A closer look at your Core & Pelvic floor.

What is your pelvic floor?

Your pelvic floor is comprised of a group of muscles that link your whole core together – they are located at the bottom of your core muscles. The pelvic floor muscles consist of your: Deep Transverse Perineal muscle, Levator Ani muscle & your Perineal Membrane (amongst other soft tissue) – they originate from different points in your pelvis and sit like a sling from your pubic bone at the front of your pelvis to your coccyx at the back of your pelvis and from side to side creating a support network across the whole of the base of the core.

The pelvic floor muscles work in conjunction with your deep abdominal and deep spinal muscles and diaphragm to support and stabilise your spine. Imagine this to be a cube of stability: your diaphragm on top, your deep abdominals at the front, your deep spinal muscles at the back, your obliques at the sides and your pelvic floor at the bottom. The pelvic floor helps to control your intra-abdominal pressure to prevent injury with pushing down forces when you lift or strain – such as during exercise.

The pelvic floor muscles support the bladder, bowel and uterus whilst maintaining your urinary & faecal continence – meaning they stop you peeing & pooping when you don’t want to, stop gas escaping & allow you to be in control when you want to use the toilet. They also play a huge role in sexual function.

Pelvic Floor & Pregnancy

As you can see your pelvic floor muscles play a super important role in pregnancy to support your baby in the womb, and during childbirth. When you are pregnant your core muscles along the front of your body have to grow and stretch to accommodate your growing baby, which often leads to a Diastasis Recti (separation of your tummy muscles). Your pelvic floor muscles hold your abdominal continence in, but as your pregnancy develops your abdomen becomes very heavy and can weaken your pelvic floor over time. Your pelvic floor can also be injured during labour & birth causing further weakness postnatally.

During Childbirth what happens to my pelvic floor?

Whether you gave birth vaginally or via C-section your pelvic floor muscles will be affected. 

During a vaginal birth your pelvic floor muscles will be under a considerable amount of strain and will be expected to stretch a lot to allow your baby to pass through the birth canal. You can experience tears during a vaginal birth but also trauma to the muscle if you had an assisted birth like the use of forceps or an episiotomy. 

During a C-section 7 layers of the abdominal wall are cut through to birth your baby – this leads to a longer recovery but also a weakened abdominal wall which will put added pressure on the pelvic floor.

Why is it important to rehab your core & pelvic floor?

Your core & pelvic floor play a massive role in your overall health for the rest of your life – a weakened core can lead to a multitude of problems not only now but also later in life. This can range from low back pain to vaginal prolapse & incontinence & everything in between. It gives you the independence to go the toilet when you want to & that (I’m sure you’ll agree) is pretty important!

You just spent 9 months relying on your pelvic floor & core to hold your baby in whilst it became under more and more pressure & then put it through considerable strain to birth your baby – it needs help to recover & attention to strengthen it for the rest of your life. If we don’t do this now – it will lead to problems later in life if you don’t already suffer from some sort of pelvic floor/core related dysfunction now.

What is Diastasis Recti? (DR)

Diastasis recti is the separation of your abdominal muscles (Rectus Abdominis) & thinning of the Linea Alba which is the connective tissue between your abs. Diastasis recti can mean your abdominal organs are not fully supported, and if the gap is very large it can create a tummy bulge as your organs are no longer held in by your muscles. 

The gap can be anywhere along the abdomen from being just above your belly button, over your belly button, or below your belly button in your lower abs. However sometimes the separation is the entire length of the core.

What does DR look like?

DR can affect both men & women & every person is different & therefore the physical look & symptoms can vary from person to person. Some people suffer greatly with pain, bloating, discomfort & more, whereas some people are not aware they have any gap at all. Even though someone may not have symptoms currently – it is no indicator of the condition of the gap – the gap can also worsen over time leading to problems later in life.

Abdominal Bulging

The tummy bulge or ‘pooch’ although not always an indication of DR is a very common symptom if you do have it.

This bulge happens when your abdominal organs are no longer supported through your rectus abdominus because they have separated and the organs start to push through your Linea Alba which is thin connective tissue.

This bulge can look like a cone shape around your tummy button area, however depending on where your gap is it can range through the length of your stomach and can worsen after you have eaten.

The muscle gap & Linea Alba weakness.

The muscle gap is the most common sign of DR. This can range from a minor separation of 1-2 fingers to a severe case of 5 or more fingers. Even if you have a mild case of 1-2 fingers – it can worsen in the years after the birth of your baby or if you have more pregnancies, so it is important to rehab it post birth. 

It is also important to note the integrity of your Linea Alba – if there is weakness in the connective tissue as well as an abdominal gap this will cause further problems also. 

Before we start the programme – lets complete a baseline Diastasis recti & overall posture analysis.

Diastasis Recti Check:

1. Lie on your back & bend your knees up & put your feet flat on the floor.
2. Place one hand in the middle of your core with your fingers flat on your midline.
3. Place your other hand behind your head and neck for support. Very slowly lift your head a couple of inches off the floor and press gently with your finger-tips into the middle of your stomach.
4. Only lift your head a couple of inches – this is a very small movement – as you do you should feel your abdominal muscles contract on either side of your fingers.
5. Do this movement a few times to get the feel of the movement and what you are feeling for with your fingers. When you are comfortable & confident gently see how many fingers fit in-between the two hard walls of muscle.
6. Also check the integrity of your Linea alba (connective tissue between your abs) Is it firm like a trampoline? Or squishy & bouncy? Assess how far you can push your fingers down.
7. If you can push down past your knuckles you have Linea Alba weakness.
8. Repeat the steps above along the whole length of your core from under your ribs down to your pubic bone to determine where the gap is located.

Posture Check

It’s difficult to assess your own posture alone so if you have someone to help that’s great but not necessary if you don’t.

1. Stand against a wall with the back of your head touching the wall. Stand with your heels 6 inches out from the wall.
2. Your butt and shoulder blades should be touching the wall. If you have a second person ask them to measure the space between your neck and the wall and measure the distance between the wall and the small of your back.
3. Both these measurements should be less than 2 inches.

If you don’t have a second person:

1. Stand against the wall in the same way as above.
2. Put a flat hand behind the small of your back. There should be no more than two inches between the back & wall.
3. If there’s too much space between your lumbar spine and the wall, gently draw your belly button in toward your spine – this reduces the curve in your spine and gently brings your lower back closer to the wall.
4. If there’s too little space behind your lower back, gently tilt your pelvis to great a gap.
5. Walk away from the wall while holding this new posture & then return to the wall to check whether you kept the new posture.

Important to Know

It’s important to note at this stage that this check is only a guide! Everyone’s posture is different & some people genetically have increased or decreased curves in their spine which is something that isn’t muscular and therefore cannot be changed or adapted. We are assessing your posture on a muscular level to see if any adaptations can be made – this may or may not be possible depending on your body type.

Why is good posture important? Poor posture can lead to:

• Fatigue and breathing problems. 
• Back & neck pain
• Headaches.
• Knee, hip and foot pain.
• Shoulder pain & related pathologies
• Jaw pain. 

During pregnancy due to hormones relaxing your ligaments and your centre of gravity changing – your posture can be affected greatly, especially if you have an office job, had to change or stop your exercise habits or were poorly during your pregnancy. 

Our Mamma Pro Fit programme works to heal DR & your Linea Alba, strengthen your core & pelvic floor, improve your posture and strengthen your whole body.

Ok – let’s go!