Restore Your Core: Diastasis Recti and Pelvic Floor Talks

Yoga is an ancient practice that’s sought to unite a person’s body, soul, and mind for whole body health and wellness. Today, yoga has been refined and used as a routine that boasts many health benefits and restorative exercise planning for men and women around the world. Some studies have shown that yoga poses health benefits in potentially helping with anxiety, depression, stress, and helping reduce inflammation in the body. Thus, yoga can go far beyond aiding in balance and flexibility by taking part in exercise routines designed to restore function to your core, pelvic floor, legs, hips, and lumbar spine. As someone who has experienced a severe back injury and benefitted from restorative yoga, I prioritize how I move in my programs. Instead of reducing exercise, I have developed techniques for continuing yoga and exercise that prioritizes movement safety dynamically. In this article, I will address yoga poses I use in my program that focus on: Building strength, even during stretchingMaintaining good alignment and formWise and dynamic sequences that challenge you but do not break you What are The 5 Basic Types of Yoga Stances? In the practice of yoga, there are 5 basic stances or types of yoga. In order to find the right program for you and which yoga best suits your needs, it may be helpful to give an overview of the most commonly practiced types of yoga. Below is a list of the 5 basic types of yoga. Standing Poses: Standing poses are often a warm-up practice to help prepare your body for movement. In slow flow yoga, standing poses are often practiced in longer sequences with stages of rest in between.Balancing Poses: Balance poses are great for beginner’s. This form of yoga can help build the necessary core strength for more advanced movements, postures, and stretches. Seated Poses: Seated stretches are great for loosening hips and hamstrings after a workout or at the end of your yoga class. Using a pillow or folded blanket for your bottom can help make these stretches a bit more comfortable.Supine Poses: Resting poses and positions are important to learn for break periods. These positions can continue to relieve and loosen your hips, hamstrings, and provide gentle twists and inversions. What are 9 Yoga Poses? My program is designed to teach men and women how to help their bodies become more responsive in their daily activities. This means training the body to engage and respond appropriately when engaging in lifting, walking, standing, and other daily light activities. Posture, breathing mechanics, and how you move your body are crucial to full body health and wellness. Below I will address a few asanas positions and stretches that I encourage in my yoga practice. At Restore Your Core, we practice what is known as restorative yoga. This practice incorporates blocks, straps, yoga mats, and blankets to help encourage proper body alignment as well as releasing any tension in your body. Most of these stretches and poses are designed to help release the tension in your body passively – so not always during a stretch.

Leaking of any form sucks. It is a common problem that many people face and is not just a little pesky nuisance that’ll go away if you ignore it. Ignoring urinary leakage may actually lead to more complicated issues in the future, making it harder to manage. Severity of urinary incontinence ranges between a small leak when you sneeze, jump, or cough to sudden uncontrollable urges to urinate that its difficult to make it to the bathroom in time. Many fitness and health gurus will most likely recommend kegels or exercises that seek to contract or tighten the pelvic floor. However, it isn’t always an issue with your bladder muscles or pelvic floor muscles. Yes, they may be affected or may be presenting the more noticeable symptoms, but more often than not, urinary incontinence is a whole body issue. What is Urinary Incontinence? Urinary incontinence is a loss of bladder control that affects people in different ways. The most common types of urinary incontinence include stress incontinence and urge incontinence – an overactive bladder. Incontinence is likely to affect approximately twice as many women as men. This most often due to pregnancy, childbirth, and menopause. Pregnancy stresses and strains the muscles in the pelvic region which may often lead to stress incontinence. However, urinary leakage is not a normal or natural part of aging and is often a sign of an imbalance in the body. Leaking Bladder If you are suffering from urinary leakage the chances are that this issue is part of a whole body imbalance. No need to freak out! A whole body imbalance merely means that incontinence is not about your pelvic floor alone. It is about the container that your pelvic floor lives in. Your body. Treating the pelvic floor alone is symptom-targeted rather than root issue focused. Isolating symptoms can be unhelpful is truly finding and fighting the source of the imbalance. Often, the symptoms we notice did not originate in the affected area. Just like a foot injury may eventually lead to leg, hip, butt, and back pain, urinary incontinence can be a symptom that did not originate in the pelvic floor. What are the Types of Urinary Incontinence? The common types of incontinence include: Stress incontinence — More common in pregnant people or those who delivered vaginally. May be triggered by coughing, laughing, bending, lifting, jumping, or sneezing.Urge incontinence — More often an issue with aging and characterized by increased urinary frequency and urgency (overactive bladder)Overflow incontinence — Overflow incontinence is characterized by dribbling urine, increased frequency of urination, and inability or feeling of incompleteness after urinating.Mixed incontinence — It is possible to experience a combination of the symptoms and types mentioned above. Symptoms of Urinary Incontinence Some of the most common symptoms of bladder incontinence are: Leaking urine during exercise, lifting, bending, or other daily activitiesSudden and strong oncoming urge to urinateUrinating without warning or feeling of urgencyUrinating in your sleepDifficulty holding urine or making it to the restroom in timeRecurrent urinary tract infections

Symphysis Pubis Dysfunction (SPD) happens when the ligaments that keep your pubic bone and pelvis stable become overstretched and no longer stabilize your pelvis. Essentially, a structure that is designed to move very little begins to move a lot, and it can be very painful and difficult to move with ease. SPD is a condition that sometimes arises during pregnancy, though it can also first occur during labor and birth or in the postpartum period. Pelvic girdle pain in general is quite common during pregnancy—between 48% and 71% of women report feeling significant pelvic discomfort. About 30% of women report that the area of the pubic symphysis is painful. While SPD does involve the pelvis and the integrity of the pelvic floor muscles, a general pelvic floor dysfunction treatment like kegels is often not the answer to symphysis pubis dysfunction. Where is the Symphysis Pubis Located? The pubic symphysis is a cartilage joint that resides in between the pubic bones: above the genitals and in front of the bladder. In most cases, the joint can rotate and move a few millimeters without causing any issues.  What are the Symptoms of Symphysis Pubis? The symptoms of SPD can vary for different people, both in terms of severity and presentation. The most commonly experienced symptoms are: The symptoms will vary from person to person – both in severity and in presentation. However, if you’re concerned that you have pubic symphysis dysfunction, these symptoms may be present: Pain in the pelvis in general, and specifically in the groin and inner thighs; pain moving around into the buttocksClicking sounds in the pelvisPain while sleepingActivities like getting out of bed, in and out of cars, stepping up and down from steep stairs, really, any position that widens the legs can be very painful What Causes Symphysis Pubis Dysfunction Symphysis pubis dysfunction is most often pregnancy related. However, the factors that predispose people to SPD are quite varied. The medical literature on symphysis pubis pain seems to agree that the hormone relaxin is not entirely to blame. Factors as different as hypermobility, bearing twins or other multiples, and a history of back pain can play a role in pubic symphysis pain during pregnancy. SPD usually resolves for most pregnant people after delivery, with most returning to normal function by 6-12 months postpartum. Rarely, some people find that SPD becomes a longer-term problem. Most people are able to have a vaginal birth even with symphysis pubis dysfunction—finding pain-free ranges of hip movement prior to labor can be helpful if such a delivery is in your birth plan. What Causes Symphysis Pubis Pain? Symphysis pubis dysfunction (SPD) and pelvic girdle pain occurs when the ligaments and joints that help support and align your pelvic bone become overly stretched or relaxed. This often leaves the pelvic joint unstable and can lead to various painful sensations, including pelvic pain. During pregnancy, it is common for these joints and ligaments to become stretched, especially as you are nearing the time for delivery. When the pubis symphysis becomes too loose too early in your pregnancy, you may begin to notice more pain in your pubic region. Although the most common cause of symphysis pubis dysfunction is pregnancy, SPD is not entirely pregnancy related. In some cases, the cause of SPD is unknown. It may be common to experience pain during pregnancy or postpartum in these areas: hipsstomachpelvic floorpelvis What Does Pubic Symphysis Pain Feel Like? Discomfort and pelvic pain are usually the most common symptoms of symphysis pubis dysfunction. The pain is generally located in the front of the pelvis, above the genitals and pubic bone. In some cases, people report feeling a clicking or popping sensation as they walk or shift their weight. It is common for many men and women to experience the pain in their lower back, lower abdomen, hips, groin, and legs.

Sacroiliac (SI) joint dysfunction can sometimes lead to lumbar spine and leg pain. The SI joint is located between the sacrum and and ilium bones in the pelvis, connecting the spine to the hips. These bones help support and align the entire body. Although the medical field believes that the SI joint is responsible for those suffering from low back pain, it is often a difficult diagnostic to make. In this article we hope to address SI joint dysfunction and how you may find recovery in our program. What is SI Joint Pain? Because the SI joints help support the weight of the entire body, sacroiliac joint pain is often more noticeable while you are walking or lifting heavy objects. The SI joint is supported by strong ligaments and muscles. This keeps the joint from having a flexible range of motion. As people begin to age, it is common for many people to experience stiffening of the ligaments. This can often lead to low back pain. SI joint dysfunction often occurs when the cartilage wears down. This can lead to the bones rubbing together, which may irritate the sciatic nerve (located in the pelvis). If the joint is unable to move properly or degenerates, a common symptom is chronic pain in the lumbar spine. In many cases, sacroiliac joint dysfunction can range between mild to severe pain. This can depend on the health of the joint or is caused by an injury. Acute sacroiliac joint dysfunction typically occurs suddenly and resolves over the course of a few days to weeks. Chronic sacroiliac joint dysfunction is characterized by persistent bouts of pain in the pelvis, low back, and legs that may last for more than 3 months. This pain may persist constantly or significantly worsen during certain activities. Other terms for SI joint conditions include: SI joint dysfunction, SI joint syndrome, SI joint strain, and SI joint inflammation. What Causes SI Joint Pain Sacroiliac joint dysfunction is often caused by these four things: Traumatic injury: sudden impact on the sciatic joint in cases of a motor accident, a fall, or sports injury can damage the sacroiliac jointsArthritis: degeneration of the cartilage (osteoarthritis) or an inflammation of the spine and lumbar joints can cause lower back painPregnancy: During pregnancy the sacroiliac joints become loose and may stretch to accommodate delivery. The added weight of your child and altered gait may stress these joints, which may lead to abnormal wear. Infection: Though rare, in some cases the si joint may become infected causing low back pain. What Does SI Joint Pain Feel Like? Sacroiliac joint dysfunction most commonly affects the lower back and buttocks. However, pain may spread to the legs, groin, and feet. It is often described as a stabbing and pinching chronic pain. Sacroiliitis may be aggravated by: Prolonged standingBearing more weight on one leg than the otherStair climbingRunningTaking large strides How Do You Relieve SI Joint Pain? Sacroiliac joint dysfunction treatment focuses on restoring joint motion and alleviating pain. Physical therapy and movement treatments are usually an effective and preferred method over surgical treatments. Initial treatments for sacroiliac joint pain typically include: Rest: Resting for 1 to 2 days is often advised. However, resting for a prolonged period of time may cause joint stiffness to worsen and may increase the pain. It is best to rest and move carefully.Ice or Heat: Ice is a great treatment for reducing inflammation and alleviating discomfort. Heat can be applied around the joint in order to relieve any tension of spasms in the surrounding muscles.Manual manipulation: A movement specialist, physical therapist, or other qualified health professional can help relieve the symptoms of hypomobility. This form of treatment seeks to reduce joint fixation and muscle tension while restoring your range of motion.

Core exercises and workouts help strengthen the muscles in your abdomen, back, and your pelvic floor. In many cases, working out core muscles may aid in your ability to do physical activities, restore damaged muscle groups, and aid in load and weight lifting. However, there are many fitness gurus and exercise routines that encourage unhelpful and potentially damaging core exercises. One of the scenarios I run into many times with my clients is that they are encouraged to build core strength through navel to spine exercises. They are taught that in order to fully engage in fitness culture, they must try to achieve a flat belly or toned abs in order to be healthy. That cannot be any further from the truth. This is the heart of what I teach in the Restore Your Core program: navel to spine does not work. Arbitrarily pulling our navel in, tightening the core to do exercise does not rewire, re-pattern, remind our bodies of what they need to do all day long. And if you are working out 1-2 hours a day and doing a lot of navel to spine but then the other 12 hours a day of waking time, your core is not reflexively doing its job – then those 2 hours on the mat are not useful. In this article, we seek to address the proper way to pursue a strong core rather than doesn't sacrifice function for sexiness. How Long Does it Take to Restore Your Core? I wish I had an insta solution for addressing Diastasis Recti, but unfortunately, I do not. Getting a functional core is a process that involves many things including alignment, breathing mechanics and finally, the right way to train using exercise. The whole goal is to train your body to react and respond appropriately to your movements and activities. (Restore Your Core program is based on this approach.) Effective Core Exercises & Training Ensure you are not a belly breather. Belly breathing causes a lot of intra abdominal pressure and that can lead to a diastasis recti and pelvic floor dysfunction.Work on your posture and body alignment as both compromise your core.Stop sucking in your belly all day because that does not work. Here is an alternate way to practice core engagement that doesn’t suck, suck, suck your belly in and it actually works. Try it: Come to your hands and knees. Ensure that your spine has neutral curves: lower back has a slight arch and upper back is slightly rounded. Booty untucked gently. Look between your hands and imagine you have a cake between them with 100 candles. Inhale and exhale to slowly blow all 100 candles out. You should feel your belly lift away from the floor and tighten. That is your deep core. Do the same thing sitting. Sit comfortably with a neutral spine. Imagine now you are blowing out a dandelion. Slowly exhale and feel how your core responds. Amazingly, these simple exercises are key to effective core training. The next step is to get more and more complicated with the exercises so that each time your body needs support of your core – that exhale will direct the support mechanism to engage. The more you do that, again and again, and the harder and more progressive the exercises – the more reflexive your core will be. Your reflexive core will kick in for you for all of your activities because your deep internal support system will be back online.

Your pelvis is vital to supporting your spine and your entire body. At times, the pelvic floor may become overactive or hypertonic. When this happens, the muscles may be overly tight or tense when they should be relaxed. learning to relax and release the correct muscles in your pelvic floor (contracting the muscles as shortly as you would by bulging your bicep – or a long contraction as you would stretching out the bicep). If you have an overactive pelvic floor, you may experience symptoms such as: back pain, painful intercourse, a feeling of heaviness in your pelvic floor muscles, or incontinence. What Causes a Weak Pelvic Floor? The most common causes of a weakened pelvic floor usually include: PregnancyChildbirthProstate cancer (in males)Constipation (strain and forceful pushing during bowel movements) If your pelvic floor muscles are weakened, your body may begin experiencing a lack of support and alignment. Exercises can help strengthen your pelvic floor muscles and restore the proper support and alignment your body requires to function properly. They may also help alleviate pain and other symptoms you may be facing. How to Strengthen Your Pelvic Floor Muscles Find Your Pelvic Floor Muscles Education is one of the primary benefits that we at RYC offer in our programs. Understanding where your pelvic floor muscles are located and how they affect your body can help benefit your recovery. In my program, I help men and women learn more about how their bodies work and how to properly engage and exercise their pelvic floor muscles. Pelvic Floor Exercises Exercise can be a great way to heal your pelvic floor. Unfortunately, in many work out programs for postpartum people and others seeking pelvic floor recovery, kegel exercises are the most commonly recommended exercise to use. However, kegel exercises can actually increase stiffness and make it harder to feel your pelvic floor muscles. Avoiding unnecessary contraction during pelvic floor exercises can be beneficial to recovering the strength and mobility of your pelvic floor muscles. If we want things to shift in our pelvic floor, we need to also shift the habit mode of our muscles. In the case of our pelvic floors, there tends to be much confusion. Is my pelvic floor too tight? Not tight enough? How can I tell the resting tension? How can I fix it? Before we set out to resolve/fix our pelvic floor dysfunction we need to first “know” our pelvic floor. Know what engaging it feels like, what releasing it feels like, and how to control both contracting and releasing it. Only then we can discern what our tendencies are and create new movement patterns and choices. Pelvic Floor Exercises: Stretching Below are a few pelvic floor exercises I cover in my program at RYC. These exercises may help you begin to feel the way your muscles work and go way beyond kegel exercises. Supine Pelvic Floor Stretch: Lying on your back, keep your knees bent and bring them toward your chest. Slowly extend your knees to the side to stretch the inner groin. Relax your pelvic floor and butt. Hold this position for 5 to 10 breaths and relax. Supported Slight Backbend Pelvic Stretch: This is a fantastic pelvic stretcher. Using a pillow or bolster of some kind, gently lower your back to rest on top of the pillow. Once in position, slowly bring your feet together so the soles of your feet are touching. Keep your knees bent, but gently allow them to open sideways. If you feel any discomfort at all in your back or inner thighs, you can use pillows for further support or get rid of the bolster. Hold for 30 seconds or more (roughly 15 to 20 breaths) and relax.

Pelvic floor exercise routines are often very diverse in information regarding the styles and methods you should pursue when seeking to build pelvic floor strength. Some exercise experts will advise pelvic floor muscle training and engagement that actively contracts both your core and your pelvic floor. Their reasoning may seem valid, as we commonly agree that engaging certain muscle groups can help strengthen them, as they contract and release. However, I believe that there is a lot to be desired with this method of exercising the pelvic floor. In my programs, I always teach my clients how to properly train their pelvic floors to lift and release appropriately depending on the task and load. When you contract your muscles, you either make them longer (think slow release of a bicep curl) or you make them shorter (as with a bicep curl). In each case, these muscles are contracting in order to gain strength. In pelvic floor exercises, such as kegel exercises, you are contracting (making them shorter) and tightening the pelvic floor muscles. However, what many people may not realize is that with pelvic floor issues like pelvic floor dysfunction or pelvic organ prolapse, these muscle groups may already be too short, overly toned, and too strong. If this is the case, doing kegel exercises may only increase various symptoms you are already facing. In order to properly strengthen the pelvic floor we need to train the pelvic floor to be responsive to load and movement. To contract as needed and to be able to release as needed. Simply blanket statements of “contract and shorten” all the time is a very one dimensional model. How to Strengthen the Pelvic Floor Many of my clients have come to me with the same issues mentioned above – overly short contracted pelvic floor that make engagement nearly impossible for them. Your pelvic floor helps support the entire pelvic system and much of your body’s weight – that is a ton of load! If your pelvic floor is too short, it makes movement, engagement, and pressure harder to handle. What we want to do is teach the client how to properly train their pelvic floor to handle their movements and respond appropriately to their actions, exercises, and movements. Kegel exercises which continue to shorten your pelvic floor are incapable of doing this. So, how do we do this correctly? How to Do Pelvic Floor Exercises Correctly The first step to improving the way we approach pelvic floor exercises is pelvic alignment. The position of our pelvis greatly affects the tone and strength of our pelvic floor. First, we must ensure that the client is not tucking their pelvis under all the time. If this is the case, the pelvic floor is too tight and will be harder to engage. Muscles cannot go through their full range when they are limited based on posture.  The second step is resolving any chronic tension, holding, and hypertonic patterns if there are any present. In this case, it may be helpful for the client to discuss internal exercises with a women’s health physical therapist. In my program, I would be teaching women and men how to properly re-pattern their movements. In some cases this involves kegel-like exercises, but do not focus primarily on squeezing and tightening the pelvic floor. The next step would be pursuing neutral pelvic arrangement exercises. Exercises to Re-Align the Pelvis: Simply put, we don’t always need to squeeze or tighten the pelvic floor in order to resolve pelvic floor dysfunction or other additional pelvic floor issues. A responsive pelvic floor will lift up with proper core engagement when the pelvis is properly aligned and there is no chronic holding, tight, tension or hypertonic pattern. The passive lifting of the pelvic floor as a result of proper core recruitment is a much better way to train the pelvic floor. Not only that, but just squeezing the pelvic floor only gets to the more superficial fibers and not to the deeper layers of the muscles.

Diastasis recti is a common condition that is often mistaken or confused with a hernia. However, the two conditions are unique and require a variety of different treatments. Diastasis is latin for the separation of two parts. Recti is a latin plural meaning straight. In the medical field, diastasis recti is the separation of the linea alba (the straight line in between your six pack muscles) and the abdominal wall, commonly referred to as the six-pack muscles. The confusion between diastasis recti and a hernia arises from the small to large bulge that may result in the midline due to diastasis recti and since a hernia is due to a “gap” – they are often confused. Please note that the two can often go hand in hand What is Diastasis Recti? A diastasis recti is a separation of the abdominal wall muscles (the rectus abdominis). Most of us know the famous 6-pack muscles by looking at fitness models or bodybuilders as they are the most superficial layer of muscle and easily spottable when body fat is low and muscle tone is high. With a diastasis recti, these muscles separate in the center of the abs, causing a gap between the left and right sides of the muscle. The left and right sides of the muscle attach into a connective tissue that runs from your ribs to your pubic bone and that tissue, the linea alba – stretches and thins and as a result – the 6-pack splits – left from right. In both men and women, this gap can be created in the midline of your belly anywhere from the pubic bone to the base of your ribcage. One obvious way to feel for the gap is during a crunch or sit-up, where one would normally feel tension and closure at the center of the abs, there is a space and a gap and your fingers can sink into your belly easily. What is a Hernia? Your abdomen contains layers upon layers of muscles and strong tissues. These help you move while also supporting and protecting the internal organs. A hernia occurs when the muscular wall becomes compromised and allows the contents inside the abdomen to descend outward. There are many different types of hernias, but the most common two occur in the belly or groin area. Diastasis Recti vs Hernia As you may be aware, distinguishing between a hernia and diastasis recti may be challenging. However, there are distinct characteristics that help differentiate the two. A diastasis recti occurs only at the midline of the abdominal wall. Although it can range in placement and severity from the rib cage down to the pubic bone, it does not vear from the midline of the abdomen. A hernia can occur anywhere in the abdominal wall, groin, or even in the diaphragm. Hernias more often occur at the site of a prior surgery or due to a weakened abdominal wall due to the compromised muscle structures that typically occur after an invasive abdominal surgery. A diastasis may enlarge over time, but not in the same way a hernia does. Diastasis recti may stretch or spread in span due to continued strain and excessive levels of pressure on the midline. However, a hernia may enlarge over time if left untreated which may lead to life-threatening complications – strangulation. Hernias can incarcerate (also known as strangulate) which cuts off the blood supply to that particular section of the intestine. As stated before, this can be a life-threatening situation. This is not a concern with diastasis recti. Hernia vs Diastasis Recti Pregnancy There are several common types of hernias that may be mistaken as diastasis recti. These include umbilical hernia and ventral hernia. In some cases, these types of hernias may be present alongside diastasis recti.

Abdominal hernias occur when an organ or other piece of tissue pushes through a weak spot in the abdominal wall. The sac or bulge that protrudes from the weak spot may contain either a part of the intestine or a piece of the fatty lining of the colon (called the omentum). This typically occurs with hernias located in the abdominal wall or in the groin. If the hernia occurs in the diaphragm, the muscle that separates the chest from the abdomen, the upper part of the stomach may penetrate the weak area. Your abdomen is made up of layers upon layers of different muscle groups, tissues, and organs. It is possible that with age, prior surgeries, past injuries, new injuries, or medical conditions your abdominal muscle strength and support may become compromised. Weak spots may develop in these layers allowing the contents of your abdominal cavity to protrude or herniate. The most common hernias include an inguinal hernia which occurs in the groin, a hiatal hernia (herniated diaphragm), and an umbilical hernia, which occurs in the belly button. Some hernias may be congenital (present at birth), or they may be acquired (happening at any point in your life). Abdominal and Pelvic Floor Hernias Inguinal Hernias Groin hernias are the most common hernia to occur in both men and women. Of the groin hernias, there are two different types: inguinal hernia and a femoral hernia. Statistically, almost all groin hernias are inguinal. Inguinal hernias occur when part of your intestine protrudes through a weak spot in your lower belly. This affects what is known as the inguinal canal. Of the inguinal hernias, there are type different types: Indirect: Hernia that enters the inguinal canalDirect: Hernia that does not enter the inguinal canal Most people develop this type of hernia due to improper lifting mechanics when lifting weights or other heavy objects. Inguinal hernias are more common in men, yet are not limited to adults either. The primary characteristic of an inguinal hernia is a lump or bulge located on either side of the pubic bone when the thigh meets the groin. You may notice this more when you cough, stand, or strain and may be painful during these activities. The lump may also disappear when you lay down. It is important to note that one of the primary dangers of an inguinal hernia is strangulated. Although many hernias are asymptomatic and can be managed without experiencing much pain, a strangulated hernia can cause severe pain, nausea, vomiting, and may inhibit your ability to perform a bowel movement. If this ever occurs, it is important to seek immediate medical attention. Femoral Hernias A femoral hernia typically occurs through an opening in the abdominal floor in a space that allows for the femoral artery and vein to pass from the abdomen and into the upper leg. Femoral hernias are a groin hernia that tend to occur more frequently in women than men due to their wider pelvic structure. Like an inguinal hernia, a femoral hernia may pose potentially life-threatening health risks. Femoral hernias are dangerous because they are often asymptomatic until you need immediate medical attention. If you notice a lump around the crease of your groin or in the upper thigh, it is best to have a doctor take a look at it. Obturator Hernias Obturator hernias are the least common of the three pelvic floor, lower abdominal hernias. However, they are commonly found in postpartum people who have experienced multiple pregnancies or in people who have lost significant weight. The obturator canal (another connection between the abdomen and the leg) may herniate causing the obturator artery, vein, and nerve to protrude into the upper leg of the individual.

Hernias are relatively common and can affect many men, women, and children at any time in their life. Hernias may arise due to a variety of circumstances. A hernia occurs as a result of a weakening in the abdominal tissues and muscles. This may cause an organ or fatty tissues to slip through the small tear which may result in abdominal pain, other digestive issues, or even be asymptomatic, meaning, not present any symptoms initially. Often a hernia occurs in between the chest and hips or lower abdomen. However, they may also appear in the upper thigh or even in your groin. Most hernias are not immediately life-threatening. They typically do not resolve on their own and do require medical attention to diagnose and to treat. Unfortunately, there are times when surgery will be required in order to prevent any life-threatening side-effects. Symptoms of a Hernia One of the most common side-effects of a hernia is the presence of a slight lump at the site of pain or in the affected area. For example, inguinal hernias typically present a lump or bulge on either side of the pubic bone at the site where the groin and thigh meet. It is more common to feel the bulge when you are standing, coughing, or bending over. Often, discomfort and pain will be felt at the site of the hernia. Depending on the type of hernia you have, the symptoms may vary. Some of the most common symptoms include: Bulge or lump in the groin, scrotum, or noticeable swelling in the scrotum.Pain or discomfort in the groin or abdomen that worsens if you bend over or lift anythingA feeling of heaviness in the groin or abdomenDiscomfort or pain during bowel movements or urinationAbdominal pain, discomfort, or swelling at the end of the day, especially if you were standing most of the day. In severe cases, a strangulated hernia (a hernia which cuts off the blood supply to the intestines and abdomen), may present symptoms of fever, vomiting, nausea, and severe cramping. If this is the case, you will need to seek immediate medical attention to prevent life-threatening complications. In many cases, however, a hernia may never present any of the above symptoms. In many cases, a hernia is noticed during a routine medical evaluation or physical or during a check up for an unrelated issue. What is Hernia Pain Like? Hernia pain is often described as a mild discomfort, aching, or a sensation of fullness or pressure at the site of the hernia. This discomfort or pain may increase with activity, exercise, or any lifting that may place a strain on the abdomen (i.e. running, heavy lifting, or bearing down during bowel movements). Others may not feel any pain or discomfort for some time. Does a Hernia Cause Stomach Pain? In severe cases, the contents of the hernia may become twisted or trapped in the torn muscle in the abdominal wall. This can obstruct the bowels leading to severe stomach pain, nausea, vomiting, and may lead to the inability to have a bowel movement or flatulate. This is known as a hernia strangulation and cuts the blood flow to part of your intestines. As mentioned above, this can be a medical emergency and requires immediate attention. You should consult your doctor if you believe you have a hernia. They can provide medical advice, diagnosis, and look for a strangulation.

Before you begin your exercise routine, it is important that you have received medical clearance by your doctor to exercise, practice patience with yourself and your body, and rest, lots of rest! I recommend waiting at least 8 weeks before beginning any strenuous exercises. After your recovery, yoga can be a relaxing and beneficial way to begin introducing exercise back into your daily regimen. Yoga can aid in healing your abdominal muscles, building pelvic floor and core strength, improve body and organ alignment, and your mental health. As you begin adding specific yoga poses back into your daily routine, you may begin experiencing relief from diastasis recti, pelvic floor issues, tight shoulders, chest, and hips, and help you feel more energized and relaxed while caring for your new child. In this article we hope to address any questions or concerns you may have regarding postpartum exercise. How Soon After Giving Birth Can I Do Yoga? We recommend taking your time to heal and bond with your baby before you start exercising. So often women struggle with feeling a need to get back into their normal regimen and daily activities without allowing proper time for rest and recovery. This can be especially true of postpartum people who experienced no pregnancy complications or delivered naturally. As stated above, allowing 8 weeks or so to begin yoga practice is important for your health and overall well-being. Postpartum Yoga After Normal Delivery If you had a normal delivery, you may begin feeling like yourself much sooner than other women who experienced either a c-section or complications during their delivery. However, it is still important to rest and to begin gradually introducing yoga poses into your daily routine. Make sure that you feel comfortable during your exercises and if you experience any pain or discomfort, to wait a few more days to a week before returning to your yoga practice. When Can You Do Yoga After C-Section? If you delivered via c-section, it may take longer for you to begin feeling yourself again. That’s okay! You experienced a lot of trauma and pain during your delivery and it is important for you to rest. We especially recommend a 5-5-5 step program during the first few weeks of your recovery – 5 days of rest, 5 days within reach of your bed, and 5 days within a short distance from your bed. Talk with your doctor before beginning any exercises or yoga poses that may affect your abdominal muscles and belly. Can Yoga Help You Lose Weight After Pregnancy? Although losing weight should never be the top priority in returning to yoga postpartum, yoga can help you lose some of the baby weight you’ve gained during your pregnancy. There are many other benefits to contributing yoga into your postpartum regimen: Body knowledge: Yoga can help you become familiar with vital parts of your body as you begin the restoration process. Body / Posture Alignment: Your body has undergone a lot of physical stress during your pregnancy and after your delivery. Many women experience shoulder, neck, bain, back, and hip pain due to delivering, carrying, and breastfeeding their child. It is also common for your organs to be displaced during your delivery. Yoga can help restore your body’s alignment and help loosen those tight muscles in your shoulders and chest! Mental Health: Participating in a postpartum yoga program can help you get to know other people, participate in relaxing and calming practices, and reduce stress and postpartum depression. What is Postnatal Yoga? Postpartum yoga is a one postpartum practice you can start a few weeks after your delivery. Not only can yoga help relieve symptoms of diastasis recti and a weakened pelvic floor, but it can also be a great way to relax and gradually regain your strength during your recovery. Below we have compiled a few yoga poses we believe are beneficial in your early recovery.

Postpartum physical therapy can be a great way to restore function and strength in your core and pelvic floor muscles. Giving birth places a strain on your body and it is no surprise that many postpartum people experience pelvic pain and discomfort for weeks to months after delivery. Even after the typical 8 week recovery time, many women may require more time or a pelvic floor workout plan to help get them back on their feet, especially women who delivered via C-section. Although you may never look how you did before your pregnancy, physical therapy post pregnancy can help relieve symptoms of pelvic organ prolapse, diastasis recti, and other postpartum symptoms. Physical Therapy After Pregnancy Physical therapy for pregnancy and after pregnancy can help strengthen and restore pelvic floor muscle and joint function, increase body awareness, and also provide education and instruction on how to modify your daily activities to serve you in your recovery. Some of the primary physical therapy options available include: Pelvic girdle and lumbar spine realignmentPrenatal tissue and joint mobilizationPostpartum external and internal tissue, joint, scar, and visceral movement therapyStrength training for pelvic floor musclesPelvic floor stabilization and core strength exercisesProper posture, postural strengthening for back painDiastasis recti rehabilitationBody mechanics training and educationAt home strategies and education for self-care How Do You Know if You Need Pelvic Floor Therapy? The two most common conditions many postpartum people face are diastasis recti and pelvic organ prolapse. Pregnancy and delivery create an imbalance of muscles and ligament tension. This can leave the pelvic floor and abdominals unsupported potentially leading to prolapse or DRA. If you are experiencing any of these symptoms, you may need to consider physical therapy or movement therapy: ConstipationUrinary incontinenceFecal incontinencePain during intercourseVaginal painRectal painLow back painPelvic painDiastasis Recti – separation of the abdominal musclesPelvic organ prolapsePubic bone painPelvic girdle pain A physical therapist can help you recover from many of these symptoms with the education and therapy options mentioned above. If your physical therapist is specially trained to treat pelvic floor issues, they can help significantly reduce the painful symptoms you may be experiencing while also strengthening your core and pelvic floor muscles. What Helps with Postpartum Pain? Physical therapy can be a great way to help women recover from postpartum issues. However, not all exercise routines or core training workouts are created equal. Restoring your body’s function is not something to do quickly or forcefully. Exercise is important, but resting and pacing yourself are far more vital to your recovery than rushing it. Postpartum recovery requires a specific re-training of your body to regain strength and integrity. Long-term functionality is better than getting slim fast. Exercise As you begin to exercise postpartum, it is important that your focus be on the major muscle groups affected by your delivery. Short spurts of slow, simple stretches and yoga poses are a great place to begin. Shoot for around 10 to 20 minutes a day of light exercise and stretching. Many exercises can be done during your recovery, but it’s important that you don’t overexert yourself before the 8 week mark is up (and for some women, even longer). As you continue to regain strength and functionality, you can gradually increase your workout time and intensity. Rest If I could have a dollar for every person who wished they had rested more in order to spare themselves injury. Rest is so important for healing your body postpartum and ensuring that you do not damage your core and your pelvic floor. We recommend getting back into exercise at least 8 weeks postpartum, but even then, easing into it is key.

Post-pregnancy pain, whether it be pelvic floor pain or joint pain, is a shared experience among many postpartum people. However, postpartum pain, especially in pelvic pain, can vary in frequency, length, and intensity. Some people may only experience short-term pain that lasts the first 4 – 8 weeks of their recovery and others may suffer from pelvic pain for up to or over a year after they’ve given birth. Pelvic organ prolapse and other forms of pelvic floor dysfunction are very common among postpartum people. Symptoms can vary in duration and severity, but many women are likely to experience a variety of symptoms during and after their pregnancy. At Restore Your Core, we’ve noticed similarities in many of our client’s stories. Some of the most common pelvic floor complications our clients experience include: Urinary incontinenceFecal incontinencePain during intercourseVaginal painRectal painLow back painPelvic painDiastasis Recti – separation of the abdominal musclesPelvic organ prolapsePubic bone painPelvic girdle pain Pelvic floor pain can be treated and relieved in many ways. Whether you visit a pelvic floor physical therapist or take part in a program like Restore Your Core, movement specialist or your physical therapists will utilize exercise methods designed to strengthen and restore function to your core, pelvic floor muscles, and relieve any painful symptoms you may be experiencing. In this article I will attempt to address the most commonly asked questions regarding pelvic pain after giving birth. How Long Does it Take for Your Pelvic Floor to Recover After Childbirth? After giving birth, your pelvic floor and core muscles will be in the process of healing for at least a year. Although many women may begin being active again after the first 8 weeks postpartum, often pelvic pain and the symptoms of diastasis recti may be experienced for months postpartum. Both your core and your pelvic region have gone through significant changes in order to accommodate your baby. Attempting to quickly get back into an exercise or workout routine may be unhelpful in your recovery – especially if you are already experiencing complications or painful symptoms. Every postpartum person is different and the recovery length can change depending on many factors. Healing can take anywhere from a few months to over a year, depending on whether or not there are underlying conditions which may be increasing the pain. While there are no overnight success stories, there are many many success stories of people like you who have healed their pelvic organ prolapse by taking these steps slowly and surely. However, there are many things you can begin doing now to help begin the healing process. Here is a video summary covering some of the steps you can take to begin healing your pelvic floor. Is it Normal for Your Pelvis to Hurt After Pregnancy? Yes! Postpartum pelvic pain is very common. During childbirth, your ligaments and joints become loose as your body is adapting to your child’s weight, abdominal separation, and increased heaviness in your pelvic floor. It is common to experience pain in your pelvic girdle, hips, and joints as a result. Light recovery exercises and movement can also cause minimal pain as you begin strengthening your pelvic floor muscles. Seeing a pelvic floor physical therapist or enrolling in a yoga or postpartum exercise program can help relieve urinary incontinence, back pain, and other postpartum pelvic issues.

Giving birth takes a toll on your body – both physically and emotionally. Many postpartum people will feel overwhelmed and exhausted after giving birth, which can make it difficult to return to a daily regimen. Other people, especially those who had a regular workout plan before and during their pregnancy, may attempt to get back to their fitness regimen before they are ready. It is important to have a postpartum workout plan, but how do you know when it is the right time to begin? In this article I hope to answer your most pressing questions regarding postpartum exercise and when to begin. How Soon Can You Exercise After Giving Birth? Before you begin a strenuous exercise routine, it is important that you have clearance from your medical provider to begin exercising. This is especially true if you have had a c-section or had a complicated pregnancy or birth. In most cases, people who had a vaginal delivery can begin light physical activities a few weeks post pregnancy. Yet, you should only begin exercising as you are able. During your 8 week postpartum check up, your doctor will most-likely recommend beginning returning to your normal pre-pregnancy routine. This can include light exercise and beginning to develop a workout plan for the months ahead. It is important that during this time you take it slow. Focusing more on spending time with your baby, your mental health, and making gradual steps toward recovery are more important than trying to lose weight fast or regaining that sexy, pre-pregnancy body. Over the first 8 weeks or more, you may gradually integrate workouts as you regain strength in your core, upper and lower body, and neck. Ensuring that you make smart choices in your workout plan can help prevent overexertion, postpartum pain and bleeding, and help you reach a safer, sustained postpartum recovery. It is true that 8 weeks or more can feel like a very long waiting period, but your overall health is more important than a slim body. However, making sure that the early stages of your recovery are done carefully can help you get back to a more intensive postpartum workout plan safer and sooner. Rest, hydration, and nutrition should be the focus in the early stages of your recovery. When to Start Postpartum Workouts? The appropriate time to begin postpartum workouts varies depending on your delivery experience. As mentioned above, many women who delivered their child without any complications or if they delivered vaginally, may begin with light exercise (i.e. walking, food prep, household activities) only a few weeks after their delivery. Women who delivered via c-section or experienced complicated birth, should wait until the 8 week mark, or talk with their medical provider before starting a fitness plan. I always recommend waiting at least 8 weeks, regardless of delivery method, in order to approach recovery well and safely. What Are the Benefits of Exercising Postpartum? Building a smart postpartum workout plan and returning to a consistent fitness routine may help many postpartum people close their diastasis recti gap, begin strengthening their pelvic floor, and help reduce baby weight. Some women may benefit by experiencing a sense of normalcy as they begin returning to their pre-pregnancy routine, others may benefit by having time dedicated to personal health and recovery – both with their bodily and mental health.

It is not uncommon for many postpartum people to experience complications such as pelvic organ prolapse postpartum. Vaginal and rectal prolapse occur when the supporting muscle and tissue structures become weakened during pregnancy and delivery. Despite common belief, prolapse does not only affect women who have had multiple pregnancies or are outside of the advised age, but it can also affect many postpartum people as well. It can be a surprising and shocking experience for many postpartums to discover they have developed a prolapse after vaginal birth. However, in some cases, the symptoms will resolve on their own as their body recovers from delivering their child or can be managed and healed through exercise and proper postpartum aftercare. In this article I hope to address the ways postpartum people can manage prolapse after childbirth and how you may experience a full recovery. How Common is Prolapse After Childbirth? The truth is, your pelvic floor and uterine wall experience a lot of stress during your pregnancy. In many cases, people will begin experiencing the complications of prolapse and other pregnancy related issues before they deliver their child. A stressful or complicated delivery is not always the culprit for POP or DR. As your child continues to grow within you, the supporting tissues and muscle structures are strained, which can lead to you experiencing complications even before birth. However, it is common for many people to become aware of these issues postpartum. The weakness in the pelvic region can cause some of your pelvic organs (bladder, bowel, uterus) to slip out into the vaginal or rectal walls. Despite many people experiencing resolved symptoms as they continue to heal after their delivery, many may still experience future complications. Some of the most common types of pelvic organ prolapse include: Uterine prolapse –uterine prolapse involves prolapse of the cervix and uterus down into the vagina Bladder prolapse (cystocele) -involves a prolapsed bladder into the front wall of the vagina Bowel prolapse (rectocele) is the prolapse of the vagina into the back wall of the vagina or rectum. In some cases, these prolapses may coexist. Example: you may experience both a uterine prolapse and bladder prolapse at the same time. Is it Normal to Have a Slight Prolapse After Giving Birth? In short, it is not uncommon for people to experience a prolapse after giving birth. As you undergo the many hormonal changes, physical strain and stress, and the weight of your child can weaken the supportive tissues and muscles in your pelvic floor – causing the organs to shift and become misaligned. Along with the hormonal and physical demands pregnancy can place on your body, a vaginal delivery can also contribute to pelvic prolapse as well. The stretching and straining of the pelvic muscles beyond their limits can significantly compromise the strength and functionality of the pelvic region. Over-stretching can leave scarring and nerve damage resulting in damaged tissues and muscle structures – leading to pelvic organ alignment issues and can cause them to shift downward into the vagina. There are a host of factors that can contribute to various forms of pelvic organ prolapse. Some of the most common include: A traumatic deliveryBaby’s birth weightPelvic floor muscle weaknessChronic straining during bowel movements, constipationChronic coughingMultiple pregnancies, deliveries How is Postpartum Prolapse Treated? There are many options out there to help you recover from postpartum pelvic organ prolapse. It is important that after your delivery (once you’ve received clearance by your medical professional), to begin a form of postpartum rehab. Offerings can range between physical therapy, physiotherapy, or movement specialists (Restore Your Core). In many cases, you would treat this condition as you would any other physical injury: REST and light movement.

It is common for many women to experience postpartum complications like a prolapse. A prolapse happens when a part of your body (intestines or tissues) bulges or "falls out" into either the rectum or vagina due to weakened muscles structures and tissues. Prolapse doesn't only affect mothers outside of the advised childbearing age, but can also affect new moms as well. Many young mothers may be surprised or shocked to hear they developed a prolapse, but it is a very common postpartum condition, especially post-vaginal birth. Managing a prolapse - whether it be a vaginal prolapse, uterine prolapse, bladder prolapse, or other kind of pelvic organ prolapse - can add to the emotional and physical stress many new mothers may already be facing. However, it is possible to heal from a prolapse and make a full recovery! In this article I hope to address postpartum prolapse and how you can experience a full recovery. How Common is Prolapse After Childbirth During the postpartum period, it is common to experience a pelvic organ prolapse. The tissues and muscle structures that support your pelvic floor may have been weakened over the course of your pregnancy and during delivery. The weakness in the pelvic region can cause some of your pelvic organs (bladder, bowel, uterus) to slip out into the vaginal or rectal walls. Yet, though it is common for women to experience a prolapse post-pregnancy/childbirth, pelvic floor therapy can help improve the condition. In many cases, the initial presentation of prolapse can resolve on its own as you continue to heal - yet, there can still be complications in the future. Some of the most common types of pelvic organ prolapse post-childbirth include: Uterine prolapse –uterine prolapse involves prolapse of the cervix and uterus down into the vagina Bladder prolapse (cystocele) -involves a prolapsed bladder into the front wall of the vagina Bowel prolapse (rectocele) is the prolapse of the vagina into the back wall of the vagina or rectum. In some cases, these prolapses may coexist. Example: you may experience both a uterine prolapse and bladder prolapse at the same time. Prolapse After Delivery - Causes Pregnancy is the most common contributor to the development of a prolapse. The hormonal changes, physical stress and strain, and the additional weight of your baby can soften the supportive tissues and muscles in your pelvic floor. This can cause your pelvic organs to shift and move from their normal alignment. Along with the hormonal and physical demands pregnancy can place on your body, a vaginal delivery can also contribute to pelvic prolapse as well. The stretching and straining of the pelvic muscles beyond their limits can significantly compromise the strength and functionality of the pelvic region. Over-stretching can leave scarring and nerve damage resulting in damaged tissues and muscle structures - leading to pelvic organ alignment issues and can cause them to shift downward into the vagina. There are a host of factors that can contribute to various forms of pelvic organ prolapse. Some of the most common include: A traumatic deliveryBaby's birth weightPelvic floor muscle weaknessChronic straining during bowel movements, constipationChronic coughingMultiple pregnancies, deliveries How Do You Fix a Prolapse After Giving Birth? There are many options out there to help you recover from postpartum pelvic organ prolapse. It is important that after your delivery (once you've received clearance by your medical professional), to begin a form of postpartum rehab. Offerings can range between physical therapy, physiotherapy, or movement specialists (Restore Your Core). In many cases, you would treat this condition as you would any other physical injury: REST and light movement.

A uterine prolapse occurs when the pelvic floor becomes weakened and the surrounding tissues, muscles, and ligaments are unable to provide proper support to the uterus. This may lead to the uterus descending down or into the vagina. In more severe cases, the uterus may protrude out of the vaginal opening. Although uncommon, some complications may arise if left untreated. An ulceration of exposed tissues or additional prolapses may occur: rectal or bladder. However, there are many different treatment options available to you! In this article we address uterine prolapse and how you may find treatment without the need of surgery. What is a Prolapse? A prolapse or a pelvic organ prolapse, happens when 1 or more organs become displaced. They can either bulge into the vaginal canal or into the rectum. The most common forms of prolapse are uterine prolapse, bowel (rectal) prolapse, and bladder prolapse. These conditions are not life threatening, but may cause painful or uncomfortable symptoms. In many cases, we at RYC®, have noticed that these symptoms are often relieved and treated through corrective exercise and various lifestyle changes. What is a Prolapsed Uterus? Uterine prolapse is a particular kind of pelvic organ prolapse. Although it is more common during pregnancy and childbirth, a uterine prolapse can occur in women of any age and stage of life. Women who are postmenopausal or have had multiple deliveries may be at a higher risk of developing a uterine prolapse. However, in many cases, surgical treatment is not required. A mild or minor prolapse may resolve through minor lifestyle, exercise, or diet changes. Some providers recommend surgery when prolapse causes pain or unbearable discomfort that interrupts your daily life. Stages of Uterine Prolapse A uterine prolapse is often categorized in two different ways: incomplete or complete. An incomplete uterine prolapse is defined by a partial displacement of the uterus into the vagina, without protrusion. A complete uterine prolapse is defined by a partial or full protrusion of the uterus out of the vaginal opening. A complete prolapse is then graded in severity, depending on how far the uterus has descended. 1st grade: when the cervix has descended into the upper vagina2nd grade: the cervix has descended to the vaginal opening3rd grade: the cervix has protruded outside of the introitus4th grade: the uterus and cervix have both descended out of the vaginal opening In many cases, exercise may be able to help. In severe cases there may be a need for medical treatment. If you have concerns, it is always best to consult a health professional for a diagnosis. Symptoms of a Uterine Prolapse There are many different symptoms that may arise depending on the severity. The most common symptoms of uterine prolapse include: a feeling of heaviness or pulling in the pelvic floor musclesincreased vaginal discharge or bleedingpainful or difficulty having sexurinary incontinence or urinary retentionchronic constipation, bowel movement difficultylumbar spine painbulge or protrusion from the vaginal openingfeeling or sensation of something falling from the vagina or like sitting on a ballweak vaginal tissue

What is Rectal Prolapse? Rectal prolapse is another form of pelvic organ prolapse. Rectal prolapse occurs as a result of the rectum (the last part of the large intestine) being displaced or forced from its normal position. This can lead to the rectum descending or protruding out of the anus. Rectal prolapse is often more common in older adults, more often in older women, who have experienced prolonged issues with constipation or pelvic floor issues. However, rectal prolapse can affect men and women in various stages of life. Although it is reported to be more common in women postmenopause, it can also occur in people much younger as well. In this article we will address some of the most pressing questions regarding rectal prolapse and how it may be treated. Types of Rectal Prolapse As with other forms of prolapse, rectal prolapse is often a term that defines various stages of a herniated anus. The three types of rectal prolapse include: Stage 1: the rectum has become displaced, but does not protrude out of the anal cavity (also know as an internal prolapse)Stage 2: the rectal lining begins to descend into the anal cavityStage 3: the rectum extends out of the anus entirely. In many cases, people have found relief without the need of medical or surgical attention. However, in severe cases, medical attention may be necessary. Causes of Rectal Prolapse A rectal prolapse may occur due to various health conditions or as a result of aging. In some cases, it may be a result of complications during pregnancy or injuries to the pelvic or bowel region. Below are a few possible causes of rectal prolapse. Chronic constipation or diarrheaProlonged or chronic history of straining during bowel movementsOld age: as you grow older, it is common to experience a weakening of the rectal and anal muscles and ligaments. It is also common to experience similar weakening in the pelvic floor, which can create additional weakness in your core.Weakening of the anal sphincterInjury or past surgical procedures to or near the anal and pelvic regionsNerve damage: If the nerves that control your ability to contract the rectum or anus are damaged, rectal prolapse may occur. This can be due to complications during vaginal delivery, paralysis, a spinal injury, lumbar spine surgery, or other surgeries in the pelvic area.Other diseases, conditions and infections: There are many other possible causes for rectal prolapse. These can include health conditions such as diabetes, cystic fibrosis, parasitic infections, or other diseases. Or, it may be caused by other corrective surgical procedures, such as a hysterectomy. Rectal Hernia Symptoms The most common symptoms of rectal prolapse is the feeling of a bulge or ball extending out of the rectum. This can look like a reddish-colored mass extending outside of the anus, or, in the case of an internal prolapse, feel as if something is stuck in your rectum. These symptoms are often experienced during or after a bowel movement. In many cases, the symptoms will resolve quickly. However, if you have a moderate to severe rectal prolapse, over a prolonged period of time, you may experience the rectum protruding out of the anus at the end of the day. This is often spontaneous and may not require force or straining. Other symptoms may include: Anal painRectal bleeding (may appear like a hemorrhoid)Fecal incontinence (mucus, blood, stool) The symptoms you suffer may change depending on the severity and progression of your prolapse. Diagnosis A rectal prolapse requires a proper diagnosis in order to rule out conditions that may correlate. In order for you to receive a proper diagnosis, your doctor will have to perform a rectal exam. Your doctor may ask you to sit on a toilet and attempt to perform a bowel movement in order to see the prolapse.

The uterus is one of the most important support structures in the pelvic floor. It provides support for the vagina and can help prevent conditions like vaginal prolapse or bladder prolapse. A hysterectomy removes the uterus, thus, removing additional vaginal support. In 2008 and 2014, two studies were conducted to determine whether or not the risk of prolapse developing increased once the uterus was removed. Both studies concluded that the possibility of developing vaginal prolapse 1 to 2 years post surgery is greater than not having the procedure done at all. The most common form of vaginal prolapse associated with a hysterectomy is called enterocele – the small intestine herniating down toward the vagina. However, depending on the type of hysterectomy and your recovery, there is a risk of developing various types of vaginal prolapse. Prolapse After Hysterectomy Symptoms Although a hysterectomy is often recommended as a way to treat uterine prolapse. However, even a surgical procedure that seeks to resolve one issue, may run the risk of presenting complications during or post recovery. Removing the uterus may put you at a higher risk pelvic organ prolapse. Below are a few symptoms you may experience if this is the case. The Most Common Prolapse Symptoms Oftentimes, when a person is suffering from a vaginal prolapse, they may experience a feeling or sensation of pressure or heaviness in the vaginal region. This may present as a throbbing pain or a slight discomfort. Some people also report: A sensation of fullness (like something is stuck, or like sitting on a ball)Feeling as if something is falling out of the vagina. Other Possible Prolapse Symptoms Your pelvic organs are all supported by each other. If one is removed or if you are recovering from a previous prolapse, it may affect the ability for the other supporting organs to function properly. In some cases people report:Difficulty performing bowel movementsUrinary incontinence, or retention (difficulty emptying the bladder)Secondary prolapses – especially rectocele and cystocelePain, discomfort during sexDifficulty using tampons Pelvic Organ Prolapse After Hysterectomy After a vaginal hysterectomy, many women are at risk of prolapse developing. The pelvic organs may become unsupported and slip (such as the bladder or intestines) and descend or herniate into the vaginal region. If you are experiencing increased pelvic pressure after your hysterectomy, it may be best to consult your doctor for a proper diagnosis, as this may be a sign of prolapse. It may be helpful to understand how this happens and why you may be at a higher risk of prolapse after having a hysterectomy. Each of the organs located in the pelvic region are all supported and attached to the pelvic wall by the same ligaments, muscles, and tissues. If the uterus and cervix are removed, support structures must be added in order to maintain the normal support that was previously there. This may actually leave the pelvic area less secure and more vulnerable to prolapse. If prolapse does present post-hysterectomy, there are a few that are more prone to occur. These include: Vaginal vault prolapse: This occurs when the vaginal vault (the top portion of the vagina) descends into the lower part of the vagina. In very severe cases, the vagina may actually turn inside out and protrude outside of the person’s vaginal opening.Cystocele: Also known as bladder prolapse, this occurs when the supportive tissues between the vaginal wall and bladder are stretched or weakened, causing the bladder to descend into the vagina.Rectocele: Rectocele occurs when the tissues and muscles that separate the rectum from the vagina are compromised. This can cause a bulge in the back vaginal wall.Enterocele: This occurs when the small intestine herniates and drops into the pelvic cavity, pressing against the vagina. This may occur simultaneously with rectocele after a hysterectomy.

You did it. You birthed a bouncing baby and your body is in recovery from enduring the sheer awesomeness that is childbirth. As the months that follow unfold and that baby starts to grow, you can’t help but shake the feeling that something is not quite right down there. Why is peeing so weird now? When did my body decide it was okay to just leak out said pee every time I cough? Am I supposed to just wear panty liners all day every day just in case someone makes me laugh? Why does it feel like there is a bulge in my vagina? Though it is a common post-birth issue, the first time you hear that you have pelvic organ prolapse may be frustrating and quite upsetting. I mean, your body was made to have babies. Why would something so natural cause such an issue? Avoiding the S Word Your doctor may suggest many treatment options to help prevent your prolapse from advancing to the point where they begin to start talking about surgery. Surgery is a SCARY word that we would like to help you avoid. Prolapse reconstruction surgery, or Vaginoplasty, may be recommended in advanced cases. However, if you aren’t severely prolapsed, there are steps you can take that may help you avoid surgery all together. Yes, early prolapse can be corrected without ever ending up under the knife. Even a grade 3. Popular less invasive treatment offered can include vaginal pessaries and Kegels as the only form of pelvic floor treatment. Don’t hear me wrong, these can be very helpful, but I am more a fan of using a functional, whole body exercise approach to healing core and pelvic floor issues. Here at Restore your Core®, we are fellow partners of your health-focused team and are seriously invested in empowering you to make every movement throughout your everyday life healing. We believe and have seen first hand with many clients, that our 12-week program can train you to bring symptom relief and avoid the discussion of surgery altogether. No matter when you discover a prolapse, we always recommend 1 year of pelvic floor rehab before deciding on more drastic routes.  Pelvic Organ Prolapse: What is it? First things first, let’s make sure we are all speaking the same language here: pelvic organ prolapse is the injury in which one or more of your pelvic organs “drop” from their normal position. Though bladder prolapse is the most common, any pelvic organ (bladder, uterus, rectum) can make the descent. This injury happens for a variety of reasons and sometimes, it is really not known why. Birth injury, core and pelvic floor muscle imbalances, postural misalignments, and excess intra ab pressure are all reasons one might sustain a prolapse. If pelvic organ prolapse is allowed to advance to its fullest potential, the prolapsed organ will make its way down the path of least resistance into the vaginal canal. Eventually, the organ may exit the vaginal opening. Different types of Pelvic Organ Prolapse include: Bladder prolapse- Cystocele (the most common)Rectum prolapse- RectoceleUterine Prolapse Vaginal Vault ProlapseSmall Intestine Prolapse- Enterocele Though pelvic organ prolapse can be caused by obesity, aging, and other stressors on the floor muscles, vaginal birth is the leading cause of prolapse. As you can imagine, vaginal birth does a number on those pelvic floor muscles because of the amount of stretch the pelvic floor muscle must undergo to make way for the baby’s grand entrance into the world. This is why it is pretty common to pelvic floor prolapse after childbirth.

Surgery for pelvic organ prolapse is a big deal. It is a big deal because you live in an age where you have many pathways to health, and don’t have to live with pelvic organ prolapse.Although surgery can be a viable, medically recommended option for many people, it is very invasive without a guaranteed outcome. Some people may find relief from their painful symptoms, yet, like many procedures, it can often require more intensive medical treatmenteven after the first surgery was performed. Surgery should be considered a last option when dealing with core, pelvic floor, or other related issues. To be clear, our goal here at Restore Your Core is to strengthen your core and pelvic floor so you can live without surgery being a part of your story. Thousands of women use our program with amazing success as an alternative route to surgery because we work to restore function and integrity to the pelvic floor. However, we do not judge anyone’s choice to have surgery and we understand that sometimes it is the only choice! We support all choices so we would like to use this article to educate you on those choices. Please note, even if you decide on surgery, one year of pelvic floor rehab is very much recommended to prepare the body as it is a major surgery. Table of Contents How Do I Know if My prolapse is Severe?  Surgery is for severe cases. So when are you considered severe? We strongly urge you to discuss it with your provider and get multiple opinions from doctors and therapists regarding your case.  It is important to recognize that pelvic organ prolapse can involve one or more of your pelvic organs, including your uterus, bladder, and rectum. After injury to or the weakening of your pelvic floor muscles, your organs can drop into the wall of your vagina. We break down the different types of pelvic organ prolapse in other articles, but for your knowledge, we will include a list here: Bladder prolapse- Cystocele (The most common)Rectum prolapse- RectoceleUterine ProlapseVaginal Vault ProlapseSmall Intestine Prolapse- Enterocele How Do I Know What Stage My Pelvic Organ Prolapse Is? Severity of Pelvic Organ Prolapse has to be diagnosed by your healthcare provider, but the general rule of thumb for staging is: Stage 1: Very minimal prolapse – organs still have a fair amount of support by the pelvic floor.Stage 2: Pelvic floor organs have begun to drop, but they are still contained inside the vagina.Stage 3: Pelvic floor organs have dropped to, or beyond the opening of the vagina.Stage 4: Pelvic floor organs have dropped completely through the vaginal opening. What Happens if Prolapse is Left Untreated? That is hard to know because some women have it for years and it can stay the same! However, for others, it can actually get worse. It can depend on a variety of factors, many might be out of your control: like tissue integrity and genes. Other elements, like movement and exercise choices are more in your control. Strengthening your pelvic floor can keep your organs from bulging further into the wall of the vagina without surgery.

Cystocele is the most common type of pelvic organ prolapse that occurs after vaginal childbirth. During a vaginal delivery, the pelvic floor muscles can be compromised as they stretch to make room for the baby to make its grand entrance into the world. The pelvic floor muscles are designed to hold up the organs of the pelvis. A severe enough breach in the system can cause a prolapse. When these muscles are compromised, the organs are able to drift or “sag” down the path of least resistance until they bulge into the vaginal canal. It is important to know that there are many types of pelvic organ prolapse besides cystocele that will not be discussed in this article, but are listed below for educational purposes: Urethrocele or prolapse of the urethraUterine prolapseVaginal vault prolapseEnterocele or prolapse of the small bowel Rectocele prolapse of the rectum What causes a Cystocele?  Cystocele (cysto- meaning bladder, -cele meaning pouching or herniating) is the downward displacement of the bladder that descends until the bladder bulges into the vaginal wall. This is sometimes referred to as “fallen bladder” or “prolapse of the bladder.” Though it is possible that cystocele occurs because of reasons outside of childbirth, such as genetic disposition, increased age or obesity, it is most commonly seen in women who have experienced a vaginal delivery. How is a cystocele diagnosed?  Methods of diagnosis depend on how much the prolapsed bladder has advanced from its usual position.  The pelvic exam is used for the obvious prolapsed bladder. The provider may only need to do a visual exam of both the vaginal opening and the pelvis to spot the bladder in late staged prolapse (I’ll break down the stages for you momentarily). Typically this presents as a pronounced bulge in the vaginal canal or through the opening of the vagina. I strongly recommend doing this exam from a standing position.  A voiding cystourethrogram may be used in less obvious cystoceles since the prolapsed bladder is not always visible In the vaginal opening in earlier stages of descent. Essentially, an X-ray is taken of the bladder while you urinate to capture the shape and placement of the bladder and vagina during the effort. Your provider will guide you through the preparation for this procedure, but there are typically no special precautions needed. What are the symptoms of Cystocele?  Symptoms of a cystocele vary from mild, moderate or severe depending on just how far that bladder has sagged from its usual position.  Typically the first tell tale sign is a feeling of bulging in your vagina, heaviness, fullness, feeling of bubbles in your vagina and a change in your urine frequency/incontinence after a vaginal delivery that doesn’t improve over time.  If it is more advanced you may be able to see the bulge formed by the bladder prolapse in the canal or vaginal opening. Heavy lifting, bearing down or straining during bowel movements may increase the feeling of pressure in the pelvic floor. Some women report feeling as if they are sitting on a ball. 

Rectocele Symptoms A woman’s vagina is separated from her rectum by ligaments and tissues known as the rectovaginal septum. The tissues that line this wall are called fascia. At times, due to compromised pelvic health or pelvic injuries, a woman may experience a weakness of the vaginal wall and rectovaginal septum. When this occurs, a part of the rectum can bulge and protrude into the vagina. This is called a rectocele prolapse. What is Rectocele? Rectocele is a condition which causes the supportive tissues between the rectum and the vagina to weaken. This can occur due to excess pressure in the rectum, excess vaginal pressure, or excess intra-abdominal pressure leading to pelvic floor issues such as pelvic organ prolapse (POP). When this occurs, the separating tissues can herniate causing the front wall of the rectum to bulge into the vagina. This issue is also commonly called a posterior vaginal prolapse. Oftentimes, the prolapse is small and does not pose any painful symptoms or difficulties. However, in severe cases, the bulge may manifest outside of the vaginal opening and require surgical repair. Signs and Symptoms of Rectocele In many cases, someone may have a rectocele for a long period of time without noticing any symptoms. In minor to moderate cases of symptomatic rectocele, someone may experience feelings of mild discomfort, pressure, or minor pain in the vaginal or rectal regions. This may be accompanied by a feeling of incompletion after bowel movements. In moderate to severe cases, women with a rectocele may have an increased sensation of pain and discomfort in their vagina, rectum, or abdomen while pooping. This can be a result of the feces being pushed into the rectocele during a bowel movement. Women with moderate rectocele run a higher risk of constipation, painful intercourse, and lower abdominal and lower back pain. In severe cases, the rectocele can prolapse causing the tissue to protrude out of the vaginal opening. Other symptoms of rectocele may include: A small bulge in the wall of the vaginaNeeding assistance of fingers to perform a bowel movementPressure in rectumA feeling like an “air bubble” in the vaginaPain, discomfort, or feelings of looseness during vaginal intercourse Other pelvic organ prolapse issues such as vaginal prolapse, uterine prolapse, rectal prolapse, or other issues with the pelvic floor. Rectocele is a common condition many women may face without ever knowing it. Most often it is associated with postpartum issues, but it can affect women who have never been pregnant as well. If you are experiencing severe issues such as: tissue bulging through your vaginal opening or constant struggles with constipation, it may be time to consult your doctor for a proper diagnosis. Generally a Urogyn is the best bet for diagnosis.

Rectocele Repair Repair for a vaginal rectocele is pursued in order to correct the herniation or bulging of the bottom wall of the vagina. Symptoms of rectocele can become quite uncomfortable and painful over time. If left untreated, rectocele can lead to symptoms such as: the feeling of increased pressure or protrusion in the vagina or rectum, inability to defecate or feeling of incomplete emptying of the bowels, pelvic pain, and/or painful sex. Both non-surgical and surgical procedures for rectocele repair are only considered if symptoms become severe and inhibit daily life. Surgery for rectocele is typically performed transvagianally, yet, in some severe cases, may be completed both vaginally and abdominally. Why Do I Need Treatment for Rectocele? Treatment for rectocele can greatly aid in managing and reducing symptoms of rectocele or other forms of pelvic organ prolapse. In some cases, rectocele and POP may be undetectable until the condition has progressed in severity. A small rectocele is often unrecognized until a doctor notices it during a physical examination. In many cases, rectocele occurs alongside other pelvic organ related conditions.  Treatment is designed to help reduce symptoms and heal any herniations, tears, or prolapses. Treatments include both surgical and non-surgical options. Although surgery for rectocele is often rare, in severe cases surgery may be your best option. Severe rectocele symptoms include: Bowels feeling full post defecationA noticeable bulge or protrusion in the vaginaInability to perform a bowel movementRectal incontinence Is Rectocele Repair Major Surgery? Rectocele repair surgery is a major, out-patient surgery. A doctor will typically only recommend surgery for rectocele if at home exercise programs and / or physical therapy has not resolved the problem. The surgical procedure for rectocele removal is called posterior colporrhaphy which removes the herniated bowel from the wall of the vagina. Rectocele surgery is designed to: Ease pain and discomfortMinimally invasive transvaginal procedureOutpatient (usually released without needing overnight stay)Quick recovery time (2-3 weeks or less on average) What is a Rectocele Repair Procedure? The procedure for rectocele repair surgery is typically a straightforward process. The surgery is often performed through the vagina (transvagianlly.. The procedure is typically performed by a surgeon making a small incision along the posterior vaginal wall. Excess tissue along the herniation is removed and stitches are sewn around the tear sight. If the doctor notices any other forms of pelvic organ prolapse, he may resolve those issues as well during the procedure. Once complete, the vaginal incisions are stitched up and packed with gauze. Please speak with your doctor for more information on this process.

Rectocele Prolapse Rectocele is a herniation of the tissue wall between the vagina and the rectum. Over time, this tissue wall - also known as the rectovaginal septum - can become weakened resulting in a pelvic organ hernia or pelvic organ prolapse. In this article we will discuss what a rectocele is, what the symptoms are, and how it can be treated. What is a Prolapsed Rectocele? A rectocele is a herniation, prolapse, or weakening of the rectovagianl septum (tissue wall between the rectum and the vagina). Rectocele is also commonly known as a posterior vaginal prolapse or a proctocele. This can occur as an isolated injury or gradual weakening of the tissues, or occur as a result of prolonged pelvic floor dysfunction. When the pelvic floor is weakened along with the ligaments and tissues between the vagina and the rectum, it can cause the vaginal and rectal walls to weaken and bulge leading very painful symptoms and other pelvic organ related issues. In severe cases, the vaginal or rectal walls can bulge and protrude from the vaginal opening. Other types of Pelvic Floor Prolapse There are several other types of pelvic organ prolapse that may present themselves in similar ways as rectocele: Cystocele, or anterior vaginal prolapse: occurs when a woman's bladder bulges into the vaginal wallUterine prolapse: occurs when the uterine walls become weakened or unsupported and the uterus bulges into the vaginal wall.Rectal prolapse: occurs when the rectal wall is weakened and protrudes through the anusVault prolapse: occurs when the vaginal vault (top of the vagina) bulges. Pelvic prolapses can vary greatly in their severity and at times, different types may occur simultaneously. What is the Main Cause for a Rectocele? Although the exact cause of a rectocele is unknown, it is most commonly a result of a weakened pelvic floor and often goes hand in hand with excess pelvic pressure and intra abdominal pressure. A woman's pelvic floor can become weak after undergoing physically traumatic experiences such as: childbirth through vaginal delivery, difficulties with vaginal childbirth (if forceps or a vacuum were used, vaginal tearing, or an episiotomy). It is common for women to experience some form of pelvic floor or core weakness related issue postpartum. However, women who have never been pregnant can still develop a rectocele. Other Causes of Rectocele There are several other factors that may lead someone to develop a rectocele. Posterior pelvic organ prolapse can occur as a result of increased, intra-abdominal pressure. Outside of pregnancy, other causes of rectocele and increased pelvic pressure include: Chronic constipationStraining, difficulty in performing bowel movementsChronic cough, pneumonia, or bronchitisHysterectomyPelvic region surgeryImproper heavy lifting techniquesObesityAge

Pelvic Floor Stretches Persistent pelvic floor pain can be difficult to endure. Pelvic floor dysfunction issues can range between hyperactivity to pelvic organ prolapse. The result of both cases can lead to painful and embarrassing symptoms for both men and women. In this article, I will address helpful exercises and stretches that help free you of painful symptoms and aid in restoring pelvic floor and core function. To be clear, stretching is just one type of input into the pelvic floor system and is not the only thing you should do for a tight / tense pelvic floor. Downtraining your pelvic floor will require a variety of loads and inputs, stretching is one important one. How to Stretch Pelvic Muscles There are several ways you can properly stretch and engage your pelvic floor in order to reduce pelvic floor tension . One of the most beneficial and important techniques that I teach my clients is 3-D breathing – a pattern of breathing that uses the rib cage expansion rather than belly expansion for an effective and efficient strategy. One of the key elements in resolving pelvic floor dysfunction and POP is breathing mechanics. In Restore Your Core, I spend a significant amount of time teaching my clients proper breathing mechanics. Often people don’t realize the way they breathe impacts the integrity of their core and pelvic floor. Yet, most of us do not even realize easily we can fall into improper breathing patterns. Most people are belly breathers. This means that while inhaling, they’re extending their abdomen – focusing the tension in their belly. An Illustration of this would look like filling an oval-shaped balloon with water and squeezing the top creating a bulge. The exact same thing happens when you belly breathe. Bulging your gut strains your core and pelvic floor by increasing intra-abdominal pressure. This tends to cause muscle and organ damage in those regions. Our pelvic floor is not designed to handle a lot of consistent pressure and stress. I spend a lot of my time with clients training them to 3-D breathe. 3-D breathing trains you to engage your diaphragm and rib cage while breathing. This means that instead of your belly extending as you inhale, your rib cage expands. Breathing in this manner reduces pressure in your core and pelvic region. Additionally, this technique encourages proper core response and engagement in your daily activities. Now that you understand proper breathing mechanics, it is time to learn how to properly stretch and exercise your core and pelvic floor. Stretches for the Pelvic Floor: Supine Pelvic Floor Stretch Lying on your back, keep your knees bent and bring them toward your chest. Slowly extend your knees to the side to stretch the inner groin. Relax your pelvic floor and butt. Remain in this position for 5 to 10 breaths and relax.

Pelvic Floor Therapy Pelvic floor therapy is recommended for conditions where the pelvic floor and core system is not functioning optimally. Pelvic Floor Dysfunction and its related conditions can be caused by many different things. These can include: InfectionsPregnancy or childbirthPoor postureTraumaChronic back painSurgery However, PFD can also seem to have no cause and present itself with a host of painful symptoms. In some women, the cause of PFD can be a result of postpartum diastasis recti. The pelvic floor is made up of muscles and other tissues which form a sling from the pubic symphysis to the tailbone. Many cases of PFD stem from a lack of sufficient support from the pelvic floor. These pelvic floor muscles assist in maintaining correct posture, abdominal and pelvic organ support, and aid in bladder and bowel control as well as sexual activity. If these muscles become overactive or overused (hypertonic), the results can be quite painful and function can decrease significantly. Less often, the pelvic floor muscles are hypotonic–lacking sufficient resting tension to perform their jobs. Yet, due to the complexity of the anatomy and functions of the pelvic region, the underlying cause of pain can be difficult to determine. In this case, the whole body must be treated and physical therapy including pelvic floor exercise can greatly aid in men and women in their healing process and recovery. Why do I need pelvic floor therapy? (POP) or pelvic organ prolapse is a type of pelvic floor dysfunction in which one or more pelvic floor organs (i.e. bladder, rectum, small bowel, uterus, etc) shift toward or down into the vaginal canal. This most commonly happens with conditions like diastasis recti, which create an imbalance of muscle and ligament tension supporting the pelvic floor; many people who have POP also have a DRA. Women who experience a pelvic organ prolapse sometimes describe the occurrence as feeling like a “stuck tampon,” a heavy pelvic floor, or as bubbles in the urethra. Some other symptoms present may include: constipationpelvic pain during sexurinary/fecal incontinence Most fitness gurus try to educate their clients with core exercise routines that engage the pelvic floor and the core together. They believe that if you engage your core in any activity, you should also engage your pelvic floor. However, I believe there is a lot wrong with this routine and practice. As a trained and educated professional, I never, ever attempt to teach pelvic floor muscles to engage in exercise. Rather, it is important to train the pelvic floor to lift and release appropriately depending on the exercise and the weight. This is what I teach in my 13-week program, Restore Your Core.

Is Pelvic Floor Repair Major Surgery? Pelvic floor repair surgery is the most common surgery for pelvic organ prolapse. Pelvic floor repair is a broad term used to classify a variety of simple, surgical procedures for repairing the pelvic floor. The three surgeries for pelvic floor prolapse include anterior repair, posterior repair, and a hysterectomy. Although Restore Your Core does not provide any surgical treatment for pelvic floor issues, my hope is that this article may answer any questions you may have regarding pelvic floor repair and the various procedures and treatments involved in getting you back to a healthy, active lifestyle. What are the Symptoms of Pelvic Organ Prolapse? Prolapse can affect several abdominal organs. These organs are said to prolapse if they descend into or out of the vaginal canal or anus. The medical terminology for these occurrences include: Cystocele: prolapse of the bladder into the vagina, the most common conditionUrethrocele: prolapse of the urethra (the tube that carries urine)Uterine prolapseVaginal vault prolapse: prolapse of the vaginaEnterocele: Small bowel prolapseRectocele: Rectum prolapse What Causes Pelvic Organ Prolapse? There are many factors that are thought to cause a prolapse. In most cases, anything that may apply or put increased pressure in the abdomen can lead to a pelvic organ prolapse. Some of the common causes may include: Pregnancy, labor, and childbirth are the most common causesObesityConnective tissue disordersRespiratory problems with a chronic, long-term coughConstipationGenetic factors Pelvic organ cancersSurgical removal of the uterus (hysterectomy) Diastasis recti (weakened core, connective tissues) Symptoms The symptoms of a prolapse somewhat depend on which organ has descended. If you are suffering from a bladder prolapse, urinary incontinence may occur. If it is a rectal prolapse, constipation, painful bowel movements, and painful sex often occur. Lower back pain, painful sex, and bowel obstruction or incontinence tend to accompany a small intestine prolapse as well. If you are suffering from a prolapse of the uterus, you may also suffer from uncomfortable intercourse, incontinence, and lower back pain. In some cases, there may never be signs of a prolapse or the presence of any painful symptoms. However, in others some women report symptoms ranging from: Pressure or sense of fullness in the pelvic areaLower back painPainful sexSensation of something falling out of the vaginaUrinary incontinence or frequent urinationConstipationSpotting or bleeding from the vagina In cases where there may be a severe prolapse, POP symptoms may worsen. One may notice: Bulging of the vaginal regionNeeding manual assistance during a bowel movementDifficulty urinating, spraying stream of urineThe need to lift the bulging vagina in order to urinateUrinary leakage during intercourseRecurrent UTIs or kidney infections

Pelvic Floor Specialist Pelvic floor physiotherapists help women rehabilitate their pelvic floor region. The muscle groups within the core and pelvic region can be weakened by childbirth, surgery, genetics, heavy lifting, rapid weight gain, constipation, menopause, improper breathing mechanics, and more. These muscle groups aid in supporting the uterus, bladder, and bowels. They form a slinglike grouping from the pubic bone to the front of the tailbone at the back. Damaged or weakened pelvic floors can affect bladder and bowel control, leading to urinary and rectal incontinence or even pelvic organ prolapse. At times, the pelvic floor can become overactive or hypertonic. This means that their pelvic floor muscles are overly tight and tense all of the time, even when they should be relaxed. Learning to relax and release the pelvic floor muscles (muscles contractions like the short contraction of the bulging of a bicep or long contraction, like the slow, contained stretching out of a bicep) will help ease overactivity. An overactive pelvic floor can cause many symptoms such as: back pain, pain during sex, heaviness or incontinence. What is a pelvic floor specialist? Doctors who specialize in pelvic floor dysfunction issues are called urogynecologists and physiotherapists. A urogynecologist will care for women with pelvic floor disorders by providing services that help evaluate pelvic floor health and provide primarily surgical treatments for pelvic organ prolapse. Their speciality covers the muscles, ligaments, connective tissues, and nerves within the uterus, vagina, bladder, and rectum. A physiotherapist or Occupational therapist who specializes in pelvic floor treatment helps treat pelvic floor issues non-surgically. This is commonly done through exercise and manual therapy as well as extended education and advice on how to properly engage and strengthen your pelvic floor. Other specialists who aid in pelvic floor therapy include movement specialists and occupational therapists. Movement therapy can play a significant part in retraining the body toward correct posture, alignment, deep-tissue manipulation, and provide educational instruction on how the body works and how it heals. What is involved in pelvic floor physical therapy? Pelvic floor therapy most commonly involves exercises and education on how to properly engage and strengthen the pelvic floor. A specialist like a physiotherapist will help instruct their clients with a range of techniques ranging from: Breathing mechanicsTherapeutic exercise & core buildingPelvic floor realignmentProper postureSymptom treatmentPhysical education Pelvic floor therapy seeks to instruct women in how their bodies work while also treating any conditions causing pain or embarrassing symptoms – like pelvic organ prolapse. When seeking treatment for pelvic floor dysfunction or POP, there are a few things you should keep in mind.

Pelvic Floor Disorder Pelvic floor issues mostly occur when the pelvic floor muscles are lacking enough tone (hypotonic) or are too “tight” (hypertonic). Some people may experience weak pelvic muscles and core muscles from an early age. Others may not notice problems until after certain stages of life such as pregnancy, childbirth, or menopause. Something many women may not realize is that when pelvic floor dysfunction is present, it is a result of over toned, too short pelvic floor muscles. The pelvic floor cannot function in this state. Think of it this way - you can contract muscles and make them shorter (as in a bicep curl) or you can contract it by making it longer (releasing a bicep curl). Strengthening your pelvic floor means loading it long (like a slow, controlled release of a bicep curl). Overworking these muscles and connective tissues without learning how to properly engage the various muscle groups can keep you from relaxing them fully. The most common reasons why someone may be suffering from pelvic floor dysfunction are: Excessive pelvic floor tension Pregnancy and birth ongoing constipation and straining to empty the bowels being overweight or obese if it contributes to excessive intraabdominal pressure heavy lifting (e.g. at work or the gym) a chronic cough or sneeze (e.g. due to asthma, smoking or hayfever) previous injury to the pelvic region (e.g. a fall, surgery or pelvic radiotherapy) growing older Although it is hidden from view, your pelvic floor muscles can be consciously controlled and therefore trained, much like your arm, leg or abdominal muscles. A pelvic floor that is responsive to the varying loads placed on it keeps your organs functioning as they should--no more leaking pee when you sneeze. All people benefit from learning how to release and engage their pelvic floors, so that the pelvic floor reacts reflexively. What are the symptoms of tight pelvic floor muscles?  Symptoms vary from person to person. Some of the most common symptoms associated with pelvic floor dysfunction include: Stress incontinence (sneeze pee) Rectal incontinence Incessant need to pee (urge incontinence) Difficulty in emptying your bladder or bowel A prolapse (in women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping) Pain in your pelvic region Pelvic muscles spasms Painful sex Hypertonic pelvic floor muscles can result in painful and embarrassing symptoms. Pelvic pain and incontinence can be uncomfortable and embarrassing at best.. However, there are ways to begin releasing and integrating your pelvic floor muscles in order to gain back control over your body. What Causes Pelvic Floor Dysfunction? Pelvic floor dysfunction causes are still being researched. However, there are some common conditions that are linked with PFD and POP. Some of the common causes for the structure of the pelvic floor to weaken include: Childbirth & postpartum related issues Delivery trauma and more

Diastasis Recti is an incredibly common injury that many people visibly notice as an indentation in the middle of the belly. The rectus abdominus muscle is a pair of muscles that run along both sides of your stomach. Diastasis is often visibly noticeable when a gap between the pair of muscles occurs. Your abs are separated by a midline band of connective tissue called the linea alba. The linea alba goes from the pubic symphysis to your xiphoid process. During pregnancy, the abdominal region expands and various experts claim that around 1/3 to 1/2 of women experience a diastasis recti injury post-pregnancy. Men can also experience DR but its much less common and often associated with hernias. If you are a man reading this blog, we suggest you read our diastasis recti exercises for men article. If you’ve noticed an abdominal bulge, linea alba stretching, muscle separation, lower back pain, leak pee, doming, invagination, or coning, you may have a diastasis. To perform a self-test, read our article on testing for diastasis, and always make sure you consult a doctor to get an expert opinion. What Exercises Can Help with Diastasis Recti? Some easy beginning steps to healing from a DR injury is to understand more about breathing, your core, and posture. They each play a surprising role in healing and in preventing injury. 1. Practice appropriate breathing patterns Though this may seem like a simple task, many people do not practice proper breathing patterns. 3D rib breathing as opposed to belly breathing helps limit the amount of stress and pressure that you add to your abdomen daily. Inconsistent or improper breathing can add additional pressure to your abdomen causing a diastasis recti. Many people are taught that diaphragm breathing means belly breathing and have excess pressure on their core wall as a result. 2. Practice good posture and free your abs from excess tension While pregnant, it can be difficult to sit-up straight without straining your abdomen and lower back. The added weight in your belly can also allow for bad posture. When rising up out of bed, don’t sit straight up. This adds unnecessary pressure to your abdomen. When sitting up in bed or trying to get out, try either rolling over on your side before rising or focus on rising using your transverse abdominal muscles (those closer to your pubic bone). 3. Understand a good / healthy / functional core strategy Approaching strength building and core function routines, it is important to do so smartly. There should be no compromises in exercise. In both One Strong Mama and in Restore Your Core I focus on strengthening your body effectively and efficiently in order for you to be able to workout without any compensation with great results.

How to Test for Diastasis Recti? Believing you may have a diastasis recti can be a worrisome / frustrating experience. However, there is an abundance of information regarding diastasis recti recovery. We at Restore Your Core have designed a program specifically for women who are suffering from diastasis recti or other abdominal/pelvic floor issues. What is Diastasis Recti? Diastasis recti is the stretching or separation of the rectus abdominis (6 pack) muscles caused by the thinning of the linea alba (midline connective tissue). Diastasis recti separation leaves your abdominal organs unsupported, and if severe, can expose your digestive organs creating a stomach bulge.  This separation can range from being isolated above the belly button, within the belly button, and below the belly button sitting above the pubic bone. In some cases, the separation emcompasses the entire mid section of the core.  In both men and women, this gap can be created in the midline of your belly anywhere from the pubic bone to the base of your ribcage. During a crunch or sit-up, where one would normally feel tension and closure, there is a space in between. What Does it Look Like? Diastasis recti looks different from person to person. Although in some cases the symptoms can be painful and more present, in some people they aren’t noticeable at all. Below I address the most common and present symptoms you should be aware of in determining whether or not you may have a diastasis recti. Abdominal Bulge An abdominal bulge is not always an indication of a diastasis recti, yet, it can be a symptom.  This bulge, or stomach “pooch,” occurs when the abdominal organs become unsupported by the rectus abdominis muscles. This can appear as a cone shape or ridge above and within the area located close to the belly button. However, depending on where the diastasis recti has become isolated, the bulge can range from above the belly button, on the belly button (causing the belly button to flatten), or below the belly button just above the pubic bone. Testing for Diastasis Recti A self-assessment can be performed as follows: Lie on your back in a comfortable position. Bend your knees and place your feet flat on the floor. Place one hand on the midline of your core with your fingers pointing straight down on your abs.   If you need support for your head, place your other hand under your head and neck for support. Slowly lift your head and add minimal pressure to your fingers placed on your core. With no diastasis recti, there is the feeling of a toned wall as you lift your head up. If you feel a gap, or your fingers sink into your core, you likely have diastasis recti. In very obvious cases, you can feel the sides of your core muscles in between that gap on the left and right sides. Repeat the process for the areas just above your belly button and below your belly button to determine whether or not the diastasis recti is isolated or in your core as a whole.

Original Source: https://restoreyourcore.com/learn/diastasis-recti/diastasis-recti-during-pregnancy/ Diastasis recti is a very common condition that can occur during pregnancy and even extend postpartum. DR can affect women and men in varying ways and during different stages of their lives. More research regarding the prevalence, risk factors, and best treatments for diastasis recti have been on a rise.  One of the best things you can do during pregnancy is prehab. I have many long term clients who were able to prevent their diastasis recti from returning with subsequent pregnancies by working their core in a smart, functional way the entirety of their pregnancy. Many report that their core felt stronger than ever with the prehab work that they did. Pregnancy is not an illness, there is no need to halt all exercise. We do, however, want to make good exercise choices. It is very important to exercise your core during pregnancy but not to increase intra ab pressure as you do so.  Video URL: https://vimeo.com/410786638

Link to the Article: https://restoreyourcore.com/learn/diastasis-recti/is-diastasis-recti-preventable/ Link to the Video: https://vimeo.com/411566260 1. Practice appropriate breathing patterns Though this may seem like a simple task, many people do not practice proper breathing patterns. 3D rib breathing as opposed to belly breathing helps limit the amount of stress and pressure that you add to your abdomen daily. Inconsistent or improper breathing can add additional pressure to your abdomen causing a diastasis recti. Many people are taught to belly breath, are taught that diaphragm breathing means belly breathing and have excess pressure on their core wall as a result. core muscles and diastasis recti 2. Practice good posture and free your abs from excess tension While pregnant, it can be difficult to sit-up straight without straining your abdomen and lower back. The added weight in your belly can also allow for bad posture. When rising up out of bed, don’t sit straight up. This adds unnecessary pressure to your abdomen. When sitting up in bed or trying to get out, try either rolling over on your side before rising or focus on rising using your transverse abdominal muscles (those closer to your pubic bone). 3. Understand a good / healthy / functional core strategy Approaching strength building and core function routines, it is important to do so smartly. There should be no compromises in exercise. In both One Strong Mama and in Restore Your Core I focus on strengthening your body effectively and efficiently in order for you to be able to workout without any compensation with great results. Click here for a list of tips and tricks to help relieve any symptoms you may have or for exercises to help correct any unhealthy patterns you may be following.

There is really no clear way as to how exactly a diastasis recti develops. A diastasis can occur for many reasons. One of the most common ways a diastasis recti occurs is through pregnancy. This should not alarm you though. 100% of all pregnant women have a diastasis recti. This is caused by the stretching of the abdominals to accommodate the growing uterus. Issues accompanying a diastasis recti are typically only a concern if your abdominal muscles have not recentered by about 6 to 12 weeks postpartum. https://restoreyourcore.com/learn/diastasis-recti/is-diastasis-recti-fixable/ Due to diastasis recti being more common during and after pregnancy, many methods of avoiding its development involve postural awareness, corrective exercises, and a conscious prehab approach during pregnancy. Yet, there are several things to keep in mind regardless of whether you are male or female, pregnant or not. Understand a good / healthy / functional core strategy Practice appropriate breathing patternsEnsure your abs are free from excess tensionAvoid exercises that increase focalized tension in the abdomenPractice good posture Although diastasis recti is not completely avoidable in some cases, the list above helps paint a clear picture on how to protect your core while still staying active. The key is to be mindful of your body’s function and how to increase your functionality and build strength without causing harm to your body. Find the video summary below: https://vimeo.com/410783921

Read the full article below: https://restoreyourcore.com/learn/diastasis-recti/what-does-diastasis-recti-look-like/ Many symptoms that occur with diastasis recti can appear to be akin to that of a hernia. The most common symptoms that can occur if you have diastasis recti are*: Bulge in your abdominal core (also called by some as a “pooch.” Not my favorite term at all.)Feeling like your midsection is larger, less toned than the rest of your body. (Especially true if you have had a pregnancy.)Sense of having a weak core (your daily activities lack the intrinsic support of your core.)Pelvic floor issues (i.e. leakage)Abdominal gaping Pain in your lower backPoor postureConstipation Testing yourself for diastasis recti is one way to determine whether or not you may have a gap between your abdominal muscles. I always recommend having a professional do the test as well. This can be done by lying on your back with your knees up and feet flat on the ground. Once in this position, place one of your hands on your belly, fingers pointing down on the centerline. Place your other hand behind your head for support. As you exhale, slowly lift your shoulders and head slightly above the ground. Use your fingers to palpate up and down the center and see if your fingers sink into your core. If there is no diastasis recti, you will feel a “hard wall” – even if you are not very toned. If your fingers sink in, and you can feel the edges of your core muscles on each side of your abdomen, you likey have a diastasis recti. A diastasis recti is measured by finger width. If your gap is only 1 or 2 fingers wide, it might be considered okay, however, it is important that you mind your core because the gap can widen if you are not careful.  Video Summary: https://vimeo.com/410766156

One of the biggest issues with diastasis recti is that the appearance of it differs from person to person. Quite often a diastasis recti goes unnoticed, without painful symptoms, or even worse, is seen as a personal flaw, especially with women postpartum.  Read the full article below: https://restoreyourcore.com/learn/diastasis-recti/what-does-diastasis-recti-look-like/ Rectus abdominis separation can lead to a stomach bulge (aka stomach pooch), pelvic floor issues, unnatural posture, and stomach and back pain. The symptoms of diastasis recti include but are not limited to: Abdominal BulgeAbdominal GapingLower Back PainSensation of Bloatedness without BloatIncontinencePoor PostureConstipation & BloatDoming or invagination of the linea alba when performing crunches or other traditional ab exercisesDifficulty with everyday activities due to a lack of core function Unless you have a low body fat percentage or have an overly toned core with a visible 6-pack, it is very hard to diagnose a diastasis recti on appearance alone. The linea alba lies beneath the fat layer of your abdomen, so it cannot be seen. Many people have a diastasis recti for years before learning they have it. Video Summary: https://vimeo.com/410755530

You should only consider DR surgery after being enrolled in at least a year of core rehab focusing on corrective exercises and diastasis recti specific strength training. If you have done rehab diligently, and you still notice a significant gap, lower back pain, or leakage, you could consult your doctor and begin discussing whether or not surgery is the right option for you.  Another thing to consider when opting for a diastasis recti surgery is whether or not the gap is causing you pain or any other difficult symptoms. If you are wanting to pursue surgery for cosmetic purposes rather than functionality, it is key to understand that a diastasis recti surgery is highly invasive, and there will be a significant amount of time taken to recover. And, as all surgeries go: the pros should outweigh the cons.  Read the full article here: https://restoreyourcore.com/learn/diastasis-recti/diastasis-recti-surgery/ The effects of the surgery (stomach swelling, scarring, etc.) may take 6 months or even up to 12 months to fully go down or diminish in coloring and size. Once you have regained your strength and believe you are ready to begin building up core strength again, consult a trained professional to outline an exercise routine that would best suit your needs. Video Summary: https://vimeo.com/410751146

Believe it or not, diastasis recti can affect men just as it can affect women. One of the biggest myths surrounding diastasis recti is that it only occurs in women postpartum. However, diastasis recti is a universal occurrence that affects the abdominal wall without gender specificity. Read the full article below: https://restoreyourcore.com/learn/diastasis-recti/diastasis-recti-exercises-for-men/ While a diastasis recti is usually caused by pregnancy in women, research has helped reveal several causes of the condition in men. Some of the common reasons for a diastasis recti to develop are: Frequent or rapid changes in weightWeightliftingCertain core exercisesUnderlying Abdominal Illnesses (i.e. stomach cancer, or cirrhosis)Obesity Video Summary: https://www.youtube.com/watch?v=t5iv5P1P79g&feature=youtu.be

What is diastasis recti? Diastasis recti is the stretching or separation of the rectus abdominis (6 pack) muscles caused by the thinning of the linea alba (midline connective tissue). Diastasis recti separation leaves your abdominal organs unsupported, and if severe, can expose your digestive organs creating a stomach bulge.  Read the blog below: https://restoreyourcore.com/learn/diastasis-recti/before-and-after-diastasis-recti/ How you look has nothing to do with how healthy you are. Many athletes and bodybuilders have constant back, shoulder, core issues and pain despite their healthy and toned appearance. In many cases, athletes and bodybuilders have a diastasis recti without even realizing it! Buying into an appearance based program only damages any attempts at building a stronger and more functional core and balanced body. You can still have a belly and be healthy with a functional, strong core. Video Summary https://vimeo.com/410737553

The primary method of healing a diastasis recti and closing the abdominal separation is rehab and a core building program that is specific for those with a diastasis recti. The exercises in these programs are specialized to restore core function and strengthen the linea alba. Check out the full blog below: https://restoreyourcore.com/learn/diastasis-recti/can-diastasis-recti-be-fixed-without-surgery/ A diastasis recti naturally occurs during pregnancy. As the womb grows, the rectus abdominis and core muscles stretch and shift in order to make room for your growing uterus. There are several ways to help prevent your chances of a diastasis recti setting in postpartum. Below are a few exercises that you can practice in various stages of your pregnancy in order to help your muscles retain strength after you give birth. Video Summary: https://vimeo.com/404791906

In episode 1, Lauren Ohayon gives us pertinent information on how to strengthen our pelvic floor with proper form and engagement. Check out: www.restoreyourcore.com