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Diastasis Rectus- Navigating the Ins & Outs: Part 3

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Diastasis Rectus- Navigating the Ins & Outs: Part 3 - Preventing & Treating a DRA

diastasis, diastasis recti, Addison chiropractor, Addison chiropractic, diastasis DuPage county

Now that we know what diastasis rectus abdominis (DRA) is and the causes of DRA, it’s important to understand how DRA affects us and what we need to know before returning to the gym, studio, or running.

What can I do to prevent or heal DRA?

The movements and activities that heal a DRA are the same activities that prevent them. Here is a list of ways that may naturally prevent or heal DRA.

DNS, breathing, core exercises

  1. BREATHE

    1. Creating appropriate intra-abdominal pressure (IAP) and using the diaphragm synergistically with abdominal musculature and the pelvic floor helps stabilize the body and decreases undue pressure on the abdomen that can cause DRA.

    2. It is through the breath and inhaling into all aspects of the abdomen including the lower pelvis, sides and low back that our core is stabilized. It is the stabilization with the breath and IAP and breathing into all aspects of the abdomen that creates a canister of stabilization.

    3. Another way to focus on the breath is to relax. Stop clinching your butt cheeks together, stop sucking in the abdomen and let the belly and butt relax and move freely with the breath.

  1. Avoid movements that put undue stress on the abdominal musculature.

    1. This includes all exercises listed in the ineffective exercise section and it also includes any movement that causes tenting or coning of the abdomen (this is unique for each person)

    2. One thing that can cause unnecessary stress on the pelvic floor and abs is straining when you use the restroom. One way to avoid this stress is to avoid constipation. You may like to try the Squatty Potty to help ease the flow. If you are regularly constipated, please seek out medical advice.

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  1. Mind your posture

    1. Neutral spine is key! We don’t want to be pulled into anterior pelvic tilt or posterior tilt as both put strain on the body in different ways.

    2. The goal is to keep your pelvic floor and your diaphragm aligned!

  1. SLOW IS FAST

    1. Postpartum is forever and deserves to be respected. It’s not only OK to go slow, it is better in the long run! Going too fast too soon can actually slow down the healing process.

    2. Postpartum gives you an opportunity to slow down and allow your body to recover, rehabilitate, and rebuild.

pelvic floor, core exercises, Addison chiropractic, Addison chiropractor, chiropractor Addison, chiropractic Addison

  1. Restore your movements from childhood

    1. ALL babies are born with a DRA and it is through their normal childhood development that they naturally begin to close and close their DRA through movement.

    2. This is where Dynamic Neuromuscular Stabilization (DNS) in as it is based on ontogenesis- the natural growth & development we go through as children. We do purposeful movements that can naturally help to heal a DRA.

  1. See a pelvic floor physical therapist

    1. Sometimes pain and discomfort can come from weak muscles and sometimes it comes from tight muscles. The key is knowing what you are working with so it can be treated appropriately. One great way to know what needs work is to see a women’s health physical therapist in your area!

    2. If you are in the Chicagoland area, reach out, I’d love to help!

*Disclaimer:

The information by Dr. Lauren Keller of Elemental Chiropractic, Inc. is provided for general information only and should in no way be considered as a substitute for medical advice or information about any particular condition. While every effort has been made to ensure that the information is accurate, Dr. Lauren Keller nor Elemental Chiropractic, Inc. make no warranties or representations as to its accuracy and accept no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation. If you have any specific questions about any medical matter or think you may be suffering from any medical conditions, you should consult your doctor or other professional healthcare provider. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

Diastasis Rectus- Navigating the Ins & Outs: Part 2

DRA-e1515848994641.jpg

Diastasis Rectus- Navigating the Ins & Outs: Part 2 - The Causes

Now that we know what Diastasis recti abdominis (DRA) is, it’s important to look at the causes of DRA. It’s important to note that there is not one cause of DRA so there is not one solution to fix it either. However, knowing the causes may help lower the incidences.

1.  Hormones

According to Rett, “During pregnancy, hormonal changes caused by relaxin, progesterone and estrogen combined with uterine growth may cause stretching of the abdominal muscles3, affecting mainly the rectus abdominis muscles.”

What does this mean to you and me? Well, in part one we learned that 100% of women have a diastasis recti in the third trimester and this highlights that it is NOT 100% avoidable. In fact, the hormones that our body naturally produces during pregnancy, labor and postpartum naturally lead to increased stretching.

2.  Posture

Rett also stated that “during pregnancy, it is common to have anterior pelvic tilt with or without lumbar hyperlordosis3,12,5,13 . These postural changes can affect the insertion angle of pelvic and abdominal muscles, influencing postural biomechanics.”

Basically, as a woman’s belly grows in order to make room for baby, so does her posture. It’s common for women to go into anterior pelvic tilt. Anterior pelvic tilt is best described as a basin or cup in your pelvis that during pregnancy rocks forward. Just as your cup will lose water with increased tipping, your body naturally loses its stability and support with this movement. Furthermore, due to the increased muscle stretch the abdominal muscles may actually decrease in contractile strength.

3.    Non-ideal development in childhood / Insufficient postural function of the diaphragm

Did you know that every baby is born with a diastasis? It naturally closes starting around 4.5 months when optimal childhood development includes a synergistic contraction of the diaphragm, abdominal muscles and pelvic floor muscles and the oblique chains start to be utilized.14,15 This includes the integration of the diaphragm to act as both a respiratory and postural muscle. “According to Kolar, intra-abdominal pressure (IAP) regulation & the integrated spinal stabilizing system (ISSS) can be disrupted by insufficient postural function of the diaphragm.”16,17

If during normal childhood development we don't develop adequate diaphragm activity, our body will compensate with faulty movement patterns, including rib flare or elevation of the ribs. This can cause excessive use of low back muscles and is often seen with “inadequate lateral rib cage expansion or resistance of the abdominal wall against IAP changes.”15 This means as we inhale our body is not able to maintain appropriate intra-abdominal pressure and this is often seen in chest breathing or when someone only belly breaths and does not breath into all aspects of their abdomen. You see, IAP is not inherently bad. In fact, in order to breath you MUST create IAP. Therefore, it is not IAP that makes a diastasis worse, it is the body’s inability to appropriately manage changes in IAP that can cause or worsen DRA. Intra-abdominal pressure is best managed when we develop the synergistic contraction of the diaphragm, abdominal muscles and pelvic floor muscles.

Note: For more information on the causes of dysfunctional breathing, check out Dysfunctional Breathing: The Whys.. For more information on IAP, check out For the love of all things good, stop sucking in. 

4.    Multiple Pregnancies, Twins & Age

It is believed that women who have given birth (whether vaginally or cesarean), are more likely to have a DRA. Furthermore, there is increased DRA below the umbilicus in women who have given birth multiple times.5 While there is limited studies, the one study we do have indicates that there is a higher prevalence of DRA among women over the age of 50. The reason for this is due to cumulative mechanical stress on the connective tissue of the abdominal wall, the linea alba.

5.   Not exercising

In a study released in 2005 by Chiarello, et al, it was observed that “90% of non-exercising pregnant women exhibited DRA while only 12.5% of exercising women had the condition.” Furthermore, the study showed that the DRA was more severe in all three locations of testing in the women that did not exercise.18

6.   Ineffective Exercise

Not all exercises are created equal. Ineffective exercise can be exercises that are done wrong or exercises that are less than ideal for pregnancy. These exercises MAY include:

  • Sit-ups, crunches and  curls (including oblique sit-ups and sit-ups on exercise balls, incline sit-ups, roll ups)

  • Reverse crunches

  • Triangle pose

  • V-ups & V-sits

  • Double leg raises

  • Bicycle legs

  • Planks

  • Hanging knee raises

  • Pilates exercise “The Hundred”  or "roll up"

  • ANY movement that creates abdominal wall bulging, coning or tenting!!!

References:

  1. Mota P, Pascoal AG, Carita AI, et al. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther 2015;20:200–5.

  2. Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements. Mota, Patrícia et al. Manual Therapy , Volume 18 , Issue 4 , 294 - 298

  3. Corrêa MC, Corrêa MD. Puerpério. In: Corrêa MD, editor. Noções práticas de obstetrícia. 12ª ed. Rio de Janeiro: Medisi; 1999. p. 95-104.

  4. Gilleard WL, Brown JM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Phys Ther. 1996;76(7):750-62.

  5. Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(3):321-8.

  6. Rett, MT, Braga, MD, Bernardes, NO, & Andrade, SC. (2009). Prevalence of diastasis of the rectus abdominis muscles immediately postpartum: comparison between primiparae and multiparae. Brazilian Journal of Physical Therapy, 13(4), 275-280. Epub August 21, 2009.https://dx.doi.org/10.1590/S1413-35552009005000037

  7. Sperstad JB, et al. Br J Sports Med 2016;0:1–6. doi:10.1136/bjsports-2016-096065

  8. Boissonnault JS, Kotarinos KR. Diastasis recti I. In: Wilder E. ed. Obstetric andgynecologic physical therapy. New York: Churchill Livingstone, 1988:63–81.

  9. Boissonnault JS, Blaschak MJ. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther 1988;68:1082–6.

  10. Rath, A.M., Attali, P., Dumas, J.L., et al., 1996. The abdominal linea alba: an anatomo-radiologic and biomechanical study. Surgical Radiologic Anatomy 18, 281–288.

  11. Coldron, Y., Stokes, M.J., Newham, D.J., Cook, K., 2007. Postpartum characteristics of rectus abdominis on ultrasound imaging. Manual Therapy. Epub.

  12. Whiteford B, Polden M. Seu Corpo antes e depois do parto. In: Whiteford B, Polden M, editores. Exercícios pós-natais: Um programa de seis meses para a boa forma da mãe e do bebê. São Paulo: Maltese-Norma; 1992. p. 10-23.

  13. Artal R, O'Toole M, White S. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37(1):6-12

  14. Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther. 2004;9(1):3-12.

  15. Frank C, Kobesova A, Kolar P. DYNAMIC NEUROMUSCULAR STABILIZATION & SPORTS REHABILITATION. International Journal of Sports Physical Therapy. 2013;8(1):62-73.

  16. KolarP,SulcJ,KynclM,SandaJ,CakrtO,AndelR, Kumagai K, Kobesova A. Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther. 2012;42(4):352-62.

  17. Kolar P, Sulc J, Kyncl M, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol. 2010;109:1064-1071.

  18. Chiarello, Cynthia & A. Falzone, Laura & E. McCaslin, Kristin & N. Patel, Mita & R. Ulery, Kristen. (2005). The Effects of an Exercise Program on Diastasis Recti Abdominis in Pregnant Women. Journal of Women’s Health Physical Therapy. 29. 11–16. 10.1097/01274882-200529010-00003.

*Disclaimer:

The information by Dr. Lauren Keller of Elemental Chiropractic, Inc. is provided for general information only and should in no way be considered as a substitute for medical advice or information about any particular condition. While every effort has been made to ensure that the information is accurate, Dr. Lauren Keller nor Elemental Chiropractic, Inc. make no warranties or representations as to its accuracy and accept no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation. If you have any specific questions about any medical matter or think you may be suffering from any medical conditions, you should consult your doctor or other professional healthcare provider. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

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Diastasis Rectus- Navigating the Ins & Outs: Part 1

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What is Diastasis Rectus Abdominis?diastasis, diastasis recti, diastasis rectus, Addison chiropractor, Addison chiropractic, diastasis DuPage county

Diastasis Rectus Abdominis (DRA) is caused when the rectus abdominis muscles (two large, superficial, parallel bands of muscles commonly referred to as the 6-pack) become separated by a larger distance than normal. Diastasis recti occurs when the linea alba, a collagen structure of connective tissue, is no longer able to provide stability and appropriate tension.

In the pregnant or postpartum mom, DRA is commonly noticed when the abdominal muscles are firing in a non-optimal pattern. This is seen as “tenting” or “coning” of the abdomen that is often seen when women are going from lying down to sitting up or when exercising. Even at rest, DRA may be noticeable as it is commonly nicknamed “mummy tummy” or “mommy pooch” as even after a mom has lost the baby weight her stomach may not appear skinny due to a DRA.

How common is DRA?

According to a study, the prevalence of DRA decreased from 100% at 35 weeks gestation to 39% at 6 months postpartum.1That means that 100% of women have some level of DRA in their third trimester. One study showed the prevalence of DRA above the umbilicus was 68% and 32% below the umbilicus. While there was no difference the DRA above the umbilicus, the DRA below the umbilicus was greater in women who had given birth more than once.6diastasis, diastasis recti, diastasis rectus, Addison chiropractor, Addison chiropractic, diastasis DuPage county

It’s important to note that at 6 weeks postpartum 60% of mothers had a DRA, 45.5% at 5 months postpartum and 32.5% at 12 months postpartum.7 A different study showed that 36% of postpartum mom’s rectus abdominis remained abnormally wide at 5–7 weeks postpartum.11

Furthermore, diastasis recti and pelvic floor problems tense to go hand-in-hand and 66% of women with a diastasis recti have some level of pelvic floor dysfunction whether it be inconinence or pelvic pain.5,7

When can I check for a Diastasis Rectus?

Since almost all moms have some degree of abdominal separation, it is important to act as if you have a separation until at least 6 weeks postpartum. Remember, 60% of mothers have a DRA at 6 weeks postpartum and 32.5% continue to have a DRA after one year. It is safe to assume (and act/exercise as though) you have an abdominal separation until 6 months postpartum.

How do I measure for a DRA and what is normal?

Mota found that “palpation has sufficient reliability to be used in clinical practice.”2 The following is how to palpate for a DRA and what is considered “normal” for a diastasis rectus abdominis.

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First, lay on your back with your knees bent to a 45 degree angle with your feet resting gently on the ground. Next, make sure you are in a neutral position so your low back has a gentle curve and your butt is untucked.  Then as you exhale, gently lift your head and shoulders off the floor, tucking your chin and use your index finger and middle finger to measure based on the following palpation:

  1. Location and width - there are three locations to palpate for a DRA and width is measured from side-to-side in fingertip width:10
    1. Just above the umbilicus: 2.7cm is normal (at most 2 fingertip widths)
    2. Midway between the pubic symphysis and the umbilicus: .9cm is normal
    3. Midway between the umbilicus and xyphoid process: 1.0cm
  2. Depth or tension of the linea alba
    1. The linea alba is connective tissue and should be both strong and taut. There should be some natural flexibility but the tissue should resist the pressure of your fingers.
    2. If the linea alba is not able to optimally contract, you will feel as if your fingers are sinking in deeper when light fingertip pressure is applied.
    3. Depth can be measured as fingertip, knuckle or even finger depth or more specifically:
      1. Shallow: 0-3cm
      2. Medium: 3-6cm
      3. Deep: 6-7cm

*One other thing to look for as you lift your head is tenting or coning of the abdominal musculature. Although this is not specific to a diastasis rectus abdominis, it is commonly a sign that you are recruiting the wrong abdominal musculature and indicates instability that may need to be addressed.

How frequently can I check my DRA?

Not too often!  Checking too frequently can actually damage the tissue and weaken the muscles which makes the gap worse! If you “have to know” the most frequently you should check for a DRA is 4-6 weeks....give yourself time to heal from the inside out!

Keep an eye out for Diastasis Rectus- Navigating the Ins & Outs: Part 2 - The Causes of DRA

Lauren Keller, Elemental Chiropractic, Addison chiropractic, pregnancy chiropractor, Elk Grove Village, Bensenville, Villa Park, Glendale Heights, Carol Stream, Addison chiropractor, chiropractor Addison, chiropractic Addison

References:

  1. Mota P, Pascoal AG, Carita AI, et al. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther 2015;20:200–5.
  2. Reliability of the inter-rectus distance measured by palpation. Comparison of palpation and ultrasound measurements. Mota, Patrícia et al. Manual Therapy , Volume 18 , Issue 4 , 294 - 298
  3. Corrêa MC, Corrêa MD. Puerpério. In: Corrêa MD, editor. Noções práticas de obstetrícia. 12ª ed. Rio de Janeiro: Medisi; 1999. p. 95-104.
  4. Gilleard WL, Brown JM. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postbirth period. Phys Ther. 1996;76(7):750-62.
  5. Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in a urogynecological patient population. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(3):321-8.
  6. Rett, MT, Braga, MD, Bernardes, NO, & Andrade, SC. (2009). Prevalence of diastasis of the rectus abdominis muscles immediately postpartum: comparison between primiparae and multiparae. Brazilian Journal of Physical Therapy, 13(4), 275-280. Epub August 21, 2009.https://dx.doi.org/10.1590/S1413-35552009005000037
  7. Sperstad JB, et al. Br J Sports Med 2016;0:1–6. doi:10.1136/bjsports-2016-096065
  8. Boissonnault JS, Kotarinos KR. Diastasis recti I. In: Wilder E. ed. Obstetric andgynecologic physical therapy. New York: Churchill Livingstone, 1988:63–81.
  9. Boissonnault JS, Blaschak MJ. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther 1988;68:1082–6.
  10. Rath, A.M., Attali, P., Dumas, J.L., et al., 1996. The abdominal linea alba: an anatomo-radiologic and biomechanical study. Surgical Radiologic Anatomy 18, 281–288.
  11. Coldron, Y., Stokes, M.J., Newham, D.J., Cook, K., 2007. Postpartum characteristics of rectus abdominis on ultrasound imaging. Manual Therapy. Epub.
*Disclaimer:

The information by Dr. Lauren Keller of Elemental Chiropractic, Inc. is provided for general information only and should in no way be considered as a substitute for medical advice or information about any particular condition. While every effort has been made to ensure that the information is accurate, Dr. Lauren Keller nor Elemental Chiropractic, Inc. make no warranties or representations as to its accuracy and accept no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation. If you have any specific questions about any medical matter or think you may be suffering from any medical conditions, you should consult your doctor or other professional healthcare provider. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

The Hows and Whys to Working that Sexy Core

The Whys Behind Proper Core Exercise

The "core", as defined in “The Core Muscles of Core Exercises”, is more than those six-pack muscles. In fact, it has a lot more function than making you look sexy.

The core should work together, or work synergistically. What does this mean? When training the core, you should train it as a unit, the way it works as you breath and move throughout the day. The core is a system that only functions when the entire system is working in coordination. Working one aspect of the core without considering the other parts is pointless. It’s like doing a clam shell when you are capable of doing a single-leg deadlift. It may benefit a little, but it’s not the most efficient or effective movement.

Just as we shouldn’t work muscles separately, we also shouldn’t use our core without using the diaphragm and pelvic floor. In fact, our muscle activity should be tied with both respiration (breathing) and functional movement. All trunk muscles along with the diaphragm and pelvic floor help modulate intra-abdominal pressure (IAP) to create stabilization. When abdominal and back musculature, the diaphragm and the pelvic floor work together, the entire system is a well-oiled machine that has both stability and strength.

When the core is stabilized through breathing and the muscles work synergistically, the body is able to function optimally.

  • Abdominal and pelvic organ support
    • Including proper and timely use of orifices (i.e. pee’ing and pooping when you want to and not just because you are vomiting, sneezing, lifting or coughing)
  • Movement control and mobility
    • “Dynamic core stability for optimal athletic performance is not achieved purely by adequate strength of abdominals, back extensors, gluteals or any others muscles in isolation, but is accomplished through precise coordination of the ISSS and IAP regulation.”(1)

The Hows to Core Exercise

1. Through the Breath core exercises, Addison chiropractic, Addison chiropractor, chiropractor Addison, chiropractic Addison

The breath (and therefore the core) should be three things - reflexive, anticipatory and reactive.

Reflexive Core & Breathing

Just as you don’t tell your eyes to close or your arm to move, you don’t want to tell your diaphragm to inhale and exhale.

Not sure what a reflexive breath looks like? Well, as we inhale (breath in), our diaphragm descends and the pelvic floor should relax, this allows the lower ribs to expand (outward and downward) and allows the abdominal wall to relax and expand. The breath inwards should be felt in a 360 degree expansion which means you should feel the breath in your pelvic floor, the sides of your abdomen and even in your back. Then, as we exhale, our diaphragm ascends and creates a gentle tension throughout the pelvic floor, abdominal wall as well as lumbar and thoracic musculature to create a support system.

Anticipatory Core (Feed-Forward Control Mechanism)

Before working, our brain sends signals that are beyond one’s consciousness to tell the body to be prepared for movement before any purposeful movement occurs

Reactive Core

All muscles that surround the anticipatory core creates the reactive core stabilization

2. Through Relaxing

Overtime pulling your abs in (aka suck your belly button in aka navel to spine aka holding the abs) creates a disconnect in the core system. So stop sucking in and forcing your abs to work, let them relax and work as they should. Not sure how they should work? Well, it’s through a reflexive, anticipatory and reactive core. You cannot have true core stability without letting your body do what it should.

What about tone?

The goal for core strengthening exercises should be to train the core to function optimally through stability, which includes a deep, diaphragmatic, reflexive breath.

But alas, I will concede and talk about those sexy abs.  When people think about the core and those six-pack abs, they often think about tone.

Tone is affected by many things including:

  1. Breathing strategies
  2. Posture and alignment
  3. Pregnancy
  4. Weight
  5. Digestion and constipation
  6. Nutrition and hydration
  7. Neurologic disconnect
  8. Poor exercise choices
  9. Pelvic floor dysfunction

I know it's not the answer you wanted, but exercise is just ONE of the MANY ways to "tone those abs" and get a six-pack.

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The Core Muscles of Core Exercise (aka…an Anatomy Lecture)

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Understanding the Anatomy of Corecore exercise, breathing, DNS Exercises

The Core Muscles of Core Exercise (aka…an Anatomy Lecture)

New Years is coming up so you are probably seeing the swarm of advertisements saying “New Year, New You” or “get your body beach ready”. When we talk about core exercises it’s important to remember what exactly makes up that core. When talking about the core a lot of  people think about the fancy six-pack muscles but there’s so much more than that. So here it goes…the core is comprised of the following:

Diaphragm

DNS, breathing, core exercises

  • What does it attach to?Lumbar vertebra (1-3)core exercise, breathing, DNS
    • Lower 6 ribs
    • Back of sternum & xiphoid process
  • Function?
    • Concentrically contracts and lowers on inhalation
    • Eccentrically contracts and rises on exhalation
    • Helps mobilize the ribs, lumbar spine and thoracic spine
Multifidus
  • What does it attach to?
    • Vertebra from sacrum to skull
  • Function?
    • Important role in stabilizing the joints within the spine
    • Supports and protects the spine and pelvis to prepare movement of limbs
    • Commonly inhibited in pain
Abdominal Raphe (Linea Alba & Linea Semilunaris)
  • What does it attach to?
    • Runs along anterior abdominal wall connecting xiphoid with pubic symphysis and crest
    • Receives attachment of obliques and transverse abdominis
    • Extends from cartilage of 9th rib to pubic bone
  • Function?
    • Mostly collagen connective tissue
Rectus Abdominis (the six-pack…actually the eight-pack, but who is counting?)core exercises, Addison chiropractic, Addison chiropractor, chiropractor Addison, chiropractic Addison
  • What does it attach to?
    • Arises from pubic symphysis and runs vertical to typhoid and costocartilage of 5th and 7th ribs
    • Contained in rectus sheath (which is derived from external obliques, internal obliques and transverse abdominis)
  • Function?
    • Important in forced exhalation
    • Helps with strength termination
External Obliquescore exercises, Addison chiropractic, Addison chiropractor, chiropractor Addison, chiropractic Addison
  • What does it attach to?
    • 5th-12th ribs
    • Connects with fibers of serrates anterior and latissimus dorsi
    • Connects to iliac crest
    • Crosses the pubic symphysis
  • Function?
    • Stabilize the pubic symphysis (with anterior pelvic floor muscles)
Internal Obliques
  • What does it attach to?
    • Connects to thoracolumbar fascia posteriorly (via transverse abdominis tendon)
    • Connects to anterior iliac crest and lateral inguinal ligament
    • Posterior fibers connect to 11th and 10th ribs
  • Function?
    • Accessory muscle of respiration
    • Forms inguinal ligament with transverse abdominis
    • Rotates and side-bends the trunk by pulling the rib cage and midline towards the hip and lower back, of the same side with contralateral external oblique
Transverse Abdominis
  • What does it attach to?
    • Connects to thoracolumbar fascia with tendon and iliac crest
    • Connects to the lower 6 ribs and lateral aspect of inguinal ligament
    • Inserts into linea alba
  • Function?
    • Forms inguinal ligament with internal obliques
    • Helps support the spine and internal organs
Psoascore exercises, Addison chiropractic, Addison chiropractor, chiropractor Addison, chiropractic Addison
  • What does it attach to?
    • All lumbar vertebra bilaterally
    • Lateral edges of vertebra from T12-L4 (and intervertebral discs!)
    • Lesser trochanter of femur
  • Function?
    • Stress response shortens the psoas
    • Affects structural balance
      • Commonly seen in an anteriorly tilted pelvis and/or rib thrusting
Pelvic Floor
  • Function?
    • During breathing, raises and lowers synergistically with the diaphragm
    • Works to control the spine and pelvis by offering support for abdominal and pelvic organs
    • Supports the urethral and anal sphincters (what you pee and poop out of)
Superficial Pelvic Floor
  • Composed of bulbocavernosus, ischiocavernosus, superficial transverse perineal, external anal sphincter
  • Function?
    • In women, it contributes to clitoral erection and orgasm
    • Helps empty the canal of the urethra
Deep Urogenital Diaphragm Layer
  • Composed of deep transverse perineal
  • Function? Supports central tendon of perineum through perineal body
Pelvic diaphragm
  • Composed of levator ani (pubocococcygeus, iliococcygeus, coccygeus), piriformis, obturator internus
  • Function?
    • Support pelvic viscera
    • Closes back part of pelvic outlet
    • Keeps vagina and rectum closed
    • Facilitates birth

Up Next? Learn about the The Hows and Whys to Working that Sexy Core!

Helping Mamas feel strong, confident and ready to move

Our appointments are limited each week to ensure optimal care and one-on-one attention.
In-network with BCBS PPO & BCBS Choice ONLY as of July 1, 2021. Schedule online for prenatal and postpartum chiropractic care as well as pelvic floor therapy.

Serving the communities of Addison, Villa Park, Lombard, Glen Ellyn, Glendale Heights, Bensenville, Carol Stream, Wood Dale, Itasca, Bloomingdale, Hoffman Estates, Elk Grove Village, Elmhurst and surrounding areas.