I haven’t had experience yet to know if we can make good changes after that. I do find the oblique and recti releases I teach in my Postpartum Body course are effective in changing the LA tension but I haven’t correlated these changes to within or without of the 8 week timeframe. I have one client that is past the 8 weeks and we are trying everything and time will tell if she’s able to make any changes. I wouldn’t encourage anyone to do any surgical procedure to fix DRA until well after 1 yr PP and lots of strengthening.
When performing crunches and twisting during pregnancy and postpartum, how can you determine when the recti muscles are fatigued? Do you use the RUSI (rehabilitative ultrasound imaging)?
Thanks!
You watch to see when the recti muscles are pulling more apart than coming close together. When they stop coming together as closly as the first couple of times then you know it’s time to stop. When the Recti muscles fatigue the TA will kick in more and cause more separation of the recti. That’s when you stop.
For recti strengthening, you said to stop reps when the linea alba is no longer narrowing. If the patient is unable to do even one rep of recti strengthening without widening the gap, is it best to just do the traditional manual approximation with a sheet/hands while activating the recti?
I would try to decrease the strain by having her start with a reverse curl up in a very shortened range. Then work on increasing the range as her strength improves. Get creative and find ways to get it to activate, even hands and knees cat/cow motions but keeping the pelvis more still will activate the recti.
I’ve heard conflicting things about using abdominal binders immediately postpartum due to putting more pressure on the pelvic organs and possibly worsening prolapse. If you are starting postpartum treatment before you are able to assess internally, do you follow any guidelines to determine if a binder will be doing more harm than good?
Carolyn, An abdominal binder immediately after birth when worn correctly shouldn’t cause any downward pressures as the uterus is still shrinking down to size. Once it is it original size then we need to be more careful. If pressures from the binder are greater lower and lesser on top it should minimize the forces down. I share this with my clients during pregnancy so they know how to place it on correctly afterwards.
I have a patient who is now 8 weeks post partum after having twins. I assessed DR and noticed separation above her umbilicus and below. I would say it’s 1 finger of separation and depth above and two below. We’ve been working on strengthening the TA, but after listening to this it sounds like it would be helpful to start working on her recti muscles. Since she is 8 weeks now, is it too late to use the technique you explained in this video? (bringing the recti muscles together and having her do crunches and twisting exercises? What would be the best way to support her?
Yes it would, if you haven’t taken the Holistic Postpartum Body course and learned the oblique and recti releases then start here. But adding these two techniques are also very helpful. I one finger separation is not a DRA in my book. 1-2 is still considered normal.
Is it still possible to heal a DR if they aren’t seen until after those 8 weeks?
I haven’t had experience yet to know if we can make good changes after that. I do find the oblique and recti releases I teach in my Postpartum Body course are effective in changing the LA tension but I haven’t correlated these changes to within or without of the 8 week timeframe. I have one client that is past the 8 weeks and we are trying everything and time will tell if she’s able to make any changes. I wouldn’t encourage anyone to do any surgical procedure to fix DRA until well after 1 yr PP and lots of strengthening.
When performing crunches and twisting during pregnancy and postpartum, how can you determine when the recti muscles are fatigued? Do you use the RUSI (rehabilitative ultrasound imaging)?
Thanks!
You watch to see when the recti muscles are pulling more apart than coming close together. When they stop coming together as closly as the first couple of times then you know it’s time to stop. When the Recti muscles fatigue the TA will kick in more and cause more separation of the recti. That’s when you stop.
For recti strengthening, you said to stop reps when the linea alba is no longer narrowing. If the patient is unable to do even one rep of recti strengthening without widening the gap, is it best to just do the traditional manual approximation with a sheet/hands while activating the recti?
I would try to decrease the strain by having her start with a reverse curl up in a very shortened range. Then work on increasing the range as her strength improves. Get creative and find ways to get it to activate, even hands and knees cat/cow motions but keeping the pelvis more still will activate the recti.
I’ve heard conflicting things about using abdominal binders immediately postpartum due to putting more pressure on the pelvic organs and possibly worsening prolapse. If you are starting postpartum treatment before you are able to assess internally, do you follow any guidelines to determine if a binder will be doing more harm than good?
Carolyn, An abdominal binder immediately after birth when worn correctly shouldn’t cause any downward pressures as the uterus is still shrinking down to size. Once it is it original size then we need to be more careful. If pressures from the binder are greater lower and lesser on top it should minimize the forces down. I share this with my clients during pregnancy so they know how to place it on correctly afterwards.
I have a patient who is now 8 weeks post partum after having twins. I assessed DR and noticed separation above her umbilicus and below. I would say it’s 1 finger of separation and depth above and two below. We’ve been working on strengthening the TA, but after listening to this it sounds like it would be helpful to start working on her recti muscles. Since she is 8 weeks now, is it too late to use the technique you explained in this video? (bringing the recti muscles together and having her do crunches and twisting exercises? What would be the best way to support her?
Yes it would, if you haven’t taken the Holistic Postpartum Body course and learned the oblique and recti releases then start here. But adding these two techniques are also very helpful. I one finger separation is not a DRA in my book. 1-2 is still considered normal.
Can you name few exercises that encourage trunk flexion and trunk rotation?
Crunches, reverse curl ups, reverse curl up with a twist are a few that come to mind.