The pelvic floor is crucial to address immediately postpartum. Most folks will be dealing with some kind of issue with pelvic floor postpartum. Because muscles are more internal and there can be multiple issues going on, every person should attempt to see a pelvic floor specialist postpartum.
Addressing pelvic floor health is crucial as pelvic floor health can impact urinary incontinence, fecal incontinence and may cause pain during sexual intercourse. Please know that none of these things are “side effects” of childbirth that should just be accepted. If any of these things are happening, you should definitely see a specialist to help address the issue. Pelvic floor health also impacts the overall functioning of the core and should be addressed in conjunction to healing the core postpartum. If you are beginning to do core work but have weakness in the pelvic floor, pressure from doing core exercises can be displaced to the pelvic floor and can cause further injury or trauma so strengthening pelvic floor along with core is key.
The most significant muscle stretching in the core happens along the rectus abdominus and impacts the connective tissue called the linea alba. The linea alba runs along the midline of the rectus abdominous from the sternum to the pubic bone connecting the muscle bellies (think of the muscles we see in six-pack abs) of the abdomen. As the uterus expands, the muscle bellies can separate and the linea alba stretches thin. This creates what is called a diastasis recti. In its most scientific sense, diastasis is a musculoskeletal injury, where the rectus abdominus tears at the connective tissue, separating it from the linea alba.
Postpartum, as students return to yoga, a big focus is on strengthening the core. During pregnancy, the core sees the most impact and change and rebuilding strength and function takes time. As the core is strengthened not only will there be more ease in yoga asanas, but students will also notice better posture, less back pain and often less glue and hip pain.
The main struggle? As students return to practice, they may feel a particular pull to start doing strong core work immediately to help “rebuild” the core. It is important to remember that you can actually do more damage to the core and prolong healing if you push too hard too fast. Here are some things to keep in mind with postpartum core work:
One of the first questions many of my postpartum yoga students have is how to navigate recovery from a c-section and returning to their yoga practice. C-sections, whether elective or not, also can have an impact on core function postpartum. Luckily, it is no longer common practice for abdominal muscles to be cut during C-sections, but there is still healing that must take place. What is most common now is that once the top layers of skin, tissue, and fascia are cut, the abdominal muscles are separated along the linea alba to give access to the uterus. The muscles are held open during the period of the surgery, but, while this sounds intense, because the separation is brief, the connective tissue, while traumatized, re-heals rather well. And because the abdominal muscles are not cut, there is less dysfunction in the core postpartum because the length of the muscle bellies remains intact and strength can be more easily rebuilt.
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