Diastasis Rectified

My journey to heal postpartum diastasis recti


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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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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.

Image

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!