Updated: Aug 21, 2022
Pregnancy is a pretty amazing thing. Humans have the ability to generate life, nourish and support it internally, and then deliver that new life into the world. That’s pretty amazing, and the body has to undergo some pretty wild adaptations. The ribs need to flare and expand as the uterus expands, the body releases relaxin to loosen the joints to allow the pelvic canal to widen during delivery, and the placenta mediates nourishment between the parent and the new life. There’s even evidence that the fetus exchanges DNA cells with the parent; fetal chromosomes have been found in the heart tissue of their parents long after delivery, but there’s evidence they migrate to the skin, the liver, throughout the body. Pregnancy has long lasting effects.
People always ask me “Well, I had a kid a few years ago; am I still post-partum?”
And I always say yes. For those same reasons above; pregnancy creates some long lasting hormonal and physical shifts.
For those of you that are worried “Oh no, I’m going to have my pregnancy body forever,” that’s not what I’m saying. You can recover your strength, your lean muscle mass, your endurance within a year or two after your pregnancy with clear and personalized programming.
What I am saying is that, if you haven’t thought about your pelvic floor, thought about your strength and conditioning after your pregnancy, those effects are probably still lasting. The most common one I see is breathing; new parents start breathing in their chest and their shoulders because the fetus was pushing up and taking space in the abdomen. And then once your body has adapted a motor pattern, it tends to stick with it. What fires together wires together, even if it isn’t the most efficient pattern, it ends up being the series of neurons your body uses the most. I call it a neurological groove. Which is why years after pregnancy, clients still presents with post-partum symptoms like a diastasis recti, pelvic floor weakness and incontinence, and core weakness, and even larger joint pains.
I have clients coming to me anywhere from 3 months to 12 years after a pregnancy with post-partum symptoms. Let’s talk about what each of those symptoms are and break it down to understand why they happen, and how they can manifest in your life.
Diastasis Recti: This is a separation of the rectus abdominis. As a fetus is growing, the uterus expands, pushing upwards and outwards, which can stretch the abdominal muscles. You can see this happening if you fit a basketball underneath a T shirt, where the fibers in the front really have to stretch, and might even pull apart. A diastasis occurs when those fibers separate horizontally, creating a “space” that runs lengthwise down the middle of your abdomen. Unfortunately, this space means there’s now a gap in your abdominal wall, and that reduces the integrity or ‘strength’ of your abdomen and core as a whole. If you think about your abdomen like a can, and the walls of the can are your abs and obliques, imagine trying to crush an intact can. It’s not so easy. But suppose you cut a line down the side of the can, and then try to crush it; much easier, right? That’s why a diastasis can be so troubling, because it compromises your overall core strength significantly.
Pelvic Floor Weakness: If the core is a can, and the abs and obliques are the sides, then the pelvic floor is the bottom. These muscles originate in the pelvis and control what I call the ‘ins and outs’ of the pelvis, from urination and defecation to sexual satisfaction. The pelvic floor helps contract to promote continence, and its resting tone helps keep organs in place. The pelvic floor also needs to be able to relax to allow urination, defecation, and can be helpful for individuals utilizing penetration in their sexual intimacy. You can think of it, if these muscles are cinched tight, they cannot elastically expand to allow something to enter the pelvis.
- Pain with penetration
- Core Weakness
I talked earlier about how a diastasis can impact core strength, but there are other core muscles like the obliques that wrap all the way around the abdomen. These muscles are also stretched and lengthened during pregnancy, and like a stretched out rubberband, they can have a hard time contracting in that really lengthened position. If you don’t consistently train those muscles following your pregnancy, then they’re not necessarily going to regain that strength and coordination that you had.
Knee, Hip, and Low Back Pain: This one always surprises my post-pregnant clients, but it’s pretty common. If you have pelvic floor challenges or aren’t training regularly after pregnancy, all the core instability from the pregnancy is going to require other joints and muscles to provide that stability for you. And this results in a lot of excess force driving through the hips, the low back, and the knees, which can create pain and discomfort. Essentially, you’re compensating for your weak core by pulling for stability somewhere else, but this isn’t the most efficient strategy and can easily tax these tissues.
All of these symptoms can persist, because your body is going to hold onto what’s familiar, and what’s worked. What wires together, fires together. Which is why PT can often be about the brain, and retraining what you’re recruiting. Many of my clients hear my talk about exercises and movement as a “brain game,” and not just a ‘body one.’
So, if you’ve delivered a child, there are still some residual changes in your body, changes in your pelvis and core. If you’ve carried, it doesn’t mean you’ll never have a strong core or pelvic floor again, but these areas might need a bit more attention and focus to get there, especially if you're a high performing athlete.
If you’re curious, or have some of these issues, please reach out so we can get started on helping you feel strong and capable in your body!