March 22, 2023 - DX Physio Balgowlah & Cremorne Sydney

How common is DRA?
DRA is extremely common. Evidence shows that almost 66%-100% pregnant women experience DRA during the third trimester.
The good news is that 60% women can regain the elasticity of the linea alba and abdominal muscles and close the gap between the two halves of the rectus abdominis within 6-12 weeks after giving birth. However, there are still around 40% of those who still have DRA at six months postpartum, or longer.

What are the risk factors for developing diastasis recti?

Having multiple pregnancies (especially back-to-back)
Age> 35 years old
Having multiples (such as twins or triplets)
Having a heavy or big baby
Being extremely petite
Vaginal delivery – pushing can increase abdominal pressure

What are the symptoms of DRA?

Weak abdominals
‘Doming’ or ‘bulging’ when you increase abdominal pressure
Low back pain / pelvic / hip pain
Poor posture
Pelvic floor related dysfunction

How to treat DRA?
At DX Physio, we recommend our clients to get a thorough pelvic floor and abdominal wall assessment 4-6 weeks after giving birth. We use a real-time ultrasound and manual assessment to examine the abdominal wall, breathing pattern, linea alba integrity, abdominal muscle activation as well as pelvic floor function.
Based on our experience, the sooner new moms start physiotherapy intervention for DRA, the better the outcome will be. We will help you to rebuild your core strength and close the gap between the Rectus Abdominis muscle. We also recommend that pregnant women start to strengthen their core muscles during their pregnancy to increase or maintain the strength of their abdominal muscles throughout their pregnancy.

Book with us today and get your first post-natal assessment with our experienced Women’s Health Physiotherapist!

Menopause is sometimes referred to as ‘the change of life’ as it marks the end of a woman’s reproductive life. At “menopause”, there are no longer eggs being produced by the ovaries and the production of oestrogen and progesterone ceases. The term “menopause” refers to the last or final menstrual period a woman experiences.

When a woman has had no periods for 12 consecutive months she is considered to be “postmenopausal”. Most women become menopausal naturally between the ages of 45 and 55 years, with the average age of onset at around 50 years. “Premature menopause” may occur before the age of 40 due to either natural ovarian function ceasing, following surgery to remove the ovaries, or as a result of cancer treatments. Menopause is considered “early” when it occurs between 40 and 45 years.

For women at the ‘midlife’/menopausal point, it can be difficult to separate the effects of ageing from the effects of menopause. Ageing is associated with weight gain in both women and men, while weight gain during and after menopause is associated both with lifestyle factors and the physiological changes of ageing, as well as with the hormonal changes of menopause.

A healthy diet and lifestyle, incorporating exercise and strength training, lowers risk for many health problems associated with ageing, gives you more energy, and improves quality of life. A healthy lifestyle may also reduce menopausal symptoms including hot flushes and sleep disturbance. Whilst these still may happen and are a physiological response of the hormonal changes that occur as one enters the menopausal period, you can also help to reduce your core temperature to prevent additional temperature rises or triggering the vasomotor symptoms of menopause like the hot flushes. Some of these are listed below:

adjusting clothing
- dress in layers
- wear sleeveless blouses or tops
- wear clothing made of natural fibres that breathe
- avoid jumpers and scarves
using a hand fan or electric fan as required
keeping cooler at night
- lower the room temperature
- put a cold pack under the pillow
- turn the pillow over to the cool side when feeling warm
- use dual control electric blankets
- use a bed fan that blows air between the sheets
drinking cool liquids such as iced water.

If you are experiencing any symptoms with menopause such as reducing muscle mass, weight gain or aches and pains, book in with our Women’s Health Physiotherapist who can help assess you and also assist with exercise recommendations to help you through the changes.

If you want to learn more about menopause stress, a great resource is the Australian Menopause Society.

Women exercising with kettlebell and weights during menopause fitness class.

Stress Urinary Incontinence (SUI), is the involuntary leaking of urine that occurs during activities that causes an increase in pressure in your abdomen and on your bladder and surrounding muscles.

This can occur during coughing, sneezing, lifting weights, or impact sports like running and skipping. This can happen to both women who have had children and those who have not, and doesn’t only affect ageing women. SUI in fact also affects many young women, including those within the female sporting population as well.

Stress incontinence happens when the pelvic floor muscles and supporting tissues of the bladder weaken. When the bladder fills with urine, it expands. Any activity that puts pressure on the pelvic and abdominal muscles such as bending over, laughing, sneezing, and lifting heavy objects can lead to leakage of urine when those surrounding muscles are weakened.

The muscles in the pelvic floor, as well as the neck of the bladder/urinary sphincter, can lose their strength due to:

Childbirth
Incorrect breathing pattens and form during certain exercises such as weight lifting
High-impact activities such as jumping and running, over the course of several years without proper core activation
Disease that leads to chronic sneezing, coughing or vomiting
Obesity
Smoking, which can lead to frequent bouts of coughing and respiratory issues

A Women’s Health Physio can help treat SUI by assessing your pelvic floor muscles, as well as surrounding muscles such as your abdominals, hip flexor and adductors etc which can all affect how the pelvic floor works.

After completing your physiotherapy assessment, they will be able to assist you in learning how to perform certain exercises correctly to strengthen the muscles, while also helping you to either tighten or relax those muscles. You can have tight muscles that are still weak, so it is important for your Women’s Health Physio to be able to assess this for you. Similar to other exercise regimens, the effectiveness of pelvic floor exercises depends on the regular performance of these movements.

Here at DX Physio, we use a real-time Ultrasound machine to be able show you your muscles and help to provide biofeedback to reinforce proper contraction and use of these important muscles.
If you are suffering from Stress Urinary Incontinence, please book in today to help address the issue and get you feeling relief as quickly as possible.

Pregnancy is a very exciting time for most women, but with it comes a lot of physical, biological and psychological changes. As the pregnancy progresses, even your body’s centre of gravity (COG) changes and does so constantly as you grow. Your COG gradually starts shifting up and forward as your uterus enlarges and this can cause you to feel less coordinated and challenge your ability to maintain your balance.

There is also an increase of pressure around your abdomen and an increased level of a hormone called relaxin which loosens your muscles, joints and ligaments to accommodate for the growing baby bump and prepare your body for birth.
These are just a few of the changes a pregnant woman will experience. And while these changes are beneficial and necessary, with them comes the need to adjust how you exercise to keep you and your baby safe.

Throughout your pregnancy, you will want to avoid certain exercises like full sit-ups and double leg lifts as these can put more pressure and pull on the abdomen. This then can contribute to Diastasis and other musculoskeletal issues during your pregnancy. You will also want to avoid excessive twisting, or weighted rotations, or movements that involve bending backwards, or compressing your abdomen.

After the first trimester, you will also want to avoid any exercises that involve lying face-up on your back or laying on your back in general for extended periods of time. Doing so can put too much pressure on the vena cava, the vein that carries blood to your heart, and affect the flow of oxygen to you and your baby. To avoid laying flat on your back, you can alter the exercise by propping up your upper back so that your heart is above your belly button with a towel, pillow, pilates ball, swiss ball or with your forearms for example. Or you can perform alternative exercises that work the same muscle groups but in differing position.

Exercises to avoid during pregnancy

Activities and Exercises/sports with a high risk of falling or abdominal injury, e.g. downhill skiing, surfing, snowboarding, gymnastics, ice-skating, contact sports, horseback riding, outdoor cycling, diving etc
Exercises that involve lying flat on your back for extended periods of time after the fourth month of pregnancy as the weight of your growing uterus, and baby, can compress major blood vessels and restrict circulation to you and your baby.
Certain abdominal exercises, like full sit-ups or double leg lifts, or any movement that can excessively pull, twist, bend and compress the abdomen.
Exercise in extreme temperatures, especially heat. Exercise in environments that raises your body temperature too much should be avoided, like exercising outside on hot summer days, or hot yoga etc.
Holding your breath/Valsalva Manoeuvre is never recommended during pregnancy. Both you and your baby need a constant and good flow of oxygen.

Before starting any new exercise regimes when pregnant, it’s best to consult your doctor or Women’s Health Physio prior to beginning to ensure you do not have any contraindications to exercise.

If you experience any of the below symptoms when exercising, stop immediately and contact your doctor/practitioner:

Unusual pain that doesn’t subside (hips, back, pelvis, chest, head, neck, arm etc)
A cramp or stitch that doesn’t go away when you stop exercising
Regular, painful uterine contractions
Chest pain
Calf pain that remains or calf swelling
Light-headedness or dizziness that doesn’t subside quickly
Very rapid heartbeat
Severe breathlessness
Difficulty walking
Loss of muscle control
Sudden headache
Increased swelling
Amniotic fluid leakage
Vaginal bleeding
A noticeable decrease or absence of usual fetal movement

If you are unsure on how to start exercising during your pregnancy or would like to increase your confidence and work with a trained pre and post-natal specialist, contact us today.

Pregnant woman performing safe exercise with resistance bands during pregnancy.

Joint pain in general is common during pregnancy, and it can be especially common for pregnant women to experience discomfort or pain around their lower backs and hips as the pelvis expands to accommodate for the growing baby bump.

The onset of this discomfort or pain is usually toward the end of the first trimester and is referred to as Pelvic Girdle Pain (PGP).

Although research suggests approximately 50% of women experience PGP, each women tends to feel it differently.

PGP tends to be felt:

across the lower back around the Sacroiliac Joints (SIJ)
at the front of your pelvis at the public symphysis
deep within the glute muscles

The good news is there are many ways to provide relief throughout pregnancy. One way is to see a Women’s Health Physiotherapist, such as Deman at our DX Physio clinic, to have your hips taped for added pelvic stability. You can also work actively with one of our Exercise Physiologists to safely strengthen the surrounding muscles and your core to also provide increased stability.

Working with our Women’s Health Physio and Exercise Physiologists can help you to:

Increase your walking endurance without experiencing pain or discomfort
Feel more comfortable in bed making it easier for you to roll over
Reduce discomfort you may feel climbing stairs, walking on uneven surfaces, getting in and out of cars, getting up from sitting etc.

Also Read: Enhance Your Maternal Health with Pregnancy Reformer Pilates

If you or any soon-to-be or new Mums are experiencing any pain around your lower back, hips or pelvic region in general, call us today to book in for an assessment.