Diastasis Rectified

My journey to heal postpartum diastasis recti


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My diastasis recti recovery update, or how I hope I don’t get fitted for another bridesmaids dress anytime soon

Sometimes when I am feeling particularly deflated about my glacial progress to restore tone and function to my midsection, I do what every wallowing person does and Google magical success stories. These shining examples are always self-motivated, and fitnessy, and tan – why are they always so uniformly tan? Do they not have sub-Equatorial arms and Icelandic thighs? They pop back to strong and svelte without ever even changing their intensive exercise routine. It’s neato!

Let me tell you another story. I was getting fitted for a bridesmaids dress a couple months ago and the sweet 21 year old measuring me noted that my stomach is four sizes bigger than my hips and chest (yes, f-o-u-r). I was even sucking it in a little, shame on me. She says, “don’t worry, I get girls in here all the time who drink a little too much and I tell them it all goes to your middle!”

Fast forward to this week. I’ve been getting ready to go to Vegas for the bachelorette party. Me, the woman who in a measure of austerity – or was it exasperation? – got rid of all her pre-baby clothes except for seven (now quite ratty) nursing shirts and three jeans will be going to a place where they permit entry based on your appearance. Did you know many clubs in Vegas require women to wear high heels? And the more scantily clad, the more likely you are to get in free? It makes me feel like in Vegas woman are the commodity and men are the purchasers, but let’s save my feminist rants for never.

Also, have you ever tried to open a really heavy door with one hand? My brain is yelling, “HEY ABS! Could really use your help right now!” and my abs are like “eh, mate? Can’t quite hear you. ZZzzzzz.” And that’s how I learned my abs are Australian.

Getting my mind right

I am a person prone to frustration and black and white thinking and guilt, which means you hope you’re never invited to a picnic in my head. I have to continually remind myself of these things:

  • My body is unique. No one else has my body and no one else is responsible for my body and it’s no one else’s responsibility to love my body but me.
  • Exercise programs are great, just like weight loss program or other life improvement programs. They do not guarantee long term success, though. Often they predict the opposite.
  • 15 minutes of exercises a day can make me stronger, but it’s what I do the 23 hours and 45 minutes of the day that will determine my long range outcomes.
  • Every time I choose to sit on the floor or stretch my hamstrings or hang from a pull-up bar (side note: don’t do pull ups! just hang until you can handle pulling up) or untuck my pelvic or unthrust my ribs or do a couple squats or go for a walk – each time I do those things I am changing my trajectory. It may seem inconsequential at the time, but over time those habits will make all the difference.
  • Any time I want to hide or give up or start comparing myself to others or even to my previous selves, I can stop and give myself a little breathing room. I can ask myself what that critical part of myself is afraid might happen if it stopped doing its job (yes, I got this from counseling. Hey, it works!).
  • Listing the things I am specifically grateful for in my life and then letting specific people know that I’m thankful for them helps to give me perspective.
  • I’ve also found superbetter.com to be helpful for those days I need help building momentum. It turns your recovery into a game and you invite friends and family to be allies who support you in your Epic Quest toward regaining strength.
  • Stop measuring the diastasis recti gap

What do you do to keep a healthy perspective?


 

My Update

diastasis recti side view 13mo postpartum

13 months postpartum, irregularly Mutu-ing, making progress with alignment materials!

Here is my latest picture from the side. I’ve been doing a little bit of Mutu but I’ve mostly been doing exercises from The Restorative Exercise materials. Side note: I LOVE Wendy’s new MuTu videos! She has incorporated so much of what I’ve been learning from Katy Bowman’s alignment materials, and I like her revised exercises much better.

Despite my wallowing, I have been feeling stronger and more flexible, even if my middle still feels like a Jell-O mold. In fact, it feels so much like a Jell-O mold that sometimes it even looks like one:

Innards bulging out through diastasis recti gap

Innards bulging out through diastasis recti gap after a meal

Does this happen to anybody else out there?


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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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Mutu System Week 4: Photos and a Review

Mutu System Week 4 Results

The “mummy tummy” diastasis recti with transverse not engaged and then engaged

Mutu System Week 4 Results

Transverse not engaged on left, engaged on right

Although I’ve been doing this for more than four weeks, this past week was when I graduated to the Week 4 curriculum with Mutu System by Wendy Powell. This means I was doing Mutu Intensive Workout No.1 four times and Core Phase 1 seven times this week.

I’m finally feeling like I see some results and actually feel different! I’m so glad I’m taking photos because, man, I was really pooched out on Week 1! I’m not seeing a difference since last week with TVA engaged, but I definitely see and feel a difference with it not engaged. My insides feel more tightly packed, if that makes sense.

How have I been liking Mutu?

  • I love that the daily workouts do not require sound. This is GENIUS. I live in a 1 bedroom loft, so there are no interior walls and any sound is game to wake the baby.
  • I haven’t purchased any special equipment yet, which has been lovely. This is what I’ve needed:
    • Pillow or rolled up blanket instead of half bolster
    • Big exercise or kids soccer ball for ball slams and squeezing exercises
    • My therabands from prenatal physical therapy (you’d need to buy those if you don’t already have some)
  • In the videos, Wendy doesn’t do everything perfectly and I also smile with her when she wobbles (because I’m usually wobbling with her).
  • I still can’t do normal push-ups, so I have been doing wall push-ups. This prevents me from getting my heart rate up as high as the HIIT (high intensity interval training) intends.
  • Wendy, who is adorable and so likable, uses a plus sign instead of the word “and” in all of her materials. I don’t know if this is a cultural thing or what, but the grammarian/librophile in me gets pretty distracted by it because I read it in my head as “plus” not “and”Nitpicking, yes, but I can’t be the only one!

I’ve been eating clean, cleaner than I had originally intended, due to my son’s doctor taking me off of gluten and dairy. Good thing I got rid of the chocolate chip habit before she broke that news! 

I have a lot more hope about actually healing the diastasis recti at this point. I’ve been told by so many people that it’s impossible and to just give up. I really hate that the medical community has been taught that line and I wish OBs had more knowledge about biomechanics and alignment. In the mean time maybe this blog will find someone frustrated with their “mummy tummy” out there and give them some hope!


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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.