I have previously written an article on separated abdominal muscles, explaining what it means and how it can be rehabilitated.
I have organised information sessions on separated abdominal muscles and postpartum exercise for sports professionals together with a physiotherapist who specialises in the pelvic floor muscle area and a personal trainer who specialises in exercise during and after pregnancy. The aim has been to increase knowledge in the topic because it was not previously included in any personal trainer training nor in the training of healthcare professionals. In other words, knowledge on the topic depended on independent studying and the interest of each individual. Luckily, the situation has improved slightly since then, and the topic is written and talked about more widely.
The reason for my own interest and the wish to distribute information about the topic is that I have personal experience of separated abdominal muscles.
I had two children in quick succession. It has been around five years since my last childbirth. I have always exercised a lot, partly because of my work as a sports instructor but also because I enjoy intensive training. I did not really train between my two pregnancies, and when I went back to training after having given birth to my youngest child, the difference between then and the time before the pregnancies, when I was very fit, was huge! I had lost my balance and coordination and had to learn to do some exercises again from the beginning. Lunges was one of the most difficult ones to master. In addition, I felt that I could not trust my core, which made me relatively timid when exercising.
When I started to search for information on the topic, I finally came across separated abdominal muscles and realised that I suffered from this condition myself. At that point, my youngest child was 1.5 years old. Later, a qualified physiotherapist confirmed the diagnosis. For me, it was clear from the start that I should start rehabilitating myself with the help of a professional. I know my body very well and try to listen to its messages as carefully as possible. My body was not yet ready to go back to my normal training routine, but I believed that with the right exercises and instruction I would get there in the end.
We completed various functional tests with a physiotherapist and they showed that e.g. my transverse abdominal muscle did not activate at any point but remained in practice “asleep” for the whole time. Therefore, my first task was to “wake up” this muscle and make it participate in normal muscular activity.
It is highly important that all core muscles are activated in the right order and participate in muscular activity. If they are not, this can cause imbalances in the body, back pain, and bowel and urinary incontinence. At worst, it increases the risk of uterine or vaginal prolapse. As abdominal muscles keep internal organs in their right places, the condition of abdominal muscles also affect e.g. the operation of the bowel.
Abdominal muscle exercises must be started slowly after the pregnancy; instead of straining the muscles to the extreme, concentration is the key. Due to the changes that occur in the body during pregnancy (the stretching of the direct abdominal muscles horizontally to the sides), the aim of the abdominal exercises is to teach the brain to activate the muscles again correctly and to strengthen the nerves, which enable activating the muscles and making them work effectively and purposefully. And what does it take? Continuous and systematic work at a moderate intensity.
After childbirth, new mothers are often told at the hospital and the maternity clinic to train their pelvic floor muscles. This is very sound advice, but they often fail to explain how the pelvic floor muscles should be trained, and what the goal of the training is. Also, it is not always mentioned that learning to relax the pelvic floor muscles is just as important as training them.
In my own training, the rehabilitation of the pelvic floor muscles was started in addition to activating the transverse abdominal muscle. The younger of my two children who were born in quick succession required a C-section, which is a more major operation than people usually think: in a C-section, seven abdominal layers are cut through in order to remove the baby from the womb. This meant that the nerves in my belly area had become severed. This caused e.g. numbness and difficulty in activating the muscles. As I was used to training relatively hard, I found it difficult to find a sufficiently slow pace of training.
Training too hard can cause stiffness in the pelvic floor muscles and make the problems in the core even worse - this is exactly what happened to me.
Luckily, I was being supervised by a skilled physiotherapist, and so we soon got back on track after a short setback. However, the process of rehabilitating my core continues. The topic is very important for me because of my personal experience and because I hope that no one needs to suffer and search for help for as long as I did before my diagnosis. I hope that knowledge among both specialists and women who have given birth will increase, and that the specialists will be able to provide the right kind of help and the women will be able to demand help and be aware of this condition.
Personally, I continue to visit a physiotherapist regularly and train with a professional personal trainer because I harmed myself at the beginning by training too hard, which made the separation of my abdominal muscles worse and weakened my posture.
I understand extremely well how much systematic work rehabilitation requires but the good news is that with the help of a professional, something can almost always be done. I have seen separated abdominal muscles heal after just a few training sessions and women who gave birth dozens of years ago and suffered from e.g. urinary incontinence to regain control of their pelvic floor muscles and get rid of the incontinence.
My own separated abdominal muscles have required more systematic work, but progress is happening all the time. And what’s best, I can trust my core again and can do the sports I enjoy the most, namely snowboarding and surfing, as I used to do before the pregnancies even though they require a great deal from the core.
I would like to say to all women who are struggling with these same issues - stay strong! Taking good care of yourself promotes the quality of life of not only yourself but those close to you. We mothers have deserved it!