Diastasis Rectified

My journey to heal postpartum diastasis recti


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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
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    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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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.


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Mutu System Week 5 Progress Report

It took me 8 days, but I did make it through doing the “intensive workout 1” four times. This week I moved onto Phase 2 core, which was at least psychologically important because I felt like I was actually progressing.

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Phase 2 Abs

This week I graduated to the next level of abdominal work. The main differences were:

  • More twists
  • More load put on the TVA (for example, in “Drop Your Knees, Find Your Middle” you can’t use your hands to brace your knees anymore
  • Bigger, meatier squats
  • The addition of a toe/shin stretch (which I don’t get much out of because I have inhumanly flexible feet)
  • Modified Bridge poses. Love this since I am having serious yoga withdrawal
  • Hip strengtheners and openers (including the same exercise the physical therapist had me doing for sacroiliac joint pain in pregnancy)

I was surprised at how different the second phase was from Core Phase 1. I was thankful for her mixing things up!

Progress

Looking at the photos, I think I see a little improvement from last week! That surprises me because:

a) I haven’t been walking, and this has not been good for my mental health with a 6 month old

b) I pushed myself too hard and it wasn’t until I had my husband feel my abs during Staggered Push-Ups that I discovered my abs were separating during them. So, back to wall push-ups!

Barefoot in Winter

We don’t really have “winter” per say here in San Francisco, but we definitely get rain and wind. I’ve been wearing my Tieks into the ground, so I have been on the lookout for a pair of winter shoes. I found this fabulous post on barefoot walking boots for winter. I love Katy Bowman and I kind of want to be her when I grow up, but I have a legit case of city fashion and most of those boots look like they were designed in a darkroom (Frye, are you listening? Chop, chop!).

Thankfully, I found two that I think I could work with tights or skinny jeans.

Nepal boots by Tom's Nepal boot, by Tom’s.

I find regular Tom’s pretty uncomfortable (especially compared to Tieks), but I’m hoping these will be a totally different story.

barefoot boot by VivoBarefootRyder by VivoBarefoot

While certainly not the sexiness that was my Frye Carmen Lace Up (love you forever, RIP), these will do when I need something waterproof. Giving up heels is tough, but think of all those bunions and joint replacements I’m hopefully avoiding!

Thanks for coming along the ride with me! Please let me know if you’re in this journey, too, so we can band together and offer each other support.


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Starting the Intensive workouts, struggling for motivation

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Wendy wrote some powerful words over the weekend and they helped me get my mind right.

I missed almost a whole week. Here’s why I was losing traction:

  1. I so badly miss group exercise. Motivating myself when at home baby-talking to a 6 month old feels like a herculean task. This is why I need your support! (I know Mutu has a Facebook group but I closed my FB account on purpose, so my loss).
  2. I’m frustrated about my insides poking through my diastasis on the EASIEST exercises. I am used to being “tough” and I am not used to feeling so weak. Weakness, vulnerability, lack of control, letting go of expectations – so many themes in my life are applicable here.
  3. “No time” (aka excuses)
  4. Negative thinking (“I’m never going to get strong” “my husband will love me anyway, so why try” “I’m a mom now, I should lessen my expectation of what fit is” “I can’t do it perfectly, so I just won’t do it at all”)
  5. During pregnancy I felt like a superwoman. I now feel like the opposite of a superwoman.

So, when I read these words by Wendy I felt a little prodded:

“Please, please, try this. Shift your mindset before you try to shift your body.  Diastasis recti is merely a symptom, one outer manifestation of pressure + mal-alignment within your body. It’s telling you your body is not quite in the right place or comfortable, which is why it doesn’t look + feel the way you want it to. It is not *the problem*. I know you feel overwhelmed  + I know you’re frustrated + searching for answers. You’re trying to change everything + fix everything all at once + you feel everything about your body is ‘wrong’ + broken.”

Wendy! You’re hitting too close to home. Ouch.

After skipping a week of Mutu my thoracic (upper) spine was popping like rubber bands being snapped on my back, my left shoulder started clicking, incontinence came back (UGH), and headaches came back. I reread Wendy’s words, had some patience with myself, and thanked my body for letting me put it through this trial so I could have this baby I love so much.

And a word about willpower

The Willpower Instinct by McGonigalI also thought about The Willpower Instinct by Kelly McGonigal at Stanford. In that book she explains that the smallest steps help build our willpower strength, just like building a muscle. So if you say no to the anxiety snack (I threw out the chocolate chips last week), you’ll be more likely to stick to your commitment to walk every day or to do six minutes of Mutu.

This morning I got up and went straight for Mutu before I could talk myself out of it. And you know what? It felt really good. I wasn’t even that hard on myself that I was doing wall pushups instead of regular ones.


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Sit Bones, Tucking, Intraabdominal Pressure, and the Postpartum Pooch

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Along with my new diastasis recti friend Jamie at Belly After Baby, I have gone through some rough patches lately. 

Let’s review the life changes this process has brought so far:

  • Never sitting on sofas, the mattress, chairs, or anything that would displace the intraabdominal pressure. I mainly sit on the floor on my sit bones (those two bottom points pictured above). 
  • Getting rid of all of my heeled shoes, even the slightest ones.
  • Walking with weight in my heels, totally upright (which looks a little bit like a soldier and is hard with a stroller!)
  • Squatting instead of bending and lifting
  • Not torquing or twisting
  • Avoiding front carrying whenever possible.
  • Putting a bolster under my knees at night (if sleeping on back) or in between them (if sleeping on side)
  • Giving up my favorite exercises until I have strength again
  • NOT TUCKING MY BUTT. Muscle memory is for real, peeps. I learned to tuck my butt in lifting classes at the gym (grr) and it has been absurdly difficult to stop.

The list could go on. Needless to say, this takes serious commitment! It is easy to get discouraged.

I have been spending a lot of time on the Aligned and Well blog, trying to understand the role alignment plays in my diastasis. 

Takeaway: alignment is everything. I gently pressed on my belly today just to feel the force that intraabdominal pressure is putting on my midline and WOW, it is powerful! No wonder the muscles can’t keep it together. Only by taking away the pressure I’ve been loading these muscles down with will I be able to regain and keep a strong, flat core.

One of the things Katy over at Aligned and Well said in her first Alignment Snack shoulder class (screenshot below) was that it’s a great idea to move your body in ways that aren’t as familiar. For example, if you normally cross one arm over the other in a stretch, then do the opposite. Get your body out of its routine. She even advises gradually weaning yourself off a pillow, for example, in order to increase mobility.

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I’m starting to wonder if I had a small diastasis before pregnancy and didn’t know it, or at least poor alignment and a weak TVA. Then, wearing (chunky! sensible!) heels during pregnancy and doing literally thousands and thousands of weighted reps with my butt tucked probably took me over the edge. Let this be your fair warning, oh ye adorably fit pregnant person! 

I am going to be starting the Mutu interval training this week, as last week I still was doming in the easiest of exercises and I even missed a couple days. I hope I will see more progress by next week after trying the “Week 2” Mutu routine this week. 

We can do this, ladies! We’ve certainly met with much more difficult challenges before, even if they weren’t so easily visible to the outside world.