Post Natal Core Restore – Why The Breath Comes First!

As we take over 20,000 breaths a day and the breath is one of the primary restorative influencers for the Post Natal Core, let’s take a look at how we can help our clients get back to original function in order to build a firm foundation for their return to wellness and the movement we prescribe......

As a specialist working with this client population, one of your first steps is to assess for Intrinsic Core Synergy™ (ICS).  Defined as: ‘The capacity of the client to perform the natural chain reaction of expansion and compression of the constituents of the Core, driven by the breath’.

Intrinsic Core Synergy (TM)

 

 

 

Expansion – the inhale – Diaphragm descends, PF relaxes, rib-cage expands, abdominal wall relaxes and explands.  The Core is being LOADED!  Eccentric phase.

Compression – the exhale – Diaphragm ascends, PF tensions, rib-cage contracts, abdominal wall tensions, lumbar and thoracic muscles and other soft tissue contracts/tensions to support.  The core is being UN-LOADED! Concentric phase.

For many post birth women, this synergy needs to be re-taught as the rigours of pregnancy and birthing have served to create varying degrees of ‘core amnesia’. In most cases, this requires a little hands-on input from the therapist and/or the application of soft-tissue techniques such as massage and myofascial release strategies to free our clients of restrictions so they are re-aligned for function and ready to ‘exercise’.

I like to think of expansion and compression as ultimately representing the ebb and flow of life.  As a reflected in the natural world (day and night, tide in and tide out, cold and warmth, and consequently within our bodies.  Re-establishing the natural sequence of true Core function with the breath as the ‘driver’.

Faulty breathing/alignment habits or strategies will totally negate attempts at rehabilitation of Pelvic Floor and Diastasis in the Post  Natal client as restoration of both are TOTALLY dependent on re-establishing the natural chain-reaction and the capacity of the Core to load and un-load the breath.  Faulty INFORMATION IN, faulty FUNCTION OUT!  And, reverse/faulty breathing strategies lead to pressure outwards onto the healing/re-knitting  collage and elastin of the midline tissue of the abdominal wall and a downward pressure into the pelvis and against the pelvic organs and tissues that ultimately, over time, may lead to Pelvic Dysfunctions such as incontinence and prolapse.

So......what prevents optimal loading/co-ordination of the components of the Core?

  • Non-optimal breathing strategy – how a woman currently breathes....belly-breathers, apical/chest/boob-breathers, stressed/shallow breathers, hypertonicity of the Diaphragm, preventing its optimal elevation and depression and therefore inability to assist in loading/unloading of the core, rib-flaring and overactive intercostals preventing the ideal expansion and compression of the ribcage......
  • Non-optimal pelvis position – anterior/posterior tilt versus neutral putting the ribs anterior or posterior to the relative position of the pelvis.....what is holding the client in this position – habit or /and stuck soft tissue? – Think.... Lower Crossed Syndrome and butt tucking.

Pic Courtesy of www.pponline.co.uk

  • Non-Optimal thoracic position - think.....Upper Crossed Syndrome
Janda's Upper & Crossed Syndrome

Janda's Upper & Lower  Crossed Syndrome

  • Nerve Damage
  • Scar Tissue/Adhesions (think....the C-Section client and those whose birth involved instrument delivery)
  • Poor connective tissue quality within the Pelvic Basin and elsewhere in the core due to poor nutrition and hydration.
  • Weakened attachments of connective tissue/muscles to boney attachments.

Your New Post Natal Assessment Strategy

  1. Assess FIRST for Intrinsic Core Synergy™
  2. Release soft tissue that is restricting optimal function – the ribs, diaphragm border, Scalenes, Sternocleidomastoid, Pectorals, Rec Fem, TFL, QL are all generally sure bets, but each client is an individual and needs a bespoke ‘release’ presciption.  Using the Thomas Myers’ Myofascial Lines as a guide map is a great strategy.
  3. Then create a bespoke ‘exercise’ programme for your client that is heavy on cueing, visualizations, and attaching the breath ‘exhale on exertion’ to EVERY EXERCISE!  Progress from more static exercise options to locomotion and then onto dynamic locomotion – layering function for the client so they have a chance to understand/learn/absorb/get stronger.

Final thoughts.....the overactive or  hypertonic/over tensed/shortened Pelvic Floor will not allow the Core chain reaction to occur....we can’t load an already overloaded PF and true range of compression/expansion can’t be achieved.  Here, the strategy is to restore a functional tension that will allow loading ie., the tissues need to be returned to their optimal length as opposed to this shortened/hypertonic position to allow the eccentric/concentric  and/or expansion to compression action to occur.

And lastly, ultimately we can never over-emphasize the nourishing/cleansing/soothing/restorative benefits of the breath.  Its role in oxygenation, the removal of waste, it’s ability to positively affect the parasympathetic nervous system and calm.  All hail the almighty breath!

 

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