Postpartum Rehab

[David Oswald]

I am posting on behalf of my wife, she is three months past delivery our fourth child, and has a pretty typical case of diastasis recti, which our two year old calls a "playdough belly". My wife is originally from Belgium, but we live in the United States currently, and has stated that postpartum physical therapy is standard after delivery in much of Europe. She seems to be thinking if she found "the right physical therapist" she could significantly improve her diastasis recti.

Can her diastasis recti be treated with therapy, is the therapy well known among physical therapists, or do we need to see a specialist? I'm a little skeptical of just googling this and trying exercises at home due to the amount of non-experts making things up on the internet, so if you have resources that would be helpful, I would appreciate it.

For detail, my wife is 32, 5'10, and about 160 pounds. And currently is not following any exercise program. She also has struggled to get back to her pre pregnancy weight of 150 after being treated for Graves Disease, if that is relevant.

Thank you.

[RVR]

Would be curious about this as well. "Functional" general core work is generally fairly obvious (i.e. most things that aid in core endurance/bracing/etc) but I have yet to find a reputable source that indicates what the best approach is to this.

[Derek Miles]

I would start here:
https://soundcloud.com/user-34431316...c-floor-health

Pelvic health physical therapy, and especially post partum rehab is definitely a thing. To my knowledge there is not good evidence for an expedited recovery of diastasis recti but there are certainly things that have shown beneficial in both feeling better and returning to prior levels of activity. In the podcast Meryl mentions two resources for looking for a pelvic health specialist. This would be a good place to start.

https://ptl.womenshealthapta.org/#s=1

[SSHartmann]

I'm 4 months postpartum and currently 2 months into my pelvic floor rehab and live in middle TN. If you're in this area I can recommend a therapist.

My question relates to the valsalva maneuver specifically and how it impacts the pelvic floor strength/functionality? I can post a separate post if needed.

From several pelvic floor therapist (3 different therapists over the course of 3 years) plus researching pelvic floor rehab, they are all saying that holding breathe while working out is not ideal and negatively impacts the pelvic floor. They recommend strengthing the pelvic floor enough in order to exhale & suck in (zip up) using pf muscles and if unable to do so, should hold off on weight lifting until able to do so.

basically the info I've been given contradicts (at least my understanding) of the valsalva maneuver. Could you comment on the maneuver and how it impacts the pelvic floor, at least for a women?

[Hannah Mora]

I'm 4 months postpartum and currently 2 months into my pelvic floor rehab and live in middle TN. If you're in this area I can recommend a therapist.

My question relates to the valsalva maneuver specifically and how it impacts the pelvic floor strength/functionality? I can post a separate post if needed.

From several pelvic floor therapist (3 different therapists over the course of 3 years) plus researching pelvic floor rehab, they are all saying that holding breathe while working out is not ideal and negatively impacts the pelvic floor. They recommend strengthing the pelvic floor enough in order to exhale & suck in (zip up) using pf muscles and if unable to do so, should hold off on weight lifting until able to do so.

basically the info I've been given contradicts (at least my understanding) of the valsalva maneuver. Could you comment on the maneuver and how it impacts the pelvic floor, at least for a women?

Hi here! Unfortunately, I don't know any pelvic floor PT in that area, so I can't speak to this. I am not a pelvic floor specialist by any means, but I do know that the valsalva maneuver is safe and unavoidable if lifting anything of substantially "heavy" load. We would not recommend holding off on holding off on resistance training until you can execute this specific pelvic floor contraction. If you would like more information on this topic, I would highly recommend the podcast Derek mentioned above: https://soundcloud.com/user-34431316...c-floor-health