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Considering DRA during pregnancy – recent literature has cited that it is a normal adaptation nearing end stage pregnancy. At what point (stage) of pregnancy are we to assess for a DRA that is restricting uterine mobility? How is it measured via a predetermined threshold? Symptomatic vs asymptomatic?
Rebecca, yes there is normal adaptation at the end of pregnancy for DRA. A DRA doesn’t usually restrict uterine mobility. It creates space for the uterus to expand. I’m not sure what you mean by a predetermined threshold. I don’t measure for DRA in pregnancy, I work to help my pregnant clients to engage their abdomen to avoid abnormal forces on the anterior abdominal wall as to try and minimize excess strain. If someone is symptomatic then we want to help lengthen lateral trunk wall and strengthen TA as much as possible as baby/babies grow. I assess for uterine mobility and treat uterine ligaments which are the main culprits for restrictions to uterine mobility. Hope this helps.
100% of mums will have some degree of DRA by 36/40, but I find it tends to be second (or more) time mothers who may have significant DRA that will contribute to this more pendulous abdomen and anterior position of baby out of the pelvis.
I have had midwives also suggest abdominal support garments in the later stages of pregnancy if this is the case to help relocate baby’s pressure over the cervix to help initiate labour and dilation.
Lynn, what are your thoughts on this? Thank you 🙂
Abdominal support garments can be a great asset for some however i would love for them all to be instructed to engage their abdominal muscles away from the garment so they are still actively using their muscles and not relying on the garment to do the job of the muscles. So use it as a feedback support to remember to engage away from the support. To many people put them on and rely on their support instead of making the muscles still work. Yes second time moms who haven’t done any rehab in between the pregnancies have harder time with this.
When instructing clients to do the side trunk release, are they also pulling on the obliques for a gentle stretch or are they just rotating to encourage the release of their obliques ?
They are pulling on the obliques to get them to lengthen. We want it stretched gently with the twist and then work with the tissues to lengthen it more.
Ruth, Yes it is and also if the client has acid reflux they won’t be comfortable in the inverted position. The only modification with this is elbow and knees as it doesn’t offer as steep of an incline to the body. Really have clients feel into how this position feels in their body. If it’s too intense going from a height difference, on the floor on knees and elbows is an alternative.
I rewatched this unit. Sometimes a woman can have a lumbar curve with the anterior tilt and not have the ability/mobility to do a hip hinge or flatten their back. Do you think that a supine position would still be of benefit for getting baby to orient to the pelvis?
Generally speaking, could you suppose a breech position is due to abdominal restrictions? Surely uterine mobility assessment and treatment would likely help too! I’m just considering an “overgripping RA” perhaps in fit individuals. Thanks for your thoughts, loving this course!
There are so many reasons for breech presentations. With the abdominal wall it could be fascia or muscles. This is where listening to the tissues which I teach in my Holistic Postpartum Body course is helpful to get a better idea of what is really causing the issue. I have to say in my experience though it’s more uterine ligaments and fascia restrictions that cause the problems than overgripping RA. But it could be anything! Stay curious with the tissues and baby!!
Considering DRA during pregnancy – recent literature has cited that it is a normal adaptation nearing end stage pregnancy. At what point (stage) of pregnancy are we to assess for a DRA that is restricting uterine mobility? How is it measured via a predetermined threshold? Symptomatic vs asymptomatic?
Rebecca, yes there is normal adaptation at the end of pregnancy for DRA. A DRA doesn’t usually restrict uterine mobility. It creates space for the uterus to expand. I’m not sure what you mean by a predetermined threshold. I don’t measure for DRA in pregnancy, I work to help my pregnant clients to engage their abdomen to avoid abnormal forces on the anterior abdominal wall as to try and minimize excess strain. If someone is symptomatic then we want to help lengthen lateral trunk wall and strengthen TA as much as possible as baby/babies grow. I assess for uterine mobility and treat uterine ligaments which are the main culprits for restrictions to uterine mobility. Hope this helps.
100% of mums will have some degree of DRA by 36/40, but I find it tends to be second (or more) time mothers who may have significant DRA that will contribute to this more pendulous abdomen and anterior position of baby out of the pelvis.
I have had midwives also suggest abdominal support garments in the later stages of pregnancy if this is the case to help relocate baby’s pressure over the cervix to help initiate labour and dilation.
Lynn, what are your thoughts on this? Thank you 🙂
Abdominal support garments can be a great asset for some however i would love for them all to be instructed to engage their abdominal muscles away from the garment so they are still actively using their muscles and not relying on the garment to do the job of the muscles. So use it as a feedback support to remember to engage away from the support. To many people put them on and rely on their support instead of making the muscles still work. Yes second time moms who haven’t done any rehab in between the pregnancies have harder time with this.
When instructing clients to do the side trunk release, are they also pulling on the obliques for a gentle stretch or are they just rotating to encourage the release of their obliques ?
They are pulling on the obliques to get them to lengthen. We want it stretched gently with the twist and then work with the tissues to lengthen it more.
My understanding is that inversion is contraindicated in those with hypertension. Would you then suggest some sort of modification?
Ruth, Yes it is and also if the client has acid reflux they won’t be comfortable in the inverted position. The only modification with this is elbow and knees as it doesn’t offer as steep of an incline to the body. Really have clients feel into how this position feels in their body. If it’s too intense going from a height difference, on the floor on knees and elbows is an alternative.
I rewatched this unit. Sometimes a woman can have a lumbar curve with the anterior tilt and not have the ability/mobility to do a hip hinge or flatten their back. Do you think that a supine position would still be of benefit for getting baby to orient to the pelvis?
Absolutely, we need to help the spine move better so the sacrum can move. They are dependent on one another. Good comment.
Generally speaking, could you suppose a breech position is due to abdominal restrictions? Surely uterine mobility assessment and treatment would likely help too! I’m just considering an “overgripping RA” perhaps in fit individuals. Thanks for your thoughts, loving this course!
There are so many reasons for breech presentations. With the abdominal wall it could be fascia or muscles. This is where listening to the tissues which I teach in my Holistic Postpartum Body course is helpful to get a better idea of what is really causing the issue. I have to say in my experience though it’s more uterine ligaments and fascia restrictions that cause the problems than overgripping RA. But it could be anything! Stay curious with the tissues and baby!!