Dealing with a belly that doesn’t work or look right after baby.

Erin Wilson, MPT

SEPTEMBER 17, 2017

Things will never be the same. People wished me well before the birth of my first child and told me to enjoy my last few months before he came. I have to say I am very glad for the experience of being a mother but I could do without the changes to my body pregnancies have brought me.

It was during my first pregnancy that I noticed a deep stretching, burning pain at my belly button area. I later came to find out that is my linea alba or white line, a band of connective tissue that connects the two rectus abdominus muscles. These are the "six pack" muscles that go down the center of the abdomen. This burning stretching pain should have been my first clue that I would have a rectus diastasis or a separation of the linea alba. But after he was born I didn’t notice pain there, in fact I didn’t have much pain at all. It wasn’t until I went back to work fulltime and my exercise regime was decreased to keep up with the responsibilities of work and taking care of baby that I started to have low back pain and a feeling of instability in my pelvis and at my pubic symphysis, this is the joint in the front of the pelvis where the two halves come together.

My sister is a different story, she has had three children and despite boxing, hot yoga and spinning and being in awesome shape she has a separation and instead of pain, she has bulging of the rectus diastasis. This is another presentation of the same problem, an intraabdominal pressure issue. It is not that she is weak, it is that her muscles are just confused about which ones should be working. So when she sits up from laying down, "pop" a little bulge occurs right down the middle of her belly. Other people do this same motion and instead of a bulge they get a deep pit between the two muscles.

Our bodies truly are amazing, they are able to go from a 28" waist, to having a basketball inside and back to a 28" waist all within a few months’ time. Why are we amazed then when the abdomen doesn’t go back to working the way it should? One reason is that it isn’t just the basketball that changes. There are many postural changes of pregnancy and postpartum baby care that help to perpetuate some of the changes that have occurred because of the basketball. In fact there are 85 joints in the torso that are attached or have influence on the stresses placed on the linea alba. Changes to the positions or functioning of any of these joints can cause muscle spasms in the surrounding muscles that actually fight against closure of the diastasis.

For example, the external oblique muscles are rotators of the trunk and they are attached to the six pack muscles. Therefore if I have a rib cage that is stuck open and out because my baby was pushing up into my ribs when I carried him, then my external oblique muscles are likely engaged in spasm or they turn on too soon when I go to move my body. This action works to continually pull the linea alba apart widening the gap and keeping us looking like we are still pregnant!

Though things will never be the same after baby there are a lot of plans and braces out now to finally help us get back to our pre-pregnancy function. Unfortunately the one size fits all plan doesn’t fit everyone. Working to improve posture, working on bringing the diaphragm back down to its original position (instead of staying up like the baby is still there under the ribs) and working to bring the muscle groups into better synergy to create the optimal tension on that linea alba are all things that need to be addressed to return to pain free and flatter post baby bellies! I’ll admit, I tried the braces, I tried the different plans, but it wasn’t until I delved deeper and took everything into consideration that I got better.

We accept most major insurances in the Louisville area including Medicare and Passport.