You have probably seen people in the gym straining to lift heavy weights, giving it their all — the pain of such an effort marked by loud grunts and bulging veins. Well, you can bet that there’s more “bulging” going on than just the capillaries of the face. If we zoom into the core’s activity during a moment of such supreme effort, we can count on not only a significant increase in muscular recruitment, but also on a spike in intra-abdominal pressure (IAP).
What is IAP?
IAP is the amount of pressure in the abdominal cavity at any given time. The pressure changes based on the volume of the cavity and the contents within it, as well as outside forces placed on the body. That means that if someone gains mass in the belly (like a pregnant client), or there is a heavy resistance to overcome (as when moving a load), then the IAP rises above resting levels. IAP also increases in other circumstances that deserve our attention:
- Coughing (especially relevant to consider when someone is sick or who has a chronic pulmonary condition, such as asthma)
- Bearing down on the toilet (occurs with constipation)
- Breath-holding (or “Valsalva” — a chronic habit of many when lifting heavy)
- Jumping (more specifically, upon landing when the body has to absorb significant ground reactive forces)
Is IAP Always a Bad Thing?
Absolutely not. A certain amount of pressure is needed in the abdomen so that the core can assist in accelerating, decelerating, or stabilizing any movement. Trunk stiffness is key to successfully achieving almost all activities — both during high-performance and common ADLs (Activities of Daily Living).
Issues arise when there is too much pressure over time. Consistent, and excessive pressure can contribute to the development of two major core injuries, Diastasis Recti (the image shown up top) and Pelvic Floor Dysfunction. The reason these conditions are so common during pregnancy is that the growing belly alone creates a significant amount of pressure in the abdominal cavity, so pregnant women have chronically elevated IAP. Therefore, we need to make smart training choices that do not significantly add to this pressure.
How to Manage IAP During Pregnancy
What to Focus on:
- Coach her into neutral alignment (poor alignment adds pressure)
- Help her develop strong “Core Canister” functioning
- Teach her to breathe properly! This one is huge…
What to Avoid:
- Sucking in, or keeping the core chronically engaged (this shuts off the Core Canister and creates a pressure buildup)
- Breath-holding upon exertion (Valsalva)
- Bearing down on toilet. Give her these tips to help her avoid constipation
- All the movements listed in Core Exercises to Avoid