, and pelvic floor dysfunction.
To reduce this risk of diastasis recti we can modify Pilates in pregnancy.
Pilates is known for its ability to give you flat, strong abdominal muscles! Unfortunately in pregnancy, we need to steer clear of these types of exercises because they increase intra-abdominal pressure and can further stretch the connective tissue in the midline. A sign that your body is not managing these pressures well is when your stomach goes into a peak, also known as doming or coning. This means that your abdominal wall is not managing pressures well and is the weakest link of the core. Repeating exercises that make your stomach “dome” can weaken the midline further.
For example, think of our midline like old underwear or swimwear. We all have an old pair that has been stretched so much it has lost its elasticity and is saggy on the bum. There is a point where the material will stretch and go back to how it was. However if we repeatedly stretch and load up this material it will lose its elasticity and look weak and saggy.
This is why we need to avoid abdominal strengthening exercises in Pilates. We want our abdominal muscles and obliques to lengthen and stretch. If they stay strong and tight, this will encourage them to widen further.
We can, however, continue whole body exercises that utilize core strength and stability. By this I mean exercises that don’t involve curl-up or flexion type movements that shorten the recti muscles. You can continue to do upper body and lower body exercises that challenge your core stability. There will be a point that the stomach domes, and this will mean that you are not strong enough in the core to complete this exercise.
Sounds confusing? Join Jess Kostos, @the.mama.physio Women’s Health Physiotherapist on the next Ante and Postnatal Pilates course and learn all about modifying pilates for pregnancy and postpartum.