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Jerusalem physiotherapy by Tamara May

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RAD

How should I get back into exercise a few months after having my baby?

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Months have gone by, everything has healed nicely and you are in a good routine with your baby. Some of you might only get round to thinking of exercise at this point in your life, but where to start? You may be a few pounds heavier than before pregnancy and introducing exercise into your lifestyle is a really good idea.
I just have to mention it before I get into the nitty gritty but starting with your pelvic floor exercises is a good idea; it might not get you the flat tummy you’re after but it will give your body a good head start into avoiding incontinence.

Now for the tummy exercises, the pelvic tilt is a really good one to start with, it helps flatten the tummy even if there is a gap (RAD) above your belly button. You need to tilt your pelvis and hold for 3 seconds. Start with 10 a day and build the number up.
Another good exercise is the plank, again this is good for the tummy muscles and again it will not cause damage to those that do have a weaker pelvic floor. You need to hold yourself in press up position, tightening your abdominal and glutes. When you have mastered that and can hold for 10 seconds without too much wobbling then raise 1 hand in the air and let your body turn and follow through. Aim to hold this position to for 10 seconds. Start less and work your way up.
Now exercise can be incorporated into your lifestyle instead of setting time aside which can easily be pushed off and forgotten. On that note another one of my favourites is with your baby, and as your baby grows, so too the weight that you are using. Place your baby over your legs when you are in a lying position and raise your legs up and down, your baby might like this one too.
If you are suffering from any pain and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com. I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or a home visit if you live in Gush Etzion.

RAD: Getting Your Body Back After Birth

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Rectus Abdominis Diastasis (RAD) can be quite common after giving birth. So, what exactly is RAD? How do I know if I have it? I hear many of my patients say “I have a gap of 2 fingers when I prod my tummy, I don’t really know what I am feeling for or what it even means.”

RAD is caused by the hormone relaxin, which I wrote about in my previous blog. The hormone relaxes your ligaments and soft tissue to make room for the growing uterus. It allows the abdominal muscles to stretch, permitting the uterus to move out into the abdominal space. The outer most abdominal muscle is called the rectus abdominis. It has two halves and is joined at the midline by a connective sheath called the linea alba. The two bands of recti muscle lay parallel but during pregnancy they can stretch away from the midline, and it is this separation that is called RAD. A significant RAD is a gap greater than 2 fingers in width, three days post-delivery.

Overall, 66% of pregnancies leave the mother with RAD at the end.  Scenarios in which RAD is most common include:    
  • ·         If you have gained excess weight
  • ·         If you are an older mother
  • ·         If you have a larger baby (classified as above 4kg)
  • ·         It is a multiple birth
  • ·         It is your third, fourth etc. pregnancy
  • ·         You have had pregnancies close together
  • ·         You have carried out inappropriate exercise during pregnancy.

Are there any symptoms?

There are no obvious symptoms from RAD, which may leave you wondering why my patients should care about how many fingers worth of a gap they have.  In fact, although there are no obvious symptoms, it can alter your posture and contribute towards lower back and pelvic instability which in turn can lead to pain. It can also simply prevent you from gaining back your old figure.

What can I do about it?

Sit ups, which are a well-known exercise for toning your abdominal muscles, would be counterproductivefor any patient that has RAD and should be avoided. Instead, focus on exercises that isolate the correct muscles. For instance, going on all fours or on your back doing posterior pelvic tilts would be more suitable.
It should only take one visit to your physiotherapist to measure RAD properly and show you how to do it yourself in future. They will also show you what exercises you should be doing at that stage, and advise you how to progress your exercises program. You cannot measure correctly simply by lying on your back prodding your tummy. The correct method, that should be demonstrated first, is lying on your back with your knees bent, drawing in your abdominal muscles, tilting your pelvis back, raising your head and shoulders off the floor and feeling 2cm below the umbilicus.

If you suspect you have RAD and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or at your home if you live in Gush Etzion. 

Filed Under: RAD