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I don’t have a Diastasis- Why is my abdomen still distended postpartum?

I get asked this question all the time! Here is my answer:

Research has shown that 100% of pregnant women will develop some degree of diastasis recti. A diastasis is a lateral separation in the abdominal wall between the recti or “six pack”, due to a stretching of the midline connective tissue or “linea alba”. Although some diastasis will heal postpartum, in many cases a separation will remain without restorative exercise.

Distention from DR will present as a doming in the midline. Women who heal a diastasis spontaneously or through restorative exercise may still find that their abdomens are distended, particularly after a meal and/or at the end of the day. If there is no diastasis, why is this?

This abdominal distention does not occur in the midline, but rather across the entire abdominal wall. This is due to a weakened hypotonic TVA- transverse abdominis muscle. The TVA is the deepest anterior abdominal muscle, wrapping around the midsection like a girdle, with a left and right side. The TVA becomes lengthened due to the excessive intra abdominal pressure (IAP) of pregnancy. After delivery, it often will not return to its optimal length and therefore strength.

A hypotonic weakened TVA will fatigue during the day. In the morning the abdominal wall will be flat, as it has not been loaded during the night. It has rested and is at its strongest. As the day progresses, the load of the abdominal contents on the TVA will cause it to lengthen gradually, as it doesn’t have the strength to maintain an optimal resting tone. This will be exacerbated by any increase in IAP such as a full stomach, indigestion, PMS, etc. resulting in a rounded abdomen.

How do we tone the deep TVA?

The TVA will strengthen and shorten with isometric holds. However, because the TVA works with the pelvic floor (PFM), we must avoid increasing hypertonicity in that allie. In many cases a hypertonic pelvic floor will present with a hypotonic TVA. How do we strengthen both functionally to restore a flat abdomen?

First, we must ensure there is range of motion (ROM) in the PFM, connecting to the eccentric phases of its movement- the “release”. Once we have functional ROM we can begin to set the core with “piston breath” and hold isometrically. Following a set of isometric holds I always recommend dedicated “release only” breaths, to allow the PFM to relax.

As the TVA strengthens, isometric holds can become movements such as plank variations. Progressively increasing the load on the abdominal wall with exercise will further strengthen the functional core. Research has shown that when the core 4 is contributing to movement, the strength can increase up to 40%. It is always the goal to restore core 4 synergy with functional movements.

I hope that answers the question! Want a flat abdomen? Train with me for the best results!

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