If you've been working out at The Lotus Method you may have noticed that your trainer will occasionally feel your belly or take a peek under your shirt during an exercise. That's not just because we love a good belly (we do!). It also has a purpose. We're checking you for abdominal doming.
What is Intra-abdominal Pressure?
First a quick lesson in physics. Wait! Please don't leave! This is relevant.
Your core functions as a hydraulic pressurized system. This is great news because without intra-abdominal pressure (IAP) we'd all be big piles of jelly. Ideally, your pressure system works like this:
Inhale ➡️ Pressure increases. The belly will inflate and expand to give that pressure somewhere to go. The pelvic floor will yield downward to give the pressure additional space.
Exhale ➡️ Pressure decreases. The balloon deflates. The pelvic floor lifts and reverts back to its starting position.
Let’s try together. Take a deep belly breath. Keep inhaling deeply until you can't fit any more air in. Do you feel your front abdominal wall get hard, tight and stretched. With some focus you may have felt that pressure in your vagina, anus and low back. This illustrates that all abdominal tissues are displaced by pressure. You can relax now!
Certain positions, exercises and breath strategies can cause additional influxes of pressure on top of breath. For the most part we handle those just fine. But now you're pregnant (congratulations!). Your abdominal wall is expanding, and the connective tissue running down the mid-line of your belly (called the linea alba) is stretching. Your pelvic floor has the weight of your little bundle of joy on it 24/7. Your core system is under a new workload, and sometimes (and isn't this just the perfect metaphor for life) the pressure is just too much.
How Does Intra-abdominal Pressure Cause Doming?
Back to physics! Uncontrolled pressure in a system will try to escape through openings and weak spots. Imagine a garden hose that has become weak and threadbare in one spot. When you turn the water on blast, you're going to see pressure bulging out at the weak point of the hose, right? Same in your abdomen. For some, the point of vulnerability is the pelvic floor, and pressure leaks can result in various types of incontinence. For others, poorly managed pressure during an exercise can push out against that vulnerable linea alba creating a dome shape that appears as a ridge down the center of the belly. And that is what we are watching out for.
Can I Still Exercise if My Abs Dome?
What does this mean for your training plan? Well, if we see doming in a client we try to listen to what the abs are telling us. Usually it's, "Whoa! You need to slow your roll. This is too much for me right now." Sometimes we can change breathing or alignment strategies and eliminate doming. Other times, we make the decision to put that exercise on hold until postpartum or until strength is amassed. It's really case-by-case and why we are so committed to one-on-one training for the perinatal population.
Does Doming Mean I Have Diastasis Recti?
We've managed to discuss abdominal doming without ever saying the “D-word.” Diastasis Recti, or the permanent separation of the abdominal muscles. There is no evidence that doming causes diastasis. There is no proven treatment or prevention strategy for diastasis recti. But intra-abdominal pressure management manipulation is the current working theory used by the best in the industry. That includes pelvic floor physical therapists and extremely well-informed fitness trainers, like those at The Lotus Method.
Here's why we operate on this assumption. We know that women who strength train during pregnancy have 35% lower rate of postpartum diastasis compared to their sedentary counterparts. Anecdotally, the rate of postpartum diastasis for women who strength train at The Lotus Method during pregnancy is much less than this. We also know that connective tissue is connective tissue whether it’s in the ankle, the knee or down the midline of the abdomen. We know that connective tissue responds to progressive strength training. So when exercises that used to cause doming, no longer do, it suggests that the linea alba has strengthened and the vulnerability point has resolved. And that's why we treat doming as valuable feedback to your current strength and function.