The abs have it
Last week we talked about "Belly after Baby" and how to know if you have a Recti Diastasis Abdominis (DRA) and what exercises you should not do. (If you did not see that article it is posted on our Lake City Physical Therapy Facebook page). This week, we will learn how to re-engage the "poochy" belly and how important the four layers of the abdominal muscles are for the core trunk to work well again.
There are four layers of abdominal muscles that are extremely important belly muscles. These consist of the most superficial layer of muscles called the Rectus Abdominus, which is the notorious "six pack." They run from upper portion of your rib region to your pubic bone. DRA occurs when there is a tear in the facial component of these muscles, and a recent study noted that 66 percent of all people who had a DRA tear also had pelvic floor pain.
Then the next two layers of muscles are the external and internal oblique muscles. They are the "wrapper" muscles and they come around the trunk to the Rectus muscles. They control the twisting motions the trunk does and they help you have a nice midsection.
The deepest layer is called the Transverse Abdominis, affectionately known as the "TA" muscles. These TA muscles are deep in the abdomen and can be felt the easiest when you put your hands in your pockets. These are the first muscles we teach our patients to engage, as they are stabilizers for the core trunk region and all the other abdominal muscles. Interestingly enough, they are the first muscles often to lose their ability to work after pregnancy. However a lot of people who have low back, hip or pelvic floor pain often have poor firing of the TA as well.
As you can see, these layers of the abdominal muscles and their organized motor control plan make for a good anterior canister for your body. Without them, the core trunk of your body will suffer and you will be working other muscles in all the wrong places to help you try to control the front of your trunk.
In my physical therapy practice, I see athletes young and old, pregnant patients, and everyone in between with poor abdominal muscle control. This inevitably leads to multiple other musculoskeletal issues, which could be avoided if only the abdominal muscles were trained as they are suppose to be.
The first step is to slow down and reboot the abdominal system. It means you must engage the brain to tell the muscles what to do. It's a crazy idea that someone with a six pack has no motor planning ability and has to initiate the brain in order to fire the abdominal muscles in the right order especially the TA's.
Seven excercises to reboot abdominal muscles:
1) Transverse Abdominus (TA's). Place your second and third fingers on the muscles that are right below lateral pelvic bones, right where you put your hands in your pant pockets. Then gently tighten your muscles under your fingers by pulling them away from your fingers. These muscles need to fire first, and they are the stabilizers for all the other abdominal muscles.
2) Hip fall outs with TA's: Lay on your back bend your knees, contract your TA's and hold the contraction while you allow your knee to sway out away from midline, and then bring it back to midline. Keep TA's contracted the whole time.
3) Bilateral hip lifts: With bent knee, tighten TA then lift bent knees towards your chest.
4) Bridging with TA's: Laying in your back with knees bent tighten TAs then glutes, then lift buttocks towards ceiling. Keep TAs tight throughout the lift.
5) Bridging with straight leg lift with TA's: Tighten TAs, squeeze glutes together, lift buttocks to ceiling while you hold one leg straight out while other leg
6) Oblique abdominal twists: Hip and knees bent to 90/90 with TA's then gently twist legs to the right and left. Keep TA's contracted.
7) Plank position: on elbows and toes, Tighten TA's, then bend knee up towards your chest, alternate legs x10 while you hold your TA and back flat. You can alternate your leg work by tapping out with straight leg to the side or doing a knee flex to opposite hip.
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Sheree DiBiase, PT, is the owner of Lake City Physical Therapy and she and her staff are happy to help you get fit for a summer of fun. Please join us at 5:45 p.m. this Thursday at Hayden CrossFit for an educational event all about re-booting your abdominal muscles, especially your TA's, checking for DRA and your pelvic health. Call for further info or to reserve a spot: Hayden office (208) 762-4201, Spokane Valley (509) 891-2623 and in our Coeur d’Alene office at (208) 667-1988.