Popular Science: What is postpartum rectus abdominis separation?
The rectus abdominis consists of four muscles on the left and right sides of human abdomen, and the rectus abdominis on the left and right sides is connected by the tissue of abdominal white line. The white line of abdomen is equivalent to the gap between two rows of rectus abdominis, which is about 1-2 fingers wide under normal circumstances.
During pregnancy, with the growth of the fetus, the woman's stomach gradually becomes bigger. In the third trimester, the enlarged uterus will lengthen the abdominal muscles, separate the two rectus abdominis from the white line of the abdomen, and the gap between the rectus abdominis will become wider and wider. This phenomenon is called rectus abdominis separation.
The abdominal wall of prolific women tends to be slack and weak due to repeated stretching of the abdominal wall. Multiple pregnancy, fetal oversize, hydramnios, etc., which lead to excessive uterus during pregnancy, will lead to excessive expansion and extension of abdominal wall.
The survey shows that 60%-70% of parturients will have different degrees of rectus abdominis separation on the third day after delivery, and gradually recover from 4 to 8 weeks after delivery. People's muscles gradually recover within 3 months after delivery. Young mothers and mothers who usually exercise or have good muscle strength will recover to about 2 fingers within 3 months. If after 3 months, the muscle tension has recovered and the is of rectus abdominis is is still separated by more than 2 fingers, it is unlikely to recover on its own. The incidence of rectus abdominis separation in natural delivery was 60.3%, and the incidence of cesarean section was 70.8%. The incidence of rectus abdominis muscle separation in women with second or more cesarean sections is high (90.8%).
How to check yourself? (Figure 3)
? Lie on your back, bend your knees and expose your abdomen;
? The left hand is supported behind the head, and the right index finger and middle finger are vertically inserted into the abdomen, and the body is relaxed.
? When the upper body is lifted, I feel the abdominal muscles on both sides squeezing my fingers in the middle. If you can't feel the squeeze, point your hands to both sides. Move until you find tense muscles. Measure the distance between the muscles on both sides.
norm
Normal: within 2 fingers (including 2 fingers)
Need to be improved: 2~3 fingers
Need to see a doctor: 3 fingers or more.
If the distance between the muscles on both sides is greater than 3 fingers, it is a serious separation of rectus abdominis, which may cause external abdominal hernia and requires timely medical treatment; If it is between 2 and 3 fingers, should you pay attention? It is not allowed to carry out weight-bearing exercises with twisted trunk, because it will make the separation more serious.
Treatment of rectus abdominis separation (Figure 4- Figure 9)
? Biomimetic electrotherapy (rectus abdominis muscle separation is greater than or equal to 3 fingers)
Through electrical stimulation, the abdominal muscles are passively contracted, and the muscles are excited to contract and relax, which can strengthen the training of muscle groups, restore the physiological curvature of the spine and improve the inclination of the pelvis.
In the hospital, it is generally recommended to treat postpartum rectus abdominis with more than 3 fingers (including 3 fingers).
? General hospitals will require everyone to do pelvic floor muscles first, and then do rectus abdominis. Because the separation and treatment of rectus abdominis will increase abdominal pressure, if the pelvic floor muscle is not good, it will increase the severity of the pelvic floor muscle. Generally, the pelvic floor muscles can be treated with rectus abdominis electrotherapy when they are restored to grade 3.
? Autonomous training method of rectus abdominis separation (rectus abdominis separation is less than or equal to 2 fingers)
Action 1: Stand still and tuck in.
Preparation: Stand with your back against the wall, your upper body against the wall (keep neutral, with your head, back and hips attached to the wall), and your feet are about 30 cm away from the wall.
Action execution: inspiratory preparation; Exhale, stick the lumbar spine to the wall, then inhale and restore. Each group 10~ 15 times, repeated for 2~3 groups.
Precautions: avoid pushing your arms back against the wall, pull your abdomen inward as far as possible, and actively approach the wall, imagining the feeling of your navel approaching the wall.
Action 2: Kneeling and abdomen.
Preparation: Kneeling at four o'clock, hip joint and knee joint vertical, shoulder joint and wrist joint vertical, spine neutral position (thoracic spine naturally bends back, lumbar spine naturally bends forward).
Action execution: inhale, and the lower abdomen naturally relaxes; When exhaling, forcibly retract the lower abdomen inward. Repeat 10~ 15 times in each group, and do 2~3 groups.
Note: Do not change the neutral position of the spine during the whole process. Only the abdomen is moving. Imagine pulling your navel to your lumbar spine.
Action 3: kneel down and stretch your legs.
Preparation: Kneeling at four o'clock, hip joint and knee joint vertical, shoulder joint and wrist joint vertical, spine neutral position (thoracic spine naturally bends back, lumbar spine naturally bends forward).
Action execution: prepare to inhale and exhale with your right leg slowly backward; Inhale, exhale and slowly retract your legs. Complete 4~6 times, and repeat on the other side. When you can control your body well, start stretching your legs alternately. Stretch each leg 4-6 times and repeat 2-3 groups.
Note: Keep the torso and pelvis neutral all the time, and do not deviate from the midline. Imagine putting a bottle of water on your pelvis. You can't let the bottle fall.
Action 4: Lie on your back and lift your legs.
Preparation: Lie on your back, chin slightly retracted, hands at your sides, knees bent, and lumbar vertebrae pressed against the mat.
Action execution: inhale and lift your right leg; Exhale, and the right leg falls back to its original position 6-8 times. Repeat with the other leg to complete 2~3 groups.
Note: When lifting legs, try to press the lumbar spine on the mat. The other leg remains the same, and the hips are on the ground, keeping the lumbar spine from lifting.
Action 5: Kick on your back.
Preparation: Lie on your back with your chin slightly retracted, hold the upper part of your right leg and calf with your hands, and press the mat with your lumbar spine.
Action execution: inhale and prepare; Exhale and push your right leg out 6~8 times. Repeat with the other leg to complete 2~3 groups.
Precautions: When holding your legs, try to press your chest and let your lumbar spine press on the mat. Stretch the other leg as far as possible, while keeping the lumbar spine from lifting.
Action 6: Plate Support
Warm-up action: prone, elbow and toe support, keep the upper body parallel to the ground.
Action execution: keep the body stable and stay 1 min. You can leave one toe off the ground and do a complete flat support. In the case of action standards, the longer the better.
Note: Don't collapse, tighten your abdomen, don't collapse your shoulders, and press your elbow hard on the mat during the whole process.
Exercise instructions:
This exercise is recommended for people whose rectus abdominis is separated by two fingers. (If the separation is serious, you need to carry out rehabilitation training in the hospital first and exercise step by step under the guidance of a doctor. Avoid more serious separation). In practice, you can choose a single action to practice, or you can change a series of actions. It can be adjusted according to the repetition times and actions of each group. If you keep practicing every day, you can obviously improve the separation of rectus abdominis in about 2 weeks.
? A special reminder:
This group of exercises also needs to be carried out after the pelvic floor muscle test is qualified. Because these exercises put pressure on the abdominal cavity and pelvic floor, affecting the recovery of pelvic floor.
? operate
If the separation width is greater than 3 fingers, and the recovery after delivery 1 ~ 2 years is not reduced, surgery should be considered. The operation is to narrow the abdominal white line and make the separated rectus abdominis close again. Surgery can be achieved by open surgery and laparoscopic surgery.
Exercise posture that should be resolutely avoided when separating rectus abdominis (more than 2 fingers);
1, sit-ups
2. Wheeled, cobra pose, upper dog and other back bends;
3. Severe abdominal posture such as boat shape and V-shape balance;
4. Russian-style rotation, abdominal participation;
5, in addition to practice, don't lift heavy objects in life, so as not to affect the recovery of pelvic floor muscles and abdominal muscles.
To sum up, don't bend the rectus abdominis and lift heavy objects.
Every part of our body is particularly important. Once damaged, it is difficult to recover. So prevention is particularly important:
? Strengthen exercise before pregnancy, don't listen to the nonsense of "lose weight anyway, exercise". Thin people don't necessarily have small bellies. But people with strong abdominal muscles will have a much smaller stomach. When I was in the prenatal examination, I was watched by the doctor because of my small stomach. I always thought it was because of the lack of amniotic fluid. Later, I heard from the doctor that the stronger the abdominal muscles, the stronger the wrapping force to the uterus, so the smaller the stomach. In the same way, why do mothers who have a second child often have bigger stomachs?
? Weight control during pregnancy.
Weight control during pregnancy is more important than our usual weight control. Never eat or drink in the name of the baby. Getting fat is a trivial matter, but it does great harm to the body! It is basically impossible for pelvic floor muscles and rectus abdominis to recover to a certain extent.
Supplement:
No navel belt, no navel belt, no navel belt! Say the important things three times! )
Plan the delivery strictly according to the doctor's instructions. If the doctor says no, don't do it over time!
It's not just a matter of doing it! It is harmful to pelvic floor muscles and waist and abdomen muscles! ! !
As one, I bought a full set of dog prints: tummy belt, pelvic belt and tummy pants. I can't bear to waste my money. I was pricked when I went to do pelvic floor muscle therapy and waist therapy. Even when I was told not to prick by the doctor during the 42-day prenatal examination, the doctor clearly pointed out not to use it. Pelvic floor muscles and waist treatment I am the director of the top three hospitals.