Diastasis Rectified

My journey to heal postpartum diastasis recti


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Changing Habits for Diastasis Recti Healing

It’s rare I meet a woman with a diastasis recti who hasn’t beat herself up for “slacking off on my exercises” (I bet men would

pie chart of habits

If we can make changes in the blue and grey times, then the yellow will be more impactful!

say the same thing, but I’ve never yet met a man who realizes he has a DR. Come join the DiastasisRectified party, guys!).

The paradigm is: 1) “my body is screwed up” and 2) “I need to do exercises to get it better” and 3) “Why am I not doing my exercises?” 4) “Ugggggh.”

So this post is not about exercises, because let’s just give that a rest for a minute. This post is about habits. We’ve spent (x) number of decades forming habits of movement: how we brush teeth, lounge, carry stuff, sit, open stuff, cut things, and on and on. Maybe we spend one hour a day three or four or even more times a week doing concerted “exercise” efforts, but what about those other 23 hours each day?

Our bodies take the shape of our habits

sketch of skeletons, one with rib thrust, one without

Pelvis forward, ribs thrusted will put pressure on our tender midsection versus letting our skeletons do the work of carrying our mass around. Oops, I forgot to draw the sacrum on the right skeleton. Just imagine it’s there.

All those tens of thousands of times we do those things will create some pretty deep neural pathways. Copying what parents/caretakers did, getting all that sitting practice at school (what activity did we do more than sitting?!), and then friends, culture, environment, sports, interests (bike riding, reading, video games), and personal preference.

What likely didn’t shape our habits was what would be most beneficial for our bodies over time: protect joints, prevent injury (like diastasis recti, eh?), get blood flowing, maintain healthy muscles, stay flexible, yada yada.

Unless your parents were yogis and you lived in a furnitureless yurt in the rainforest canopy and foraged for food. If I just described your childhood, please let’s be friends.

Below are pictures of me doing a habitual body position and then trying an updated option that doesn’t add more stress to my already totally stressed out diastasis. I’m working on keeping ribs down, untucking my tailbone, and keeping the weight in my heels.

Rewriting the code of everyday movement…in pictures

Instead of this… I’m trying this
Sitting in a white Modernica clamshell, reading a book sitting on two yoga blocks, reading
Being stationary in my favorite clamshell, reading about moving Pelvis elevated above heels to allow tailbone to untuck
washing face, rounded over washing face, tailbone untucked
 Rounded spine, tailbone tucked. This actually hurt,
but I just don’t pay attention to the dull ache usually.
 Untucked pelvis, using my hammies to hold me
up, trying to keep ribs from thrusting toward counter
 sitting on the toilet  sitting on the toilet with elevated feet, pelvis untucked
Lots of strain on the old pelvic floor (esp if you hold your breath!) Tailbone not as tucked, feet elevated. Feelin’ so fly.
You could also try zees, but my husband has forbade.
 leaning against counter  standing while brushing teeth
I do this ALL THE TIME, like I am
incapable of holding my own body up
for the two minutes it takes to brush
my teeth (yes, I time it so what)
 There you go, lady. That’s better.
 Sitting in a chair  untucked pelvis in chair
 Working on my chair-shaped bottom  Sometimes life calls for chair sitting, but sitting
on the edge means I can untuck the tailbone.
 holding child on hip  holding child in arms
 The ever-popular holding child on hip
whilst contemplating something
 Using arms to hold kid instead (okay maybe there is a
little leaning but have you seen the size of that guy?!)
bending over to pick toys up squatting to pick up toys
 It feels so normal to pick stuff up this way,
but I’m putting tons of pressure on my spine
Switching it up to a squat, I feel the work in
the pelvic floor. Been trying this a lot more this
week and it is feeling more normal.
 getting out of chair  squatting to get out of chair
 Using momentum to send me out of this
chair, while knees go way over toes
 Keeping knees over toes, turning
“getting out of chair” into “hey let’s squat”
thrusting ribs when I need to reach up reaching without moving ribs
 Moving ribs up and out (like the illustration above)
in order to reach the cabinet
 Keeping ribs down (and therefore abs “on”) while
reaching up. Feeeeeeling the burn in the shoulder
here.

Now that I’ve done these, I am thinking of so many more! How I pick up my kid, getting out of bed (remember friends, no jackknifing!), opening heavy doors, stirring a big pot of something, how I always sit on one foot, etc.

What are some things you can switch up?

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It’s Been Dark Under This Rock, or an Update FAQ

Inside my study cave.

Inside my study cave.

Is there life out there? I wouldn’t know because I’ve been buried under the massive boulder of intense studying for the last six months. I could probably braid my leg hair at this point and fashion it into small animals that I could sell downtown with all the other weirdo stuff that gets peddled. Is there really that big of a market for personalized rice?

So, my Restorative Exercise Specialist certification week is in 14 DAYS and I could not be more simultaneously giddy and terrified. This has been consuming so many of my life cycles for months and months in my relentless path to body wellness and I can’t believe it’s all coming to a head so soon. I expect my dreams to get exponentially weirder and more Katy Bowman-filled than they already are.

I suspect you are wondering a few things about me and my big old diastasis like: Any progress or what, Emily?

Here are all the questions I could think of. Please let me know in the comments if you have more!

Is your DR getting better?

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Yes! I feel way more “right” in my clothing now, even if it does still fluctuate. The gap seems to be about a full finger smaller, but as I’ve discussed before finger measurement (or “palpation” as it’s called in the research) has not been shown to be the most accurate. You can also still have a decent gap and be stable in your core, so that measurement isn’t an end-all be-all.

It’s noticeably less deep, though, and I feel more secure in my own core. I can’t tell you what a psychological boost this is. I feel like I have been waiting every day for almost two years to feel this way. So, there is hope ladies! And gents – let’s not forget you because guys get diastasis recti at the same incidence rate as women.

Why is your DR getting better?

Ummm because I’ve changed everything about my life. Hah! Okay maybe not everything, but it sure feels like it sometimes. Things like:

  • Only wearing 100% flat, flexible shoes
  • Trying to drop my ribs down all the time which is REALLY HARD and I have to remind myself every five seconds which is annoying.
  • Doing a bunch of the Restorative Exercise movements I need for my certification, but patently avoiding some of the stretches I need the most (psoas, buddy, I’m looking at you). I signed up for the RE-based Alignment Beach classes, too, which might be another option if you’re not into Mutu or you’re looking for something more technical.
  • Walking, though not in the “right” way most of the time. See next bullet point.
  • Carrying my kid in my arm whenever possible without deforming my body with leaning or sticking a hip out (this one is so hard)
  • Hanging on all the playground monkey bars, to my husband’s chagrin, and on our pull up bar at home. I once
    135465558_123402af8c_o

    This is me writing this post right now. The transformation is pretty thorough, right? Photo cred: Chris Lott

    spontaneously started scaling a chain link fence at the playground and he just quietly ducked away so as not to be associated with the wild monkey woman.

  • Minimizing sitting on chairs and couches where my body becomes more passive and out of alignment. Except for maybe right now. Oops.
  • Squatting whenever I can, like in everyday life when getting down to the floor. Related awesome study about getting up and down from the floor and lifespan.
  • Elevating my feet when I’m on the toilet (see: Squatty Potty) so I don’t have too much downward pressure on my pelvic floor when I have to go

Have you had any setbacks?

Oh yes. I decided that I was strong enough to do pull ups because finally for the first time in my life I could get my chin above the bar. It was a big ego boost and the consequent enthusiasm drove me to keep doing it. Doing a pull up, as I found out, requires ample shoulder girdle strength and flexibility as well as arm strength. So my arms got strong lugging that baby around, but then my shoulders got ridiculously tight. This put tremendous burden on my ab muscles to try to keep my innards in place and that has been the most progress-reversing thing I’ve done. I think I could actually feel the tissue ripping apart again but that could have just been my overactive imagination.

Also, trying to do full planks did not work out in my favor. There is so much to be said for really carefully listening to your body before the ego sets in. I guess my previous exercise-intense lifestyle has set me on a default mode of wanting to feel like what I’m doing is intense. Injuring tissue is indeed intense, but not really what I was going for ultimately.

Are you still into Mutu or what?

Yes! It’s a fabulous turn-key recovery program, especially for those who are in a place where they really just need to be told what to do.

You know how Carl Sagan said that if you want to make an apple pie from scratch you must first invent the universe? So going to get certified in Restorative Exercise because you have a DR would be inventing the universe and just making the dang pie would be Mutu.

Wendy seems to be absolutely lovely and cares so much for the community of women struggling with these disorders. I think she actually just certified as a Restorative Exercise Specialist, too (but don’t quote me on that). If you’re looking for a specialized diastasis recti/pelvic floor disorder recovery program that is holistic, driven by research (for the most part, at least), and includes tons of support and community then Mutu is an excellent option.

That being said, even being faithful to the Mutu program would not guarantee healing if you’re not at a place yet to do all those dadgummed lifestyle changes. Even then I wager you’d see progress, though.

Have you been getting sleep?

Assuredly not. My craziest study time has been 2am on the bathroom floor when I had insomnia and was like “well, the kid will be up in 2.5 hours anyway.”

Did you accidentally get all your hair chopped off?

My chopped hair and that little dude I lug around to all the places

I did! Let this be your lesson to never go to the closest hair place taking walk ins because the stars aligned so that your husband is home AND your son just went down for a nap.

Okay, much more info to share once I get back from Certification Week. Wish me luck!


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Do you really need to strengthen your transverse abdominis to heal diastasis recti?

Well, I did it! I am officially and anxiously signed up to become a Restorative Exercise Specialist and will be participating in a January 2015 certification week. If you’ve thought it sounds a little quiet around here, that’s because I’ve been totally overwhelmed by the firehose of information. I didn’t know what I didn’t know, you know? I’m looking forward to sharing bite-sized bits that apply to our conversation here. Thanks for coming along with me! 

The Transversalis

Look at the height on that thing!

If you’ve gotten within a stone’s throw of a diastasis recti you’ve heard the words “transverse abdominis” (TVA) being thrown around. Whole programs have cropped up around the strengthening of this deep-down ab muscle (going up on the “elevator,” anyone? Hundreds of reps daily, perhaps?). I even wrote a post about how to know if you’re actually contracting your TVA. Everybody focuses on it and maybe is hard on it (like, “get it together TVA! You have organs to restrain. Stop lollygagging. Why are you still so weak?”) Geez, I am mean. Maybe if I understood it more I would be a little more compassionate.

Can I call you by your full name?

The full structure is called the transversalis and goes all the way up near your sternum (aka breast bone) and wraps around to your spine. On the bottom side it attaches to your pubic area. In the front, like where the belly button is, there is no TVA muscle fiber – just what’s called aponeurosis. It’s the fascia, or connective tissue, that bring the transversalis full circle and let it create a waist for you. How nice of it.

If you, like me, happen to be lacking a “waist” then the transversalis is sounding pretty important to you right now. This is why it gets all the attention in the diastasis recti recovery programs.

If your waist making muscles aren’t making a waist, then you should contract them a whole bunch and get a waist already! Right? Well, as you may have guessed, it is more complex (dare I say elegant?) than that.

What do abs actually do?

As it turns out, our ab muscles weren’t created for the purpose of giving us a sculpted look. If you think about it, our skeleton goes on a vacation between the last ribs and the “hip bones.” It’s like an organs-fluids-and-food party up in there. That is probably a real theme on a college campus somewhere. Anyway, something has to help keep all those goodies in place and manage the relationship of the top of our bodies to the bottom of our bodies so we don’t just fold over into a heap.

As you might be able to make out from my scribbles (notes from class below), the obliques move your upper body laterally from your lower body. The rectus abdominis aka “six-pack” aka “never gonna see you again” bend the torso forward.

What about the transversalis? It’s job is to concentrically compress.

Illustrations of ab muscles

When you put all these together: side-to-side movement control, frontward folding movement control, and compression you have stability.

Stability while walking, while standing on a Bosu, high-fiving strangers, riding a bull at the saloon, or whatever you are into. Like, you don’t have to do a bunch of side bends to use your obliques. You do need to do that to “get” obliques that need their own bra (bralique?), but not to just have healthy “strong enough” obliques. Just put your body in positions that it needs stability for and everything turns on.

Turn that TV(a) on

Let’s do a little exercise here to demonstrate the transversalis in action. This was exciting to me, but keep in mind that I’m easily entertained. Sometimes I play with my son’s toys after he goes to bed. He’s one and a half.

dropping ribs down

The only difference in these pictures is the position of my ribs (or at least I tried really hard to keep everything I could constant. I don’t have a mirror, so I did my best!). I am not sucking in and I am not consciously contracting my abs. I am just telling my brain to drop my ribs back down because it habitually tells them to shear upward like a big, cocky rooster. Thanks, ballet, for that muscle memory.

One finger is on the bottom point of my ribs and one is on my “hip bone” (ASIS). Just putting our bodies back into this position (which is where the ribs should naturally be) activates the TVA: while we walk, bosu, bull ride, or whatever. It also maximizes the abdominals’ abilities to be strong by keeping them in the right plane of action.

Walking with our ribs down is one of the most important things we can do to help our diastasis heal and restore tone to the transversalis. Really!

Ok, but are isolated TVA contractions bad?

I don’t think so, but they are definitely not a requirement for the road to recovery. A strong transversalis is a requirement, but isolated contractions aren’t. If you feel like you want to keep it up then just make 100% sure you are not sucking in (which I still do constantly – ack!) AND aren’t overdoing it, which could make the muscle fibers too short. Tight muscles are also weak muscles. And remember, the contractions aren’t a replacement for walking or alignment and they can’t decrease your intra-abdominal pressure.

I really want to go for a walk after writing this, but I have a sleeping kid. Can anybody relate?!


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Week 2, “Training Puppies”

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Training puppies

My all time favorite yoga teacher was this wiry ball of muscle, Janice. She was the only older woman I’ve seen rock pigtails legitimately. Anyway, at one of my first classes she explained how to engage your “yogi toes” and feet. She said that it feels strange now but it’s like training puppies – just keep showing them how and eventually they’ll get it.

I feel that way about not only engaging my TVA (transverse abdominis). Actually, I feel that way about just being aware my TVA is in there. I find constantly engaging my TVA while simultaneously not putting undue pressure on my abdominis rectus (“six pack”…”no-pack”) is especially difficult. I’m just so used to depending on my outer abs to help me out during the day. I had no idea how much I jack-knifed while getting up off of sitting surfaces.

Also, I’m not feeling much of a connection between my TVA engagement and pelvic floor engagement, which has me a little concerned. Anyone else out there experienced this?

Progress Report

Above are my week 2 pics. I think there might be progress? I have still not started the actual Mutu Week 2 course material (which uses high intensity interval training) because I feel challenged enough with just the six minutes of core work and stretches Week 1 entails. I plan to start that soon, though.

Specifically, the “Drop your heels, find your middle” exercise really rocks me. In this exercise she has me lay on my back, raise knees to the ceiling while keeping shins parallel to the floor, and drop one heel at a time down to the floor and back up. This exercise is so difficult for me that I can rarely do ten reps without feeling my abs separate and my innards poke through. This has me considering getting a splint after all!