In my last post I talked about a few of the reasons your body complains during pregnancy. In this post, we are going to get a little more specific with your abdominal and core anatomy for those of you who are anatomy nerds like me! We are also going to learn why things don’t always just snap back to normal after the baby vacates the premises.
Your abdominals include your rectus abdominis, internal and external obliques, and transverse abdominis. Rectus abdominis flexes your spine (as in a crunch), obliques twist and side-bend your spine, and transverse abdominis compresses and stabilizes your spine. Transverse Abdominis is intimately related with your pelvic floor, which is a hammock of muscles that sits inside the pelvis, supporting your bladder, uterus, intestines, rectum, and stabilizing the pelvic bones. Your pelvic floor contains 11 different muscles, which not only stabilize your pelvis but also close and open your vagina, urethra and anus, thus influencing birth, urination, intercourse, and bowel function in a major way! There are 2 hip muscles that connect directly to your pelvic floor, called piriformis and obturator internus, which are further supported by your gluteal muscles (gluteus maximus, medius, and minimus).
Opposing your gluteals are your hip flexors – most notably psoas and iliacus. Iliacus attaches all around the inside of the pelvic rim, while psoas attaches to all 5 of the vertebrae in your lower spine. These attachments sit very close to your quadratus lumborum – a large muscle that goes from your pelvis to your rib cage and assists the abdominals in side-bending and rotating the spine. Smaller, deeper muscles of the low spine called multifidi are key players in stabilization, along with your transverse abdominis. And the last big player we will mention here which literally caps off the whole “core” is your diaphragm – that large flat muscle that stretches across the lower ribcage, under your lungs and over your intestines and organs, enabling you to breathe in oxygen every moment of your life.
So what happens when baby comes out? Things just go back to normal, right?
Sometimes yes and sometimes no. For the vast majority of us, things should normalize over time as our hormone levels and weight return to normal. If we stay active, exercise appropriately, eat well, and take good care of ourselves, we start to feel more normal by about 10 weeks postpartum. But for some women, symptoms of pain, fatigue, or bowel and bladder problems can persist, and new symptoms can arise.
There are a few extremely common postpartum problems that warrant discussion so that you can spot them in yourself or a friend if they arise. These include diastasis recti abdominis, urinary incontinence, prolapse, dyspareunia (painful intercourse), pelvic pain, and back pain. For detailed descriptions of these issues, download my free PDF on Postpartum Pitfalls.
Pelvic physical therapists specialize in preventing and healing these conditions by normalizing your posture and breathing, regaining your strength and flexibility, and teaching you to avoid the common pitfalls that send many women down the rocky road to injury. An ounce of prevention is worth 1000 pounds of treatment!
Click here if you’d like to make an appointment. SHEFit Physical Therapy proudly serves Pacific Beach, La Jolla, and all of San Diego County.