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Abdominal exercises
Abdominal exercises
Anatomy of abdominal muscles:
Functions of the abdominal muscles:
- They help in respiration and defecation.
- They protect the abdominal viscera and keep them in their position.
- They concern with forward flexion of the trunk.
- They play an important role in labor, since they assist uterus with other
muscles during expulsion of the fetus.
- They assist in maintaining a good erect posture.
- They stabilize pelvis (especially rectus abdominis) during straight leg raising.
Values of abdominal exercises:
- They keep abdominal muscles in a good, healthy condition.
- They make abdominal muscles very strong.
- They help to maintain a good posture and prevent postural problems.
- They assist excretory functions.
- They make abdominal muscles so efficient during labor.
- They improve breathing.
Testing the strength of the abdominal muscles
A) Rectus diastasis test
This test can be done by the mother herself or by the therapist.
Position of the patient:
Crock lying position.
Position of the therapist:
Stride standing position at the level of the waist line with the four fingers
are fitted vertically across the linea alba between xiphoid process and umbilicus.
Procedure:
The mother is asked to raise her head and shoulders off from the plinth until the
spines of the scapulae left the plinth while the therapist measures for diastasis
by turning her fingers horizontally across the linea alba between xiphoid
process and umbilicus to determine how many fingers fit into the space between
the borders of the two rectal bellies.
B) Abdominal girth measurement:
Here, the abdominal circumference at the umbilical level is measured by
using tape measurement. The difference on tape measurement before and after
performing the strengthening exercises indicates more muscular strength.
Types of the abdominal exercises
- Static abdominal exercises.
- Dynamic abdominal exercises.
A. Static abdominal exercises
a. Abdominal bracing exercise
Position of the patient:
The patient is in crock lying position.
Position of the therapist:
The therapist stride standing beside the patient, with the inner hand under the
lumbar region of the patient while outer hand above the abdomen at the level
of waist line.
Command:
Contract abdominal muscles firmly and press lumbar region down, hold then relax.
b. Static abdominal exercise connected with diaphragmatic breathing
Position of the patient and the therapist the same as in static abdominal exercise.
Command:
Take deep breathing from the nose make abdomen like a ballon
then expire the air from the mouth, contract abdominal muscles, press
lumbar region down, hold then relax.
B. Dynamic abdominal exercises
1) Lateral flexion of the pelvis (Hip shrugging):
This exercise is very effective to strengthen quadratus lumborum muscles.
Position of the patient:
Half crock lying position.
Position of the therapist:
Stride standing with outer hand is holding the straight leg just above ankle joint,
while inner hand supporting postero-lateral aspect of the knee and the thumb just
above knee joint to prevent its flexion during movement.
Command:
Contract abdominal muscles, draw the straight leg up towards the ribs to seem
shorter then push down to seem longer, relax and return to starting position.
2) Lateral flexion of the trunk:
This exercise is very effective to strengthen the internal oblique muscles.
Position of the patient:
Crock, supine, stride sitting or stride standing position.
Command:
From crock or supine lying position:
Contract abdominal muscles, try to touch with the tips of the fingers farthest
point on your leg with the head follow the movement and eyes look behind the
shoulder, hold and relax.
From sitting position:
Contract your abdominal muscles, try to touch ground
by your fingers with the eyes should look behind the shoulder to avoid leaning
forward of the trunk, hold then relax.
From standing position:
Contract your abdominal muscles, try to touch by your
fingers the farthest point in your leg with eyes looked behind the shoulder, hold
and relax.
Progression:
To make this exercise so difficult ask the patient to perform it from
side lying position.
3) Pelvic rotation
This exercise is very effective to strengthen the external oblique muscles.
Position of the patient:
Crock lying position.
Grasp:
Inner hand of the therapist on the lateral aspect of the knee joint, just to guide the
movement and to give slight pressure to complete the range of motion and the
other hand around the ankle joint.
Command:
Contract abdominal muscles, try to touch the plinth with flexed knees, hold and
relax.
- To make this exercise more difficult ask the patient to perform this
exercise from half crock lying position.
Grasp:
Therapist outer hand holding the leg just above the ankle joint while inner hand
on the lateral aspect of the knee joint.
Command:
Contract abdominal muscles, try to roll the bending knee over the straight
one, hold, then roll the bending knee to touch the other side of the plinth, then
return to the starting position.
Precautions:
1) Contraction of the abdominal muscles must be maintained all through the
exercise.
2) Shoulders should be fixed on the bed all through the exercise.
4) Trunk rotation
This exercise is very effective to strengthen the internal and external oblique
muscles.
Position No. 1
Position of the patient:
Stride sitting on stool or stride standing with the hands around the waist.
Command:
With maintaining pelvis fixed forward, contract your abdominal muscles, tum upper
trunk to the right side as far as you can and let your head and eyes follow the
movement, hold and relax. Repeat the same exercise to the left side.
Position No. 2
Position of the patient:
Crock lying position.
Command:
Contract your abdominal muscles, try to touch the left knee with the right hand,
hold and relax. Repeat the same exercise for the opposite side.
5) Anteroposterior trunk flexion
This exercise is very effective to strengthen the rectus abdominis muscles.
Position of the patient:
Crock lying and supine lying position.
Command:
- Contract abdominal muscles, raise the head and look to the feet, hold and
relax.
- Contract abdominal muscles, raise the head, the shoulders and look to the
feet, hold and relax.
- Contract abdominal muscles, raise the head, the shoulders, upper trunk and
look to the feet, hold and relax.
- Contract abdominal muscles raise the head, the shoulders, upper trunk, with
both arms stretched out in front, hold and relax.
- Contract abdominal muscles raise the head, the shoulders, upper trunk, with
both arms crossed in front of the chest, hold and relax.
- Contract abdominal muscles raise the head, the shoulders, upper trunk, with
hands beside the eyes, hold and relax.
Ante natal abdominal exercises
1- Core stability: start core stability exercises before starting any other abdominal
exercises.
2- Static abdominal exercises
3-Hip shrugging
4- Lateral flexion of the trunk
5- Pelvic rotation
6- Trunk rotation (avoid trunk rotation from crock lying potion)
Exercises to avoid during pregnancy
- full sit-ups
- double leg lifts
- oblique twists
- frontal planks
Post-natal abdominal exercise
- Static abdominal exercise could be started from 1st day after normal delivery
or cesarean section.
- Core stability exercises is very important part of exercise program post-natal
start with core stability exercise before starting dynamic abdominal exrcises.
- All dynamic exercises are safe to be done post-natal but start gradually after
day 4 for normal labor and day 5 for cesarean section unless the woman has
rectus diastasis.
Rectus diastasis
Exercises and movements to avoid
1- Lifting and carrying very heavy objects.
2- Exercises to avoid
- Sit-ups
- Crunches
- Planks
- Leg drops or leg lowers
- Scissor kicks
- Abdominal bicycle
3- Prevent movements that causing starching in the abdominal muscles.
4- Intense coughing without abdominal support
Exercises that help
1- Activation of transverse abdominis
2- Strengthen of pelvic floor muscles
3- Supporting belt may help but it is not a treatment
