Many women come to me complaining that they have pelvic or back pain and it keeps them from being able to do all kinds of regular activities. Your body is going through major changes while pregnant, and these changes are accelerated after 30 weeks, as your body grows and the center of gravity moves forward.
This technique— using the transverse abdominal muscles—can be your secret weapon during pregnancy. The transverse abdominal muscles are sometimes difficult to feel but with practice you will figure out how to isolate these muscles. I find that when my clients do this exercise for 3x times per day, for just a few minutes, it really helps their pain go away so they can stay active and strong.
THE IMPORTANCE OF THE TRANSVERSE ABDOMINAL MUSCLE
Learning to activate your transverse abdominal muscle (TrA) during pregnancy will keep your core strong, minimize muscle weakness, and help you avoid excessive downward pressure through the pelvis. The TrA muscle is a crucial set of abdominal muscles located on the front and side of the abdominal wall.
Look at the illustration at the left to help you locate them. Proper activation of your TrA will also prevent pregnancy incontinence with coughing, sneezing and laughing. The TrA will help you to combat pain in your low back and pelvic because it helps to create lumbar and hip stability and strength. This muscle is sometimes called the corset muscle and it is responsible for keeping your organs in place and helping to maximize pregnancy pelvic power while providing pain relief with positional changes. It is the pregnant woman’s secret weapon.
The TrA is the deepest abdominal muscle and often overlooked when in your typical core program. This is not the six-pack muscle and so you cannot see its beauty from the outside. This muscle is deep within the belly. Once you learn how to tune into the TrA muscle, it is particularly important to use this skill during functional and transitional movements such as a pelvic brace. The pelvic brace is a technique that helps you protect your pelvic floor during activities like changing positions or coughing and sneezing.
TRANSVERSE ABDOMINAL BELLY HOLDS
WHAT TO DO:
- This exercise may be done sitting on a ball or chair, laying on your back or standing. Keep a neutral spine, which is a spine that is relaxed and straight, as you take a full belly breath. As you exhale draw your belly closer and more firmly toward the spine. As you pull in your abdominals try to imagine that you are trying to squeeze into an old pair of jeans that don’t fit. Make sure to keep a relaxed, neutral spine.
- Imagine that you are doing a light contraction of the pelvic floor, or Kegel, that moves all the way up to the lower part of your abdominals.
- Imagine that there is wire from the right front hip bone hip bone to the left front hip bone. Imagine the wire becoming slack as you bring the two hip bones together.
Practice activating your TrA muscles in front of a mirror, facing sideways. As your baby grows and the belly gets bigger, you will actually see the baby lift up and in toward your body.
Check in with your internal and external oblique muscles (see illustration at the left), or outermost of the three flat muscles of the abdomen, by watching the area of the belly directly below the rib cage.
If you feel or see tension develop here, you are most likely over activating the outermost or superficial muscles and need to exert less effort. .
Once you establish the above movement, hold for five seconds and repeat ten times. Do one to three sets per day. Use the different cues to help you. Although this exercise looks easy, it is extremely difficult to train and isolate the transverse muscle.
WHAT TO WATCH OUT FOR:
- Holding the breath, which can increase leaking or pain.
- Supine hypotension when lying on your back during pregnancy. Supine hypotension is a fall in blood pressure that occurs when a pregnant woman is lying on her back.
- Over-contracting the abdominals, which engages the more superficial abdominals, such as the rectus abdominis and external obliques. Your challenge is to isolate the TrA muscles and this will take a little practice.
- Increased abdominal pain or trigger points in the abdominals and/or an increase in your symptoms. Trigger points are spots where your muscle goes into spasm and can be quite painful. Check with your MD or midwife right away if you experience any unusual symptom like pain, pressure or discomfort. Remember to never ignore pain.
HOW TO CLOSE AN ABDOMINAL SEPARATION
Here’s a brief video of a second exercise, one that can help to Close Your Abdominal Separation for Strength in Labor and Fast Post Partum Recovery.
THREE FORMS OF BREATHING FOR PAIN REDUCTION AND STRESS RELIEF
And, here’s a great video to help you relax and feel less pain during pregnancy.
Medical Disclaimer: The information in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment.
Excerpted from Ending Pain in Pregnancy by Isa Herrera, MSPT, CSCS. Ending Pain in Pregnancy offers women techniques to manage chronic vaginal, pelvic, sexual and lower back pain during and post pregnancy, as well as during birth. The book also includes information on optimal labor positions and TENS therapy for natural pain relief. The best part is all the techniques in the book can be done at home.
Isa Herrera, MSPT, is a physiotherapist and clinical director at Renew Physical Therapy Center in New York City, where she specializes in pre- and post-natal care and pelvic floor issues. Her new book, Ending Pain in Pregnancy helps women stay strong and pain free while preparing and recovering from labor and delivery. Visit her website for more information or to order the book.