(1) Pressure can make you or break you.
The common misconception about diastasis recti is that the problem lies with the stretched abdominal wall. The separation is often referred to as a “gap”, although it is not actually a gap. It is a separation of muscle that occurs naturally (the linea alba is a connective tissue that joins all the abdominal muscles along the midline of the body) but becomes problematic when the connecting tissue is stretched beyond it’s natural limits. The trench or doming caused by the separation can be alarming and many become focused on closing this “gap”, but the space isn’t the problem, it is the reason the stretching occurred that must be addressed in order for the body to recover. The reason the connective tissue, the linea alba, stretches is due to constant unmanaged increases in intra-abdominal pressure (IAP). IAP pressure in and of itself is not a bad thing, it is necessary to keep our organs in place and our spine from collapsing. Our muscles are in place to manage changes in IAP. Weak or restricted muscles cannot manage high amounts of IAP and so the pressure becomes damaging, causing the fascia to be stretched beyond its limits and leading to micro-tears in the muscle and fascia. IAP is there to protect your abdominal organs. When managed it stabilizes your spine and gives your body more power and force. However, when IAP is unmanaged, it can destroy you from the inside out.
Pressure is not a bad thing, it’s how we respond to it that affects our growth. Pressure is a constant in everyone’s life and can create motivation and balance. But it is important to find healthy habits to cope with the pressures of life. One way I deal with stress in my life is through regular exercise.
(2) When under pressure, breathe.
Diastasis Recti comes down to a poor pressure management issue, and one of the most basic ways to manage changes in pressure in your body is through your breath. When every inhale the pressure in your abdominal cavity increases and with every exhale it decreases. When managing high amounts of IAP the first thing you must do is exhale; let out the air and relieve the pressure. So many people mistakingly hold their breathe during strenuous movement, but you must breathe out.
In life when the pressure gets too high it’s important to step aside and just breathe. Take deep breaths in and out to help you recover and refocus. A treatment for hyperventilation brought on by panic attacks is to breathe into a paper bag.
(3) Until you accept your brokenness you cannot recover from it.
The postpartum journey can be hard on a woman who doesn’t want to accept that she has changed. So often women want to rush back into strenuous exercise to return to their pre-baby aesthetic or to prove that they are the same person they were before they had children. It can be hard to accept this new body that doesn’t look they way it used to, doesn’t work the way to used to and doesn’t feel the way to used to. But until you accept that, you not heal from it. A major mistake postpartum is thinking that your body is the same. It is not. It is weaker. Your pelvic floor has gone from carrying about 1 to 3 pounds to about 14 to 20 pounds for several months. If you had a vaginal delivery it has withstood huge amounts of IAP and the force of an infant pushing down on it. If you had a c-section the fascia connecting your abs to your pelvic floor has been cut to allow the baby passage through. Your pelvic floor has been weakened and cannot withstand the pressures it took before you became pregnant. You should not be rushing back into high intensity exercises immediately postpartum. Your pelvic floor takes at least 4 to 6 months to recover from pregnancy during which time you should be avoiding jumping movements and should not reincorporate them back into your workouts until after seeing a pelvic floor physiotherapist. Your abs are weaker. Your transverse abdominis has been stretched to allow the growth of the uterus. It cannot withstand the load it could before your pregnancy. You should not be lifting heavy weights. You should not be running. Your body is different beyond what you can see in the mirror. And you must respect that and treat it differently. You must retrain your core before you begin training it again. Postpartum exercise isn’t about crunches and sit-ups and planks. There is so much more to it. Being 6 weeks postpartum doesn’t mean you’re clear to do every workout, the average woman takes up to 2 full years to recover from a pregnancy.
Aesthetically you cannot love your new body until you accept that it is different. Different doesn’t mean any less beautiful, your body has evolved, it is has created and sustained life. It is more than it was. It is beautiful in a new way.
(4) It’s what’s on the inside that matters most.
So many women get stuck on their 6 packs. When their talk about ab exercises they are often talking about getting definition in the 6 pack; the rectus abdominis. When they speak of core exercises they are often speaking of exercise for the rectus abdominis. The rectus abdominis is the most superficial layer of the abdominal muscles. Its purpose is forward flexion of the spine, and its strength has absolutely no effect on the leanness of your stomach, or in isolation, the strength of your core. Your abs are 4 layers deep and your deep core muscles don’t even include the rectus abdominis. When dealing with postnatal recovery the focus must be given the to deep four muscles of the core; the pelvic floor, the transverse abdominis (TvA), the multifidus and the diaphragm. The transverse abdominis is the deepest abdominal muscle and it is the ab muscle that effects the flatness of your stomach and the slimness of your waist line. A strong TvA also helps improve your balance. A strong core 4 will reduce and prevent back pain, incontinence, diastasis recti and pelvic organ prolapse.
It’s easy to get stuck on the superficial but the things that bring real change to your life are a few layers deeper.
(5) Looks can be deceiving.
You can have a 6-pack and a weak core. You can lift 200 pounds and have a weak core. You can look ripped from the outside and be ripped on the inside. The following video shows seemingly “fit” crossfitters speaking on urinary incontinence brought on by unmanaged high levels of IAP.
(6) Recovery is real
It’s okay to be broken because brokenness, like everything else in life, is a transitional state. Just like the struggle is real, the recovery is real too. I went from a 7 finger separation to a stronger core than before my pregnancies. The diastasis recti didn’t break, it built me.
(7) Life is about evolution.
You cannot be the person you are destined to become until you let go of the person that you think that you are. I hear so often, “I wish I had your motivation”, “one day I will…” or “…I wish I liked exercise…” I didn’t always enjoy exercise. It was a struggle to make it to the gym. I It still is sometimes. I didn’t always eat healthy food. I still struggle with my choices at times. I don’t always feel motivated. But instead of allowing myself to stay in the struggle, I envision the person I want to become and I push through. I’ve learnt at I can never move forward unless I take a step. I’ve learnt that instead of saying “I can’t”, I try. Instead of wishing, I do. It’s not the wanting that will change you, it’s the doing. As the saying goes, if wishes were horses then beggars would ride.
(8) Have faith.
You have to trust the process. When it comes to postpartum recovery surgery isn’t always the only answer. Surgery doesn’t fix the cause of a diastasis recti or pelvic floor weakness, it treats the symptoms. To treat the cause rehab and corrective exercise must be incorporated. 50% of those who have surgery for urinary incontinence will have a second surgery within 5 years unless they do corrective pelvic floor exercises. 60% of mesh surgeries for hernia’s fail and the percentage of reoccurring surgeries is high. Mesh surgeries for pelvic floor repair are in the process of being banned in several countries due to complications, including pain during sex.
Exercise works. Most women with stage 1 or 2 prolapse will see improvement or completely recover through exercise. Women with stage 3 prolapse will receive relief from their symptoms through exercise. In many cases, diastasis recti can be completely healed through corrective exercise relieving and preventing back pain, hip pain and pelvic pain. Exercise isn’t a quick fix solution so some get discouraged, but like anything worthwhile in life it takes time. Trust in the process and have faith that the small actions you taking are contributing to your healing. Slow and steady wins the race.
(9) Perfection is in balance
Tight muscles are restrictive and problematic. Weak muscles are lax and problematic. A hypotonic pelvic floor is one that has low muscle tone and so is weak and can lead to the inability to hold urine. A hypertonic pelvic floor is one that is tense and tight and so can lead to the inability to hold urine. You see, it doesn’t matter if the muscles are too weak or too tight, the result is the same. A well functioning pelvic floor is one that is balanced. A well functioning core is one where the muscle fibers are at their optimal length; not too short and not too long.There is no light without darkness for light is the overcoming of darkness. You can’t have the highs without the lows, the ying without the yang, the good without the bad. Overcoming a challenge is powerful because you understand what it took for you to do so. You become empowered through victory which is the overcoming of that which you thought would defeat you. Happiness is found in the balance.