Diastasis Rectified

My journey to heal postpartum diastasis recti


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Am I engaging my core or just sucking it in?

Was it the first pair of tight jeans or the baby tee craze of late 90s that led to sucking my gut in for the first time? Ew, maybe it was those crop tops. Whatever the cause, it is long gone and the sucking in remains. I was under the impression that I have just always been a stellar example of constant ab engagement. Sadly for me, this is not the case.

Engaging our cores – specifically the “waist-making” muscles of the transverse abdominis (TVA) – and “sucking it in” have nothing in common. Sucking in creates a vacuum in the midsection that in turn displaces our pesky organs, moving them up and giving a skinnier appearance.  Sucking in does not strengthen any muscles. Sucking in is no friend to those of us with diastasis recti.

Engaging our TVA is something that happens naturally during the day as we need to use it, but programs like MuTu and Tupler work to strengthen it specifically so we can heal our diastasis recti. Since healing is dependent on doing this action correctly, I better be doing it right!

I have a hard time knowing that I am working my TVA and not sucking it in. You know how research shows that you haven’t mastered something until you’ve done it 10,000 times? Once we “master” sucking in, it’s a lot to unlearn!

In Katy Bowman’s Alignment Matters book, she has a post that helped me discover my TVA and differentiate that feeling from the sucking it in feeling. Really, it’s the only thing that’s helped me feel the difference. The more I do this diagnostic exercise, the more I can feel the difference when I’m going about my daily activities.

Here’s what you do (and I recommend checking out Katy’s post for lots of more detail!):

Step 1

Get on all fours and let your pelvis and back go to their normal, relaxed position. There should be a curve in the lumbar spine.

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Step 2

Keeping that curve in your lower back and not moving anything else, contract your TVA by drawing the belly button up toward the spine. Do not move your pelvis!

TVA engaged

I was surprised how deep and low I felt this. Try it!

Step 3

Now, tuck your pelvis and suck in to feel the difference.

Sucking stomach in

This is why people suck in. So they can look like emaciated wildebeests.

Did you try it? How did it feel? Hope you have a non-sucky day!

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Encouragement for You and Me From Debbie Beane, RES

Debbie Beane, RES

Debbie Beane, RES

Recently, as I was weighing jumping into the Restorative Exercise certification, I was becoming overwhelmed with the feeling that this mountain of information and under-functioning body parts was too intimidating to surmount. I feared that I would pull a Humpty and never get pieced back together.

Then, like a vision, the kind, understanding countenance of Debbie Beane popped up in my Skype window and she spoke knowledge, encouragement, kindness, and genuine empathy to me. She is a mother who has been down the diastasis recti / pelvic floor disorder road, who did MuTu when it was still in infancy, and found Restorative Exercise at the right moment to fall in love with it and start her own RE practice. In short, she is my role model.

Lucky for you, she has bottled some of that kind, brilliant, wise empathy and let me distribute it here to you.

Here are her words for you and for me:

So.

First of all, I offer sympathy and empathy and I-know-your-pain. It is SO HARD to have done this amazing thing (bringing a human into the world?!), and to be dealing with all of the life changes (sleep??) and then to learn that your body is more or less betraying you… it’s hard. For anyone, but especially if you considered yourself particularly healthy or fit beforehand. And then, if you were a very proactive do-everything-Right sort of pregnant person, to learn that there were things you might have done that no one told you about? It’s devastating. How are we supposed to prepare when we don’t even know the right questions to ask??

So. Now you are here, with unhappy results. Know that you are not alone, that in fact there are more people with these issues than you can imagine. But more importantly, know that there *are* things you can do, and that it can, and will, get much much better. Prepare to open your mind and be willing to try things that you don’t understand. Realize that you’re up against a big project, and you’ll spend a lot of time working on it, but that in some ways it’s actually a gift. Because you will end up so much healthier than you were before, and you might never have sought out this information without the catalyst of the injuries.

It’s a small comfort, especially at first, but it’s true. And the benefits you can reap, not only for yourself but for your whole family, are huge. You can help your kids not have to deal with this later on… and maybe you can help other moms, or future moms, by spreading the word. It is frustrating, and depressing, and more than you want to deal with sometimes. But it is what it is, and now you have found the information you need, and all that’s left is to do it.

I can’t tell you how many times I’ve read this because I’ve lost count. I need to print it and put it on my wall. I hope you love it as much as I do. Thank you, Debbie!

You can find more from Debbie over at PositivelyAligned.com.


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My 4 favorite sitting postures and how they’re getting in my way of healing this diastasis

Certification Pre-Req Pack

Whole Body Alignment Pre-Req Pack

I got my pre-requisite pack from The Restorative Exercise Institute! Giddy excitement mixed with overwhelm, that. I was up reading Alignment Matters last night and couldn’t go to sleep because of all the things to learn. You should get all this information as soon as you have a body to take care of!

There are so many new things I’m learning: my feet are like sonar for your body, my tight shoulder girdle is contributing to poochy stomach, I shouldn’t have to make noise while passing gas, menstrual cramps can be mollified, tight calves are imperative to address, poking your pelvis forward is not the same as good posture, and on and on. So many things to discuss!

Today, however, I want to talk about sitting because I sure do a lot of it. Have you ever read Dear Zoo 20 times in a row? Built 105 towers of blocks to be knocked over 105 times? Fallen asleep in childs’ pose while someone crawled onto your skull? No? Well, these are a daily occurrence for me. I no longer have to spend eight hours a day at a desk, hallelujah, but there are other challenges associated with repeated activities.

Repeated body postures tell us something, and for me I tend toward these four almost exclusively:

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Did I do a good job distracting you from my nursing pads on the chair?

Anyway, these are my four sitting postures. Everything else hurts almost immediately in my upper back or hips or hamstrings or somewhere. Ouch. So it’s not that these are terrible ways to posture your body but that my body is tight and loose and misaligned in certain ways that these four are the path to least resistance. For me. Yours will be different.

The “Hello Incontinence”

I think I developed that foot sitting habit during pregnancy and picked it right back up after perineal healing – because leaking. It’s always my right foot. My pelvis is tilted as a result and so my spine has to accommodate (as you can see, since my torso looks like a backwards “C”). 

The Pelvis Tucker Sacrum Crusher

Why, oh why, do I love this one so much? Clearly I’m taking any stretch out of my hamstring by tucking my pelvis and drawing up my knees. I also don’t have to activate my abdominals because my arms are holding me in a ball and I’m leaning up against the wall or couch. I tend to get numbness in butt-town on this one, but that does not stop me.

The Go-To

Always right leg over left, usually with bent over spine and shoulders. If I sit on the floor, this is always my first posture. Again, pelvis tucked or in the process of slowly tucking. I’ve been trying to cross left over right more and keep sway in my low back while not thrusting my ribs and that does not usually last long. 

The Tight Hammy

Wow, are those legs popped up or what?! I think, “oh, I’ll stretch out my legs in front of me!” and then I end up bending one because of those tight hamstrings. Instead of sitting with my pelvis in a more neutral position and using my abs to hold me up, I have to curve over and pop my legs up for it to work.

Plan of Action

  • Stretch the hamstrings the right way
  • Open up the shoulders on a bolster
  • Ribs down
  • MIX IT UP WITH DIFFERENT POSTURES. I have to be really aware of trying new positions, even if they feel weird. These four are like perfectly well-worn shoes that feel so soft and familiar.
  • Psoas release and stretch (will post more about this later)

What are your favorite go-to sitting postures and what do they tell you about your body? 


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Rib thrusting, diastasis recti, and where to go from here

Bellies 2014

I am almost done with the Psoas course from The Restorative Exercise Institute and I am here to report that I am a rib thruster. Notice in the second photo from the right how the bottom of my rib cage is in front of my ASIS (your ASIS is the bony part of your pelvis in the front that is commonly mistaken for a hip bone). This shortens my psoas muscles, shifts the way my body carries its own weight, and increases pressure in all the wrong places. I would explain more, but I’m not an expert. Yet.

This, and other misalignments, help explain explain why Mutu isn’t giving me the results I want. I don’t meant the appearance I want but rather the body function. The machine of my body is more like the ’89 Volvo with the electrical problem that would leave me stranded in the middle of the highway (literally in the middle…of a lane…it would just shut off) and less like the aerodynamic Teslas I see zipping around the city. For example, I was out of commission for days last week with a debilitating neck and back spasm which my 22lb 9mo was only too happy to accommodate [sarcasm]. I have felt like the work I’m doing, while having some visually obvious effect on my body, has not been addressing the full root of the problem. It’s like if you put fertilizer on a plant whose soil is too acidic or alkaline – you are not going to help the plant until you adjust the soil.

I believed I was fixing my “soil” with zero drop shoes and some lifestyle changes, but I’m seeing now that the more fundamental problems require more extensive changes Habits I’ve learned over literally decades (dating all the way back to my first ballet class at 4) and things drilled into me in the Exercise Science building at my college or in the group classroom at the gym not only contributed to this problem in the first place but are preventing me from being well.

BUT WAIT, it’s not all sad panda around here! I am on a trajectory to fix these underlying issues. While Wendy does base many of her exercises on Katy’s work, I need more information and practical knowledge. I need to understand all the “whys” because that’s just the kind of woman I am, I guess. It won’t affect change in me until I really “get” it, that much I know is true. That’s why I have signed up to complete the first step of the certification program to become a Restorative Exercise Specialist. It’s a nice goal to have, but in end systems are more important than goals. So, part of my “system” is to continue to integrate what I’m learning and applying into this blog and pass on the information to all of you with separated bellies wondering if it can even get better. Together we can create healthier, happier bodies that work with us and not against us. I hope you’ll join me. 🙂


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Getting settled

Note: getting rid of your computer desk when moving may lead to leaving your computer in the box for a couple weeks. I am dragging it out onto the bedroom floor today to let you all know that I am still here and so grateful for the comments since my last post. I am going to take your advice (looking at you, Mimi!) and report back on what I learned. I will also be doing my repeat Week 6 post with DR measurement next week (I’m behind, but not shaming myself about it. Sometimes moving and a sick baby and a bag of tortilla chips gets in the way of our goals, but that doesn’t mean they’re lost!).

This morning I was given a strong dose of perspective and a renewed gratitude for the body I’m in and what it’s done for me. Also, tears. Check out this video of disabled men and women reacting to mannequins being made in their image:

Let’s move forward with the knowledge that we are beautifully made and valuable humans, no matter our shape.


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Mutu System Week 6 Progress Report, Putting One (Bare)Foot in Front of the Other

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First off, the folks over at Mutu made a very helpful infographic about what diastasis recti is, when it’s a problem, how to measure it, etc. There is a lot of disparate info out there about diastasis and it’s a concise and easy-to-digest summary.

Week Six

Week six does not introduce any new exercises. Wendy must know that getting halfway through the program can be a rough spot, especially if you haven’t seen the results that you want. I have been trying hard to stick to the guidelines, change my lifestyle, and do the exercises.

I can’t control, however, that my 7mo is now 21lbs and going through a very clingy stage. As much as I try not to move in ways that will undo my hard work, there are times that it’s just not feasible to protect that belly and things come poking out.

So, thanks to Wendy for talking some sense into me! It’s normal to not yet see a big or any decrease in width of diastasis recti and it’s also normal to feel like you’re spinning your wheels. So, I’m going to keep moving forward and just trust this is the best path forward. Despite feeling like I’m paddling upstream, I do think I see some progress in the right direction this week.

A note on the exercises

Just a note for those of you also doing the program, I think I may have started with a little lighter weights. The 5lb weights seemed very safe at the time (in fact, I kind of felt like a weenie buying them), but especially in the chuck-over-the-shoulder moves, I have to really focus so that I don’t compromise my back. I’m also still doing “Gecko with Attitude” as a modified plank on my knees with no weights. 

Hernia?

My doctor never checked me for a hernia, which is probably for the best because she also told me I can do all the crunches I want and that surgery is the only thing that will help and why don’t I go ahead and have a C-section with my last kid so she can repair the diastasis at the same time? So, my doctor was not a great help.

I’ve been noticing a hard bulge come and go above my belly button where my gap is largest (I carried very high), and for the first time I can see it in my photos for this week. It’s not super obvious, but you can see my belly took on a different shape this week – more squared off.

There’s not really anything I would do if I had a hernia unless it got strangulated or I felt consistent pain. For now I am just sticking with the exercises and trying to keep an eye on it. If I can reappropriate the abdominal pressure correctly, the hernia shouldn’t feel the need to poke through my connective tissue anyway. Whether it is poking through or not does seem to affect the measurement of my diastasis and my ability to do the exercises, though. For example, “Drop your heel, find your middle…no hands!” is impossible to do safely if the bulge is there.

Moving

I’m moving in two days, so we’ll be packing up my computer tomorrow. Good thing I have the exercises memorized! I will be back online next week, hopefully with some good progress to update you with!

How is MuTu going for you? I’d love to hear your updates and encouragement!


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Week 5 Again, or Why I Am a Wee Bit Discouraged

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Why I’m still at Week 5

As I was in a plank position, holding onto weights, grunting loudly and drawing them up toward my chest one at a time my husband said, with some alarm, “should you be doing that? Don’t hurt yourself and make it worse, you know you’ll regret it.”

He’s so reasonable and logical, I love it and don’t love it if you know what I mean. And yes, I regretted it. And no, I’m not quite ready for the new moves.

I put down the weights and went back to the web site where, clear as day, Wendy says:

Stay on Phase 2, doing all the exercises, stretches + alignment shifts DAILY, for 2 weeks at least.

Moving on: your midline must have firmed sufficiently, the gap narrowed + reconnection must have been established to withstand the exercises. Not sure? Try them! But don’t leave Phase 2 whilst you have: 2+ finger width diastasis, with still soft / unsupported midline connective tissue and/or pelvic floor weakness (sudden urgency or any leaking when rushing to the toilet), OR if you have been doing them for less than 2 weeks!

Which led me to the question:

How accurate is self-measurement of a diastasis recti, anyway?

I was able to find two studies on this.

  • One study was from 1987, in which participants were measured by palpation (aka the hand method we all use) and by ultrasound four days postpartum.
  • The second was from 2012 and used women in varying stages of life (some postpartum, some not, all with a diastasis recti). They had two physical therapists, one with 20 years experience, one with seven years, perform measurements with their fingers (palpation). In 15 out of the 40 cases, the two physical therapists got different measurements. Still, they basically conclude that palpation is “good enough” given how expensive ultrasound is.

My Status

My own measurement, with zero years as a physical therapist, was at least a 3-finger-width diastasis around the umbilicus. I feel it’s gotten smaller above and below. This is significantly larger than it was a couple weeks ago, sadly, which I attribute to:

  1. Doing exercises I shouldn’t have
  2. Skipping a few days
  3. Not walking enough. Walking “barefoot” is as integral to the program as the exercises, so I need to get out for longer walks. I am probably averaging 4 miles a week right now, but that’s because Target is a 1mi walk and Whole Foods is a half mile walk.

 

I’m the type of person who doesn’t own a scale and doesn’t like numbers attached to her body, so I kind of hate having to worry about the width of my diastasis recti at this point. But, for safety, it looks like I’m stuck here for awhile until this magical firming takes place and I can measure at a 2-finger or smaller width.

A note about equipment

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I promised I’d update when I got new equipment in order to do the exercises. For the Intensive 2 material, I got an all-cotton yoga bolster and 5lb hand weights from Target. She says you don’t need the bolster, but it’s useful for baby blockading and other things.

If it were easy to do, doctors all over wouldn’t act like it’s impossible! So, onward I go and hope that I have some lovely ladies alongside me getting strong again, too.