Q. “Are sit-ups the best way to strengthen my abdominals after childbirth?”
A. No, sit-ups should not initially be done to reduce the pooch, your waistline, and to regain solid, supportive abdominals. A woman should initially draw in her abdominal muscles, especially the transverses abdominis, towards her spine while exhaling. When she can engage the muscles correctly, she will slowly progress, performing more challenging exercise with longer and varying duration of contraction and lever arm resistance.
Q. “A little bit of leakage is normal after giving birth. There’s nothing I can do, right?
A. Due to the stretching of the pelvic floor muscles and the displacement of bladder during pregnancy, the bladder does not always fill to capacity and the muscles do not have the same strength, endurance, coordination, or timing. As the muscles recover from the challenge of the birth process, they will function more quickly with rehabilitation exercises.
Q. “When will I be able to fit into my pre-pregnancy jeans?
A. The average length of time to be able to don your jeans is three months to a year post birth. Depending on your weight loss after weight gain with pregnancy, comfort of your connective tissue after having a C-section, episiotomy tenderness, or trauma to the perineum will determine when you will comfortably wear your jeans.
Q. “Is regaining my pre-pregnancy weight realistic?
A. Yes, however most people lose twenty pounds soon after the baby is born. Nursing does help to stimulate your metabolism and melt the pounds away. If you eat well balanced meals and drink at least 48 oz of water, weight loss is more dramatic. A nursing woman should not eat less than 1800 calories. Nursing a baby helps you burn calories by making breast milk.
Q. “What is a diastasis? Does it go away?”
A. A diastasis is a separation of the two muscle bellys of the rectus abdominis. The linea alba stretches sometimes with weight gain, and cumulative trauma, bearing down while holding your breath during delivery, and lack of orthotic support during morphological changes of the connective tissue during pregnancy. These are all contributing factors to the development of a diastasis. The condition can be significantly resolved through proper rehabilitation exercises, not holding your breath during functional activities, or during a bowel movement. Othotics, like a belly binder or taping can approximate the right and left rectus abdominis. While the connective tissue is still malleable is the time to address this issue: up to three months post delivery or up to three months of ceasing nursing.
Q. “I love being a new mom, but when will this pain between my shoulder blades disappear?”
A. Pregnancy hormones continue to circulate for three months after you discontinue breastfeeding. Therefore, all ligaments are loose, and can be strained if the muscles can not support the bones and joints of the skeleton. Proper position for feeding your baby so you do not strain the muscles between the scapulae is important. Many women have weak and poor endurance parascapular muscles. These muscles can become strong to support the spine and work more easily with less fatigue when picking up or carrying baby or baby’s paraphernalia.
Q. “Why does my lower back still hurt?
A. After delivery, patients often have difficulty regaining correct aligned posture. Muscle imbalances are often created. The abdominals are often weak; therefore, they do not offer good lumbar stabilization of the spine.
Q. “I just attempted intercourse for the first time postpartum, but it is so painful. Will this pain eventually go away?”
A. Sometimes after the birth of a child the mother experiences pelvic floor muscle relaxation or hypertension. Either condition can result in pain or a different sexual response than in the past. Muscles can be facilitated to be more responsive resulting in muscle contraction, orgasm from thrusting. If the muscles are too tense for penetration or comfortable during thrusting, modalities such as heat, connective tissue release, with or without trainers, ultrasound, downtraining, and learning five ways to relax a muscle can be most beneficial. A skilled, advanced trained physical therapist in pelvic health can assist you in meeting your goal of resuming comfortable, satisfying sexual intercourse. Sometimes post birth the estrogen circulating in a woman’s body is so high the elasticity of the pelvic floor muscles is decreased. The use of topical education cream for a short duration can be most helpful.
Q. “I really want to get back to running long distances, but my bladder won’t last that long! Is this just something I’ll have to live with?”
A. No, everyone should be able to return to running after regaining the strength of the pelvic floor muscles in isolation and in synergy with the deep intrinsic trunk muscles which include the transverses abdominis, deep back extensor and the diaphragm. When performing exercises, the diaphragm should be relaxed and lift up as you blow out gently, therefore, decreasing the intra-abdominal pressure.
These are just the top 9 questions we hear from women, but by no means are they the only questions women have after giving birth! Do you have a question that we didn’t touch on? Let us know in the comment section below!