Post-Surgical Patient: Can’t activate Transversus Abdominus?

From Nikki Martin:


This is the medical history of a client I will be starting with in about 2 weeks.


  1. Laparotomy x 3 (ovarian cysts & infertility)
  2. C. section – which caused numbness from pubic area to half way to the navel.


  1. Anterior cervical fusion C6/C7 (20 years ago) which has limited cervical rotation.
  2. February 2009 – Discectomy L5/S1
  3. 2 degenerative discs – L5/S1 & L4/L5
  4. March 2009 Right total hip posterior aproach

She is an RN in the OB department of a hospital, super nice and very interested in “getting into her body” and we are working on slowing down, getting into breath, and thinking more about the local muscular system instead of the the global muscles. So I was wondering if you had any advice on how to gain some awareness through the transverse and deeper abdominal layers. She is also osteopenic on top of it all but moves relatively well and is gaining some connection. When I palpate the transversus, and ask her to contract/kegel, I feel NOTHING, I just see her sternum lift and rib cage flare. I am starting to do some research in the different procedures she has gone through, I really want to help her gain connection and stability throughout her body. I respect t your education and experience so much, I was hoping you could point me in the right direction.

I hope all is well with you, your hubby, Cali, and the studio.

Thanks for your time,





Filed under Physical Therapy & Exercise

2 responses to “Post-Surgical Patient: Can’t activate Transversus Abdominus?

  1. sherribetz

    Hi Nikki,
    Try getting her to cough, sneeze, “blow out birthday candles”, exhaling as LONG as she can to see if you can get the Transversus Abdominus to fire. You might also consider using the “Stabilizer” (like a blood pressure cuff to monitor lumbar control) It can be ordered online from It is a Chattanooga product developed by Paul Hodges group. When you receive it, if you decide to order it, I can talk you through how to use it. Also, if you just can’t seem to get things working, you could come with her to Santa Cruz for a session with us all together, that might be a good option if you just can’t get things working. But here is the main point: Can she stabilize her spine as she moves her arms and legs (with your fingers palpating the lumbar spine?) And can she lift both legs up one at a time into tabletop without abdominal bulge?



  2. Your blog is so informative … ..I just bookmarked you….keep up the good work!!!!

    Hey, I found your blog in a new directory of blogs. I dont know how your blog came up, must have been a typo, anyway cool blog, I bookmarked you. 🙂

    Robert Shumake Paul Nicoletti

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