Diastasis Recti Abdominus: Does This Condition Change How We Should Train Pregnant Clients?

During pregnancy one of the changes that occur to allow room for the baby to grow is hormonally induced thinning and widening of the linea alba (the fibrous tissue that connects the recti muscles).  This widening of the interrecti distance is termed a diastasis recti abdominus (DRA).

A DRA occurs in nearly all pregnant women by the third trimester, and remains during the postpartum recovery as well. Although a DRA is a normal adaptation of pregnancy, there is some concern that the increase in interrecti distance may affect the contractile strength of the abdominal muscles and pelvic muscle function. 

The development of DRA can be determined and monitored using a simple test during pregnancy.

Have the pregnant client lie on her back with knees bent and feet resting on the floor. Place three fingers horizontally at the umbilicus and have the client raise her head and shoulders upward until you feel the recti muscles contract. Determine the number of fingers fit within the soft area between the two sides of the recti muscles.  

A distance of two fingers or more is considered a DRA, and it’s suggested that women with this condition avoid curl up type abdominal exercises that put stress on the midline. Traditional curl up type exercises focus on the recti muscles, but when a DRA is present the intraabdominal pressure that occurs when lifting the upper body upward puts tension on the linea alba. In addition, the increased interrecti distances affect the function of the recti muscles, causing recruitment of other muscle groups to rise up.

 It’s important for pregnant women to maintain abdominal muscle strength throughout pregnancy by including exercises that target the transverse abdominus, a key support for the lower abdomen and pelvic floor. One of my favorite group of transverse muscle exercises are the Sahrmann series. I’ve modified these supine exercises for pregnancy, and you can see examples of the exercises at: https://www.youtube.com/watch?v=tdMjeeqUWLo

Check my blog every Monday for another “maternal exercise pearl” from my Prenatal and Postpartum Exercise Design CE course. For more information on the course please visit:www.ppfconsulting.com

New Release:2016 4th Edition "Prenatal and Postpartum Exercise Design CE Course"

Prenatal and Postpartum Exercise Design CE Course-4th Edition 2016
By Catherine Cram and Gwen Hyatt

Prenatal and Postpartum Exercise Design CE Course-4th Edition

By Catherine Cram, Gwen Hyatt

Price

$99 online format, $109 print format

To Order

Visit: www.ppfconsulting.com

Email: ppfconsultingllc@gmail.com

Call: (877) 582-2227

Audiences

A continuing education course for personal trainers, group exercise instructors, and health/fitness professionals working with pregnant and postpartum women.

Product Description

Course components can be delivered as printed products or online:

-Workbook

                          -Continuing education exam

Discover what every fitness professional working with pre- and postnatal women should know about designing safe and appropriate exercise routines with the Prenatal and Postpartum Exercise Design, Fourth Edition CE Course. Learn the effect of exercise on maternal and fetal health and how to set intensity levels and modify exercise based on guidelines from the American Congress of Obstetricians and Gynecologists (ACOG), the Royal College of Obstetricians and Gynaecologists (RCOG), and the Society of Obstetricians and Gynaecologists of Canada (SOCG). This course covers the latest research; demonstrates appropriate core strengthening and pelvic floor exercises; and includes suspended body-weight, flexibility, relaxation, and breathing exercises. It also suggests guidelines for strength training, water exercise, and competitive sports during pregnancy.

This self-guided course allows you to work at your own pace and explore the material through a comprehensive text and study guide, finishing with a 55-question exam composed of multiple-choice and true-or-false questions (test may be taken online, or mailed/faxed) and certificate and CEs provided at completion and passing of test. 
 

About This Course

Chapter 1 Benefits of Exercise During and After Pregnancy

Effect of Prenatal Exercise on Maternal Health

Effect of Exercise on Fetal Health

Effect of Postpartum Exercise on Maternal Health and Infant Growth

Self-Check Quiz

Chapter 2 Anatomy and Physiology of Pregnancy

Cardiovascular and Circulatory Changes During Pregnancy

Respiratory Changes During Pregnancy

Metabolic and Thermal Changes During Pregnancy

Anatomical Changes During Pregnancy

Self-Check Quiz

Chapter 3 Prenatal Exercise Prescription

ACOG Guidelines Reaffirmed 2009

International Guidelines for Exercise During Pregnancy and Postpartum

Prenatal Exercise Design

Prenatal Exercises

The Pregnant Competitive Athlete

Self-Check Quiz

Chapter 4 Postnatal Exercise Prescription

Postnatal Expectations

Vaginal Birth Recovery Program

Cesarean Delivery Recovery Program

Scar Mobilization

Core Strengthening Exercises After Cesarean Delivery

Postpartum Exercise Prescription

Abdominal Rehabilitation

Strength Training

Proper Body Mechanics and Ergonomics

Exercise and Breastfeeding

Check Points

Self-Check Quiz

Chapter 5 Maternal Exercise Program Design

Instructor Responsibilities

Safety

Program Goals

Fitness Components

Exercise Session Format

Choreography

Mainstreaming the Pregnant Student

Self-Check Quiz

Chapter 6 Complications and Common Conditions of Pregnancy and Postpartum

Obstetrical Complications

Common Conditions

Bed Rest

Self-Check Quiz

Chapter 7 Professional Responsibilities

Health Screening for Physical Activity

Monitoring Exercise

Record Keeping

Scope of Practice

Emergency Procedures

Self-Check Quiz

Self-Check Quizzes Answer Key

Client Handouts

Nutritional Needs During Pregnancy

Weight Gain During Pregnancy

Essential Nutrients During Pregnancy

Common Complaints and Problems During Pregnancy

Exercise Dos and Don’ts for Prenatal Women

Nutritional Needs Postpartum and When Breastfeeding

Weight Loss While Breastfeeding

Lifting and Carrying Safely

Proper Body Mechanics When Lifting Your Baby

Forms

Health History Questionnaire

Status of Current Pregnancy

Physician Consent Form

Maternal Fitness Class Record

Glossary

References

Resources

CONTINUING EDUCATION CREDITS

ACE                     0.70

ACSM                  7.00

AEA                     6.00

AFAA                   7.00

AFPA                   7.00

BCRPA                6.00

Canfitpro- FIS      4.00

Canfitpro- PFS    4.00

Canfitpro- PTS    4.00

CDR                     7.00

CFES-PT             6.00

Cooper                7.00

COPSKT             0.60

CPTN                  4.00

ECA                     7.00

FNB                     5.00

ICEA                    8.50

ISSA                    7.00

Lamaze               8.50

NASM                 0.70

NASN                  0.70

NCHEC               7.00

NCSF                  3.50

NETA                  7.00

NFPT                  1.00

NSCA                  0.80

NSPA                  7.00

OFC                    7.00

OSHF                  5.00

PTBC                  0.70

REPS                  3.00

SKESA                5.00