How to Push a Pram With a Diastasis
Updated: Oct 19
Pushing a baby in a pram up a hill is no small thing when you have a weakened core or diastasis (also known as abdominal separation).
I was reminded of just how hard it can be recently, while talking to one of my clients. She was describing her struggle to push her pram up the hill and it took me back to when this was a major issue in my life.
Before I even knew I had a diastasis, pushing the pram up the hill to our house was a struggle. That hill felt like it went on forever.
I would have to take a break halfway up because my lower back hurt, my shoulders and even my calf muscles hurt.
Getting to the top of the hill didn't offer any relief either, as I would have aches and pains in my lower back for the rest of the day.
It got to the point where I was making excuses and avoiding going out for a walk to avoid the pain.
Abdominal weakness and diastasis affects your whole body.
When the central stabilizing system for Your body isn't doing it's job properly, you end up compensating with other muscles.
This leads to dysfunction and pain in the long term.
No one tells you how you should push a pram or stroller to avoid hurting yourself.
It seems like it is easy - until it isn’t.
(I have even watched big strong looking guys with no apparent abdominal weakness, use poor technique to push their child up hills).
Pushing a pram is an every day movement pattern for mums.
If you think of it like exercise, then you can break the movements down into techniques that allow your muscles the best chance to work as a team.
Pushing a pram on the flat doesn't present a lot of challenge to Your core and pelvic floor muscles. You are mostly steering the pram and it rolls along fairly easily.
Which muscles should be working?
Pushing uphill is when you use your butt muscles (glutes) to generate the power to push both you and the pram forwards.
If you start feeling it in your lower back or calves instead (like I did), then there is a good chance that your glute muscles aren't firing properly, adding the extra work load to your pelvic floor and core muscles.
Overloading Your core and pelvic floor often results in pain, pelvic floor dysfunction and leaking.
(People with a diastasis will often have pelvic floor dysfunction as well because they can’t control their internal core pressure very well.
This means that they bear down on their pelvic floor to create tension in their core, and the pelvic floor just can’t cope with the extra load.)
So “waking up” and building strength in your glutes is important to keep your pelvic floor happy.
Keep your hips and ribs in line.
Keep your hips and ribs in line.
The easiest position for your all your core muscles to work together, function properly and control your intra or internal abdominal pressure (IAP), is when you have your ribcage stacked over your hips.
With a diastasis or pelvic organ prolapse, it becomes even more important that you pay attention to your posture when your body is under load.
Controlling your IAP means that you don’t let your core pressure push down onto your pelvic floor or outwards into your abdominals to create the strength you need to push a stroller uphill.
Pushing downwards or outwards loads the weakest tissues in your body which can make your symptoms worse and will prevent your diastasis from healing.
Keeping your alignment with your ribs over your hips puts you in the strongest position to control your IAP. This in turn makes it easier to use the right muscles to get you up the hill.
One common mistake when pushing up hill is keeping Your body too far away from the pram.
As you can see in the picture, I am stretched out into nearly a plank position. (Planks are generally considered advanced postions for people With diastasis, because they genrate large amounts of IAP).
Here the load is firmly on my core to push up the hill. This can be too much for Your IAP if when you have diastasis or pelvic floor dysfunction.
My glutes aren't helping here, as they are behind my body rather than being underneath me.
I am also working hard through my shoulders and chest to compensate for my lack of strength in my core.
Believe it or not, I have actually seen people pushing prams in this positition .
Here my lower back is taking a lot of the load, as well as my chest and shoulders.
Again, high levels of IAP are created in this position , so don't do this if you want your diastasis to get better.
The best way to push is by keeping Your ribs stacked over Your hips and Your body in Close to the pram.
Your elbows are at 90 degrees, avoid any extra tension through the wrists.
When walking Down hill, it is tempting to lean back With Your upper body to help slow the pram Down.
This unfairly loads Your abdominals and will make you push pressure outwards onto the weakened connective tissue (called the linea alba) between you rectus muscles - directly into your diastasis.
It's better to keep Your body close to the pram so that you can use Your glutes to help slow the pram down, without all that extra load on Your core.
To sum up, the Key Points to remember are:
Keep Your abdominals connected - Your ribs should be down and Your abs braced.
Keep Your body close to the pram
Your glutes are the engine to get you up and down the hill
Keep your shoulders and wrists relaxed
Keep breathing with Your diaphragm so Your core can work as a unit to help you push or slow Down.