Diastasis Rectified

My journey to heal postpartum diastasis recti


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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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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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Starting the Intensive workouts, struggling for motivation

week4tummies

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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Mourning the loss of my heels

shoes

A fundamental benefit of the Mutu program is that you aren’t required to wear an approximating diastasis splint (side note: it’s die-ASS-sta-sis, not die-ah-STAY-sis as I once thought). Anyway, this is a good thing because you have to wear the splint 24/7 with the Tupler (pronounced Tuh-pler, not Too-pler) technique except for when you shower.

In exchange for not being corseted by the splint, we must try to decrease your intra-abdominal pressure. Or, we need to stop pooching our bellies out and scrunching up our lower spine because it’s stretching out our abdominus recti. Tucking the rear under and sucking in to try to pretend you don’t have a pooch will likewise do you no favors.

In order to decrease the intra-abdominal pressure you must:

  1. Get rid of all of your heels, even the slightest heel. Ladies, this means I had to get rid of my beloved Frye boots that I wore almost every day during pregnancy. Any lift at all will pitch your whole body forward and you’ll have to tuck-and-suck to be upright (heels also flare your butt up, creating a sexier/more baboon-like look). I bought two pairs of Tieks and one pair of Uggs (pictured) and I literally wear no other shoes. More closet space!
  2. Walk totally upright with your weight in your heels. I feel this most when walking up inclines with a stroller (hello, life in San Francisco!).
  3. Stop jackknifing when getting up.  This is the toughest for me because I always used to rely on the abs to bring me up. I kind of saw it as an extra strengthening exercise. No longer.
  4. Squat when doing all lifting. This one was not bad when the baby was 10-15 pounds but now I find it really difficult not to compromise other muscles when lugging around the man baby.

There are other things but the basic premise is body awareness and creating an environment that is conducive to healing the connective tissue. I say that with a little hesitation because most doctors say that healing the connective tissue between the muscle bellies is impossible and you have to get surgery, so I consider this all one big experiment.

*Note: I am in no way affiliated with Mutu and have not signed up for their referral program because I am not far enough into the program to endorse it. My only motivation for writing these posts is to find some solidarity and help me stay committed to the program!