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Why the mummy tummy? And why is it so hard to get rid of?

by Carmen Andrews - Physiotherapist

Why the mummy tummy? And why is it so hard to get rid of?

Why do you get a mummy tummy?

A mummy tummy often means a weak core

Is the mummy tummy (or ‘mom pooch’) just fat, or is it stretched, weak muscle? What makes it so hard to get rid of?

Why do you get a mummy tummy?

Your abdominal muscle fibres lengthen and therefore weaken as they are stretched in pregnancy. And you store some extra adipose tissue (fat) in this area. But behind this there’s also stretched connective tissue and a stretched uterus.

If you had a c section, the scar also delays normal contracting of your tummy muscles. This happens even though the cut is through the connective tissue, and not into the muscle belly (the part of the muscle that contracts).

Now that you understand what all makes for the mummy tummy, you’re ready to understand how to help it on its merry way…

A pregnant woman holding a sonogram

Connective tissue and the mummy tummy

Let’s look at the most abundant structure that you can help change – the connective tissue.

Connective tissue is the glue that holds us together, the white sauce of macaroni and cheese. It’s within muscle, muscle attaches to it, and in places it thickens to form ligaments which hold our organs in place.

Connective tissue is made up of a matrix of collagen and elastin fibres with gel all around them. As your pregnancy progresses, the collagen and elastin fibres deform to accommodate your growing baby.

On the surface, stretch marks are visible evidence of damaged collagen. But what we often don’t think about are the changes to the deeper connective tissue. A DRA (Diastasis Rectus Abdominis, or tummy gap) is also collagen that has been disrupted.

When it comes to collagen, genetically you may have drawn the short straw or have been lucky enough to hit the jackpot. That is what it is. But despite your genetics, there is so much that can be done to help your body change.

Before you read any further, have a look at these beautiful women proud of the miracle their bodies made.

Acceptance does not equal apathy. It means less self- loathing and less resentment. It means giving yourself the time to change when your whole life and identity has just changed, and having those laughs that come from the deep in the belly along the way.

Help your body change and support connective tissue healing

1. Hydration

Woman holding a glass of water

The type of connective tissue found in the skin, holding the organs together, and in tendons is similar. It has a surprisingly high water content – more than most connective tissue.

This type of connective tissue is called areolar tissue because it has the large gel-filled spaces between the collagen and elastin fibres. In this space, amongst other things, are proteoglycans. Each proteoglycan is a protein fibre with polysaccharide molecules stuck to it. The polysaccharides bind to water – this makes up the gel that fills the spaces.

The water-rich gel allows the connective tissue to be pliable and elastic. It also serves as a reservoir of water and salts for surrounding tissues. Almost all cells get their nutrients from, and release their waste into, areolar connective tissue.
https://en.wikipedia.org/wiki/Loose_connective_tissue
https://www.sciencedirect.com/topics/medicine-and-dentistry/loose-connective-tissue

How to hydrate your connective tissue:
- Make sure you drink enough water. This is logic but it’s so much easier said than done!
- Be mindful if you are truly hungry or actually thirsty.
- Overdoing it won’t be of any benefit, even the opposite.

2. Nutrition

Plate of roast vegetables with woman eating

A registered dietician will be able to give you the best advice here. I want to raise your awareness to this now, so you can identify whether you need to consult someone.

The mindset you need to have: Eat to heal yourself.

A few points to start you thinking in the right direction:
(For the superficial skin and the deeper connective tissue)
- Vit C is great healer of collagen.
- Protein gives your body the building blocks it needs to repair.
- Insulin spikes from refined foods and sugar and caffeine will not help your body heal.

And remember, if you’re breastfeeding, a nutrient dense diet is super important. Consider your iron and calcium. Are you getting enough in to nourish your body and then your little one? This is so important!

A post natal diet is not primarily about losing weight. It’s about eating to nourish your body.

3. Exercise and load

Woman sitting on ground stretching next to exercise equipment

The deeper connective tissue connects muscles. Muscles put tension through connective tissue when they contract, and the body responds by laying down collagen along those lines of tension, thereby changing and strengthening the collagen.

Move in the correct way and your connective tissue will respond and by getting stronger with time. Keep moving in a suboptimal way, and the repetitive loading can further weaken the connective tissue.

So how do you move in the correct way? Build movement habits which use the correct muscles and therefore help the connective tissue to change. These are the deeper tummy muscles which flatten as they contract. The muscles fibres start to change, become a normal length and stronger, the more you train them. The pull in the muscle will bring also about change in the connective tissue. The more (within reason!) these muscles pull on the collagen, the more change is stimulated.

Mummy Tummy Exercises:
1. Learn to use the deeper abdominal muscles (internal obliques and transversus abdominis)
2. Synchronise this with the correct breathing technique and pelvic floor muscle contraction
3. Maintain this throughout an exercise

If you can control these elements, then there is no such thing as a bad exercise for a DRA.

If you are not able to control these elements, then any exercise which results in doming will not be of any benefit to you.

BUT, what’s VERY important to note is that you shouldn’t walk around with your tummy sucked in all day!

This can restrict your breathing, make your mid-lower back stiffer, and your neck more uncomfortable. And it can even make your mummy tummy worse! Why? Because for an efficient muscle contraction, you need a good relaxation. Holding it tense all the time will result in inefficient contraction.

It would be remiss of me to not mention the pelvic floor here. The pelvic floor muscles are activated with the deeper tummy muscles. They must work synchronised with the tummy muscles. (This is a blog of its own, soon to follow…)

How to check if you have a DRA:
Lie on the floor, with your legs straight
Take a deep breath in
Hold your breath and lift your head up to look at your tummy
You may see tenting or doming in your midline

Relax your head down now, place 4 fingers along your midline above the naval
Repeat the steps above and feel the ‘dent’ as well as the distance between the 2 ‘6-pack’ muscles.

A gap of 2 fingers or less is considered unproblematic.

A Diastasis is not just cosmetic! Although the ‘mummy tummy’ is what really bothers moms, the poor muscle coordination that tends to go with a diatasis results in higher pressures on pelvic organs (bladder, uterus and rectum), their support structures, as well as on the pelvic floor.

Years of poor loading strategies can result in weakening of these support structures, and problems related to incontinence and pelvic organ prolapse and pain occur

    66% of women with a diastasis recti abdominis have a pelvic floor support dysfunction(stress urinary incontinence or pelvic organ prolapse) (Spitznagle et al 2007)

Most women can learn to control the tenting without surgery by following a dedicated and specific rehab program.

4. Time

Woman holding a pocket watch

This one is what it is, and it will be different for everyone. While you’re waiting, think of your mummy tummy as a soft spot for your baby. And love yourself through the process!

A note on binding: A cultural art, possibly ‘logic’, but not (yet?) scientific

Binding is an ancient practice and art that seems to be gaining popularity again. It’s said to help in the following ways:
- Supporting the stretched muscle and tissue of the abdominal wall against gravity, which should help them heal quicker. (It’s also touted to prevent DRA but there is zero backing this claim.)
- Deep compression to the uterus could help it shrink quicker, and dispel the blood quicker.
- Lends support to the back.
- Psychological support of feeling hugged and supported.

IMPORTANT:
The one definite contraindication (reason to avoid) to binding is if you have pelvic organ prolapse (POP). This might be hard to tell straight away but if you had POP after baby no. 1 don’t try binding after baby no. 2. If you feel heaviness, bulging, or increased discomfort if you try binding, it’s a good reason to visit your gynae again.

Wrapping up

You don’t have complete control over whether you end up with a mummy tummy. But there’s lots that you can do to support your healing, and to help to get your muscle and connective tissue stronger…and back to what you are happy with. If you have questions, a women's health physio will be able to help. This is a good option if you don't know where to start with exercises for the deep tummy muscles.

Put the focus on your recovery, health, and function, and appearance will slowly change with it.

You can read more about post natal health and our WellMom services HERE

Mom walking with a pram in a beach forest



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About the author: Carmen A is mom to two young children, she has a love for the outdoor life and has competed at a high level in endurance adventure sports (particularly in running and mountain bike stage races). She is passionate about running and getting moms back to running after pregnancy. You can MAKE A BOOKING to see her to work out a rehab program that will work for you.


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