My Postnatal Body; to sit-up or not to sit-up?

I received an e-mail from a postnatal student recently after the first class in a postnatal yoga course looking for clarification whether or not she could do sit-ups. As part of the first class I always check student’s abdominal muscles to check whether there is any separation of the muscles, extremely common post pregnancy, which I will discuss further below and I am very clear on the fact that sit-ups are a big no-no during this early postnatal period. However, the student in question (who does have a separation) has been attending a specific postnatal exercise class, during which sit-ups are encouraged despite no checking of the abdominal muscles.

I have worked with pregnancy and postnatal women for many years now and it is an area I feel very strongly about. On hearing that sit-ups were being encouraged for a group of postnatal women made me want to put my head in my hands and weep.

However, I have instead decided to be a little more proactive and write down my thoughts on this subject based on fact and science to empower postnatal women to be able to make their own choices on what is right for their body during this important postnatal time.

Remember that during your pregnancy your abdominal muscles have spent nine months learning how to stretch, increasing elasticity to accommodate your growing baby. Important work.

Our more superficial abdominal muscles are called the rectus abdominis (RA) (see diagram below). These muscles connect from the bottom of our ribs to the top of the pelvis. There are two parts to this muscle on the left and the right, which are connected by connective tissue, known as the linea alba. During pregnancy this connective tissue stretches as these muscles come apart to accommodate your growing bump and the associated increased pressure within the abdomen; this is a natural part of pregnancy.

Remember these muscles have taken time to stretch so it is common for them to take time to come back together. The amount of time this takes varies from body to body; we are all different.

In some bodies there can be a significant gap in the abdominal wall between the two sides of the RA muscles; this is known as diastasis recti (see image above). Often when diastasis recti occurs the connective tissue has lost its elasticity, making it harder for it to draw the RA muscles back together.

It is important not to think of these muscles in isolation and to focus solely on these during your early postnatal days. Instead we look to work therapeutically from the inside-out slowly and steadily to heal your body. Francoise Freedman, founder of Birthlight, always says that we don’t want to just paper over the cracks.

Underneath the RA muscles sits a deeper layer of muscles, the transverse abdominis (TA). The fibres of these muscles run diagonally across the abdomen and connect via fascia into the RA. These are the muscles we want to work with, together with the pelvic floor, to work from the inside to stabilise and heal your postnatal body.

When we perform a sit-up all we are effectively doing is shortening the area between the rib cage and the pelvis, by engaging the RA muscles. Performing a sit-up can cause the abdominal muscles to ‘dome’ which will be pushing the two sides of the RA muscles further apart and increasing any separation that may exist, making it worse and possibly permanent.

If focusing purely on the RA muscles in isolation, we can overlook the importance of posture. Remember the RA muscles connect from the bottom of the ribs to the top of the pelvis. Therefore, if we are focusing on strengthening these muscles whilst sticking out our ribs and having incorrect pelvic alignment you are never dealing with the source of the issue.

When we remember also that nothing works in isolation we look at the importance of the pelvic floor. For many women (if not all!) postnatally this is an area of weakness. When you perform a sit-up you are increasing the pressure in your abdominal area, with the pelvic floor below. If you are putting increased pressure onto a weakened pelvic floor it is not going to be able to support your pelvic organs; resulting in stress incontinence or pelvic organ prolapse both of which are becoming increasingly common in postnatal women who try to do too much postnatally rather than allowing their bodies time to heal.

This is why within my postnatal yoga courses we start slowly and work in small groups. We learn gentle techniques to work deeply from the inside out with the TA, pelvic floor and lower back muscles to heal your body. We look at posture and how this can help or hinder the healing process.

Vikki is a pre and postnatal yoga specialist teaching group classes and 1-2-1s in Essex and retreats worldwide. She has trained with both Francoise Freedman of Birthlight and Uma Dunsmore-Tuli, both leaders in the field of yoga for women’s health.

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