I get asked this question frequently by women at varying points in their post-partum recovery. They see their body returning to its pre-pregnancy shape, but a little belly remains.
What is going on inside the body? At 4 weeks post-partum the uterus has gone back to its original size. By 6 weeks milk supply is at its highest before the body begins to regulate. Between 3 and 6 months milk supply is well established, and moms are starting to get back into an exercise regime. If physiologically the body is ready to get back in shape, “why is my stomach still not flat?”
The key to getting your body back and a flat stomach is twofold. 1. You must correct your posture. Poor posture can cause the illusion of a belly. 2. You must get evaluated for Diastasis Recti Separation. This is a very common condition that occurs in pregnancy where the Rectus Abdominus splits creating a gap in between the muscle.
Posture is affected by things in our environment that create stress on the body. If you are sitting all day at the computer, you are at risk for forward head forward head posture as well as tightness in your lower back and hip flexors if you don't periodically stretch. Prolonged standing can over work your lower back muscles or cause problems if you hyperextend your knees.
Posture during pregnancy is greatly affected. An increase in the lumbar curve occurs as we develop a belly caused by abdominal stretching and increased demand put on the lower back muscles and joints of the spine. There is also an increased thoracic curve or rounding of the spine. This can make women look more round shouldered if the upper back is not properly strengthened. These changes can be further increased post-partum from poor breast feeding posture and poor body mechanics holding, rocking, and caring for the new baby. If posture is not corrected, it becomes a downward spiral.
The corrections are actually very simple. Start from the ground up to give your body a good foundation.
- Stand with your feet hip distance apart, try to balance your weight in between the heels and balls of the feet, soften through the knees,
- Gently find a drawing in and lifting up in the lower abdominals.
- Keep this awareness in your abdominals and think of your shoulder blades gliding down your back.
- Keep your gaze at eye level and soften the neck and shoulders.
Now, relax and breathe into the posture. If it feels difficult, this is normal. Your postural muscles tend to be underutilized so they can fatigue quickly. The more you reset your posture the more natural your new body position will feel. You begin to change your patterns by becoming aware. Your body will adapt and develop good postural strength and endurance.
The second piece of the picture is getting checked post-partum for diastasis recti separation. We don’t know for sure what causes this splitting. It can be from pregnancy hormones, normal stretching as the uterus moves upwards in the abdomen, excessive strain on the muscles and even unrelated to pregnancy caused by poor exercise technique such as breath holding and pushing outwards when using the abdominal muscles.
Whatever the cause may be, it's important to assess for diastasis post-partum prior to engaging in abdominal exercise. If a diastasis goes untreated, your body will not regain its abdominal strength. This weakness in the muscle will also become a risk factor for lower back pain. Furthermore, if your abdominal muscles remain separated your stomach will not look flat.
The following assessment should be performed by a professional and monitored for progress:
Lie on your back with your knees bent. Lift your head and shoulder blades up from the ground. If there is a separation in the muscle, you will feel a space typically most prominent at the belly button. The assessment is done at the belly button, 2 inches above and 2 inches below. The measurement is how many fingers width fit into the space. A separation greater than 2 fingers width is considered abnormal. If there is a diastasis you will see the belly protrude in a cone shape when you a sit up from a reclined position or lifting up into a crunch.
If you have a separation that isn't within the normal range a corrective exercise needs to be performed. Traditional crunches, rotation exercises, planks and anything putting excessive strain on the muscles should be avoided until the separation is closed. Even if you are within normal, you should still focus on closing the muscle as much as possible. This can be achieved by performing a corrective exercise and visualizing your muscles knitting back together. Really emphasizing the action of the Transverse Abdominus (the deepest layer of the abdominals) wrapping around your waist like a corset, will help to close the remaining space.
To close the separation, perform the following corrective exercise: Splinted Head Raise
Lay on your back with your knees bent. Spine should be in neutral. Crisscross your hands around sides of the belly. Allow your hands to sink in so you feel you are on the muscle and not just superficial. Inhale into the ribcage. Exhale, draw your abdominals inward, splint the abdominal muscles together by squeezing the sides of the belly together and slowly lift the head. Hold 3-5 seconds. Repeat 10 times, 3-5 times a day.
**Make sure you do not hold your breath and your muscles are not pushing outward.
You can do the same corrective exercise sitting in good postural alignment. Place your hands the same way around your belly. Coordinating with your exhalation, squeeze the sides of the muscle together as you pull your muscles inward. The only difference in this position is you don't move your head or body forward.
Make sure your post-partum program is all inclusive with cardiovascular exercise, targeted strength training, stretching, nutrition, and good postural exercises. Posture and Diastasis Recti Separation may be the missing link to getting the flat stomach that you want in your diet and exercise program.
Ask Solange a question via email or comment below.