The ‘round ligament’ could be to blame!

Each woman has two round ligaments, one found on either side of the uterus. They extend from the uterus to attach to the pubic area or groin. When a woman is not pregnant, the round ligaments just sit there, without much to do.

During pregnancy however, the uterus enlarges and becomes heavy with your baby and the life giver to baby, your placenta. It becomes more sensitive to sudden movements made by mum. This is because as the uterus is so much heavier, the ligaments are on more of a stretch and the heavy uterus has more momentum. That’s where the round ligaments come in: they maintain the uterus position during movement and support the growing uterus.

So, why do the ligaments cause pain?

During sudden or fast movement, the round ligaments can often pull and cramp as they both work together to hold the uterus in the centre of your pelvis and abdomen, thus causing pain. Those movements might include coughing, sneezing, laughing, rapidly standing or walking, rolling in bed and sudden directional changes.

What does round ligament pain feel like?

Occasionally the pain is described as a dull ache as the round ligaments are always pulling tight in that lengthened new position. The most common complaint however, is a sudden, sharp, stabbing or ‘cramp-like’ pain in the groin and/or lower abdomen. Most commonly, it presents in the right round ligament, but can occur on the left side or on both sides too.

Is there anything that can be done to help with this pain while I am pregnant?

The most important thing to understand is that round ligament pain is a normal part of pregnancy. Most of the time, the pain will go away on its own. Here are some things you can do to help manage pain:

• Moving slower so as to avoid sudden movements.
• Lying on your side, with a pillow between your bent knees and another under your growing bub.
• Abdominal bracing during aggravating movements. Simply engage your belly by imagining drawing in the navel before you need to move suddenly, cough or sneeze.
• Abdominal support garments to offload pressure on the ligaments.
• Tilting your pelvis backwards during spasms (imagine tucking your bottom under, or flattening though the spine). Imagine here you are effectively shortening the 2 round ligaments at the front of your belly to take away that lengthened pulled tightness and pain.
• Belly taping can be applied by your physiotherapist.

Read more here.

Another great reason to strengthen those muscles!

What a great read about yet another benefit of resistance exercise in us all. We can easily find many a research paper or magazine article  about the health benefits of regular exercise- cardio vascular health, mental health, even the steering away from cancers, dementia and decreasing bone density.

How about the added effects of stronger muscles and greater muscle bulk? Did you know that:

• healthy muscle mass is involved in the production of greater reserves of amino acids used in the immune system? The bigger the muscle, the more of these in your muscle cells and the better you can quickly fight infection and disease! 
• muscles keep low level inflammatory responses that we all posses at a lower controlled level? This in turn decreases the risks of many chronic diseases that arise from ongoing mild inflammations present in our bodies.
• the quality of exercised muscle may prevent some cancers? The fatty deposits found in a weak unused muscle look to be a cancer risk for some cancers.
• exercise and fitness actually improves the effectiveness of vaccinations? It has been shown that exercising immediately before or after a jab helpds boost the immune system to develop immunity for the disease you were being vaccinated for.

So, get ready for that hopeful arrival of the COVID-19 vaccine! Get those muscles challenged and stronger to boost your immunity.

Read more at https://www.smh.com.au/lifestyle/health-and-wellness/how-muscle-helps-to-build-a-healthy-immune-system-20200706-p559ec.html

Diastasis is not such a dirty word

by Samah Elomari ( women’s health physiotherapist)

The belly separation dilemma

So you’ve just given birth, and one of the midwives or in house hospital physios comes in to assess you for ‘abdominal separation’. That’s already got you a little worried. Then, you’re told you have a ‘significant’ abdominal separation. There’s a panic that sets in…it really is scary to hear. But you’ve got so many other things to worry about, and YOU aren’t at the top of your own list of priorities.

The physiotherapist tells you to do this exercise which involves drawing your tummy in about 50 times all day, every day. You may even get a handout telling you not to pick up heavy loads (uh…hello, I’ve just given birth to a 3+ kilogram baby), to change the way sit and stand, the way you get out of bed and even how you do your housecleaning. She’s lost you at ‘exercise’, and she knows it.

The belly separation solution

Don’t panic! Abdominal separation is normal and there is easier, more effective and efficient ways of getting the results you want. Although you may have a separation, measured by fingers wide, it is actually the gentle tension that you can generate across this gap that will help healing of these tissues and encourage 

• Great postural awareness is the best way to be always working on your belly healing. Sitting all slumped over, hips pushed forward when you stand or even butt tucking in standing all discourage the gentle abdominal activity that correct posture would other wise promote. Simply think of taller waists, a un-tucked butt and stacked ribs, feeling the gentle tension running across your belly that these simple strategies bring. It is as if you have ‘zipped up’ your mid-line zipper! Think of this as you sit to feed, or as you settle your babe in arms, or carrier them in your carrier out front.
• Breathing well and pelvic floor activation  will also help. To breathe deeply, you will get your ribs moving and abdominal muscles contracting and relaxing as they do with natural breath. Spend a minute or 2 in your good posture when feeding or standing, and focus on mindful deep wide breaths.
• You can do small abdominal crunches to assist with belly mid-line healing also, with an excellent research paper from 2015* to support this claim. Ab crunches always face a bad rap when it comes to post natal rehab, however, done correctly, they can actually improve the abdominal narrowing significantly according to the significant results in this study. A visit to your wonderful women’s health and pregnancy physio to teach you here would be highly recommended, as the ab crunch can be performed optimally and safely with great awareness or breath, pelvic floor and deep abdominal ‘corset’ too. Yes! All at once!

If you think you have an abdominal separation or have been told so, please don’t hesitate to give us a call. There’s a lot that can be said on this topic, and it can often be scary when reading all the mother’s online forums or Dr Google. Physios are here for you.

This is part 2 of a two-part series. ‘Abdominal separation: what’s normal during pregnancy?’ to read part one.

• *Mota P, Pascoal AG, Carita AI, Bø K. The Immediate Effects on Inter-rectus Distance of Abdominal Crunch and Drawing-in Exercises During Pregnancy and the Postpartum Period. J Orthop Sports Phys Ther. 2015;45(10):781-788. doi:10.2519/jospt.2015.5459