Kate Rita- Personal Trainer and Diastasis Expert

Without rehabilitation, the postnatal body has a non optimal core. From Diastasis Recti to pelvic floor dysfunction, inhibited multifidus/lower back muscles (especially in the lumbar spine), thoracic immobility (tight ribs), and possibly abdominal adhesions from a C-Section incision- there are a multitude of maternal physiological impairments to consider. The body continues to perform by enlisting non optimal biomechanics to compensate for the lack of core strength. Compensatory strategies help to achieve the stability, strength and endurance that the core is not providing, but exacerbate deteriorating movements in a snowball effect. This is very evident in the pelvis. When the deep stabilizing core is unable to provide adequate pelvic stability control, the smaller muscles that are designed to help the core take on too much of the task. They become stuck, gripped, and can cause referred pain throughout the body. Knowing to stretch the common overused and v...

In support of Incontinence Awareness Month June 2015 Is it Safe to Run with Pelvic Organ Prolapse? I was a recreational runner pre-baby. Post-baby, I suffered stress incontinence when I returned to the sport. I was fine while running, coughing or sneezing, but if both happened simultaneously I peed my pants. Although it improved as I recovered, it never fully resolved until I addressed it with a restorative exercise program. From a pelvic floor assessment I found out I have both a grade one cystocele and rectal prolapse . There are many moms who run with symptoms of incontinence, from a few drops to full bladder leakage. The solution is not to wear a pad, it is to address the obvious weakness and strategically strengthen the muscles to support the sport. Here’s what you need to know. 1. Running involves impact and requires the core strength necessary to support it. Stress incontinence is a symptom of core dysfunction and often related to diastasis recti (althoug...

My latest contribution to the Maternal Goddess Community: Returning to Plank After Diastasis Diastasis Recti is a separation in the abdominal wall caused by an excess of intra-abdominal pressure. Movements that we know create such excessive intra-abdominal pressure include crunches, sit ups, v-sits and supine leg lifts. These movements are contraindicated. While rehabilitating a DR, front loaded positions are avoided because the abdominal wall does not have the strength to support the weight of the organs. Once the core is functional, plank position can be reintroduced as a “go-to” for core strengthening. A functional core is one that creates enough tension to support the abdominal wall through meaningful movements as well as exercise. In order to support plank position the core must have both the strength to create tension and the endurance to maintain it with the extra weight of the front loaded position. Core strength and endurance exercises to ...

Years ago I proudly used the tagline: “I can help you get your pre-baby body back!” I no longer use that language as I think it is flawed. You’ve had a baby and your body has changed. My new slogan has become, “I can help you make your postnatal body stronger than your pre-baby body ever was!” Your core needs retraining . Organs have shifted, ribs have moved, the abdominal wall has stretched beyond belief and the pelvic floor has carried an incredible amount of extra weight. Core rehabilitation has to be the underlying focus of your strength routine. Not sure where to start? Here are 5 of my go-to exercises for every postnatal client to help achieve a strong and healthy postpartum body. Activating and training the glutes is imperative to pelvic stability control, which is why exercises involving the glutes are key to attaining postpartum fitness. 1. Squat: If your quads are more sore than your glutes, you are not squatting cor...

My latest contribution to the Core Expectations blog : Surgery is often suggested to repair a Diastasis Recti (separation of the rectus abdominal muscles). My clients often ask me if they are candidates for surgery, and there is both a short and a long answer to this question. The short answer is “unlikely.” In my experience, surgery for a Diastasis is a rare case scenario.  What determines the small percentage of women who require surgery to repair a Diastasis Recti? The inability to create any tension in the linea alba with proper core cueing may be a surgical situation – with no functional core support the system is weak and vulnerable to injury – but it is still a long process to say that definitively.  Here’s the long answer. If after teaching a client effective cues to recruit the core 4 muscles (diaphragm, pelvic floor, transverse abdominis and multifidi), she is unable to generate tension in the linea alba, more work is prescribed as homework in...

I love teaching. It is one of my passions and I am working towards incorporating more of it into my professional repertoire. As a personal trainer I teach 1-on-1 all day every day. When I present to groups, I reach more people at the same time. Since 2006 I have been giving talks at the Running Room to clinics of all distances. I love educating runners about core, effective cross training, incontinence, and the importance of training smart. Knowing they all want to be uninjured and still running in 10 years, they are a captive audience and I am always very well received. My runners give me great feedback, they love my talks, and the instructors keep inviting me back. I think my genuine enthusiasm comes through, and is a tremendous strength of mine when teaching. In 2014 I designed a Trainer Trainer Workshop to educate other fitness professionals on Diastasis Recti, pelvic floor wellness, and safely training the pre and postnatal demographic. It's a 4 hour presentation that I...

Part 2 of my latest contribution the the Maternal Goddess Community : Once cleared for running, you may absolutely love sharing the experience with your baby! It is fun for them – they love the speed! It is incredible for you to finally be back in your happy place. Having a co-pilot is fun. Packing snacks and making picnic adventures en route is a bonus. Cooling off at the splash pad in the summer becomes a great option. It can make your worlds collide as the new “Mom” finds common ground with the old “Pre-Mom Runner” you. I ran with both of my kids, up until about age three. Here are some practical tips from experience for running with babies and toddlers: 1. Posture! I cringe when moms push strollers up hill in a forward flexed position, bent forward at the waist. Ouch. Please do not run that way either. Test the handle height of jogging strollers you are considering – does it adjust? Does the handle sit just below your boobs? That’s where you want it. Hold the han...

My latest submission the the Maternal Goddess Community : From the moment we stop running when prenatal, we are counting down the months, weeks, days and hours until we can resume our favorite sport. After my second baby, I began running five weeks postpartum, adhering to what I considered to be a gentle conservative “return to running” program that I designed for myself. I ran a half marathon in 2:05:59 five months postpartum. Do I recommend this? No. Looking back I did my body no service, only my ego. The core has taken a beating during pregnancy and delivery. The abdominal wall has stretched, the recti (six pack) have likely been displaced (diastasis recti) and the pelvic floor has supported the weight of a baby, stretched to 10 times its size in vaginal delivery or surgically impacted with a C-Section surgery. Pregnancy and delivery requires rehabilitation, which takes much longer than six weeks. Once a diastasis is closed and/or functional, the core has stren...

My latest submission to the Core Expections blog : New moms are viciously critical of their postnatal bodies , especially their abdomens. It never ceases to amaze me how self-critical women can be after achieving the ultimate feat of strength – growing and delivering a baby. Sadly, at this moment of our greatest strength we can be left feeling our weakest. It is my job to strengthen new moms for their demanding lives, and we work from the foundation up.    Working with a trainer who can teach you exercises to restore your core is imperative. Only through a custom-targeted restorative program can you ensure that both functional and aesthetic results are achieved. Moms often “go-it-alone” and in doing so can inadvertently undermine their own progress. Nothing is more frustrating than “spinning your wheels”! Exercise takes effort, and without results it becomes seemingly pointless. Frustration kills motivation and it’s a vicious cycle. Here are the ineffective ...

In many cases it can take months to rehabilitate a core. Any separation of the diastasis recti (DR) must be closed and the connective tissue (CT) must be strengthened to support a functional core. The pelvic floor must be activated and strengthened and the multifidus must be stimulated optimally. As you strength train with a DR , you may want to increase the difficulty of your exercises to challenge your increasing strength. There are ways to do this safely and effectively and monitor for any discomfort accordingly, especially in the pelvis. Base of support By decreasing the base of support for an exercise, you can increase the challenge of balance. You can accomplish this by using a stability or BOSU ball. Increasing the inflation will result in a smaller base support. You can also change the base of support by moving from a four-point support to a three- or two-point support. For example, to increase the level of difficulty of a hip thrust/back bridge dip, assu...

I published this article on the amazing Maternal Goddess website in March. Strength Training With a Diastasis Recti A diastasis recti (DR) is created by intra-abdominal pressure. In most cases it will occur from pregnancy, but there are other possible causes such as abdominal loading with poor technique (“pushing out” while weight training for example), obesity, constipation, and chronic cough. If you have been assessed with a DR it is imperative that you work with a core restorative trainer to rehabilitate the dysfunctional core. Many women become apprehensive to strength train with a DR. It can be difficult to know what exercises are safe and effective to use to refrain from making the DR worse (which is possible) and/or undermining the rehab work. Any movements that cause intra-abdominal pressure are contraindicated. These include forward flexion movements from a supine position such as crunches, v-sits and sit-ups. Supine leg lifts should also be avoided....

I have blogged extensively about Core Breath for the rehabilitation of diastasis recti and pelvic floor strengthening. This repatterning of the core provides a solid foundation upon which an ambitious strength program can be achieved. I have observed that connecting to the pelvic floor muscle to release it is often the most difficult part of the exercise. We have many visualizations and suggestions to help a client connect, and sometimes we need to use various cues to avoid a client becoming "saturated" with the imagery, disconnecting again. I am constantly looking for new ways to describe this intra-abdominal connection, and when I stumble upon a good one it excites me This week I learned a new cue for PFM release. I really connected with it right away and have been suggesting it to clients with a disclaimer "humor me and give this a try, I really connect with it". With inhalation through the nose, place your tongue against the back of your top front teeth ...

There are plenty of exercises that are safe, effective, targeted to strengthening imbalances, and supportive of the pregnant condition. Prenatal exercise is a tremendous investment in the health and well being of both mom and baby. Knowing the best exercises for pregnancy is the challenge, so use this as a guide. It is imperative to follow general prenatal fitness guidelines, and to have a Parmed-X for pregnancy signed by your primary prenatal caregiver. Prenatal (General Trimester Guidelines) If you were previously active you can work at moderate intensity 30 minutes/day or more. Stay well hydrated and don't become fatigued or overheated. The baby is susceptible to heat and you're more likely to be fatigued. Consume an additional 300 calories per 30 minutes of exercise. Cardio 3-5x/week 30:00 Strength 2-4x week 30:00 Stretch Daily Cardio: Low impact cardio is best suited for pregnancy. It reduces the pressure on the pelvic floor which is al...