I can stick 3 fingers in my belly in the space between the left and right sides of my abdominal muscles. It’s the most unnatural natural part of pregnancy and the post partum side effects. They call this diastasis recti and it is the bane of my existence. The latin word “diastasis” means separation. Hence separation of the rectus abdominus. Why does this happen? During pregnancy the abdominals start to separate to accomodate the growing uterus. The connective tissue known as linea alba which joins the left and right side, starts to stretch and thin. This is a necessary process to make room for the expansion of the uterus, but body size, size of baby, and positioning of baby are all factors that can create distastisis. There’s no universal studies or research on whether having strong vs. weak abs pre pregnancy, a short vs. long torso, or core work performed during pregnancy make the difference in the degree of DR. The curious part of me wants to delve into this and conduct a study so you ladies with DR email me email@example.com and let’s see if we can’t solvesthis condition. I might not get around to finishing the study until 2017 but I’ll try.
What am I doing about my bad case of DR? Besides posting my postpartum belly with loose skin and stretch marks on social media, I’m trying to retrain my core muscles to work again. It’s tiresome, frustrating at times, and requires mundane and focused energy. Those of you who have been following my journey have asked that I share what exercises and routine I am doing to correct my diastasis. To be honest the first couple of weeks it was a bit of a crapshoot. I have a pelvic floor specialist I see in San Diego who is awesome and very knowledgable in women’s pelvic health. I recently made a trip out to see her to be assessed as to how my DR was, the strength of my kegals, the function of my pelvic floor muscles, and to make sure organs weren’t falling out of me. (prolapse true story). She does external and internal exams while I perform exercises. She was very impressed with my kegals (only took me 18 months to perfect those), my perineal healing (TMI), and my core activation. I ran 13 minutes the following day because I was confident and excited after my appointment. The next day I couldn’t turn over in bed, shift weight from one leg to the other, or lift my baby without pain. What the hell? Setback #1 of 37 to come in my postpartum return. Baffled, dejected, and scared I returned to Flagstaff. I saw our team of docs at Hypo2 and Dr. Gregg helped calm down the inflammation in my pelvis, hips, and low back. I used a post partum belly support belt to stabilize my pelvis by putting pressure over my hip bones. I had a suspicion my abs and lack of strength were to blame. Visually they are a mess and physically in a coma. Sometimes you feel lost when injured or in a pain cycle because you don’t know if the exercises you’re given are helping or hurting. If they are the right ones, are you performing them correctly? It’s the worst feeling in the world to feel as if you have no control over your body’s muscle functioning. Post partum healing requires a timeline that no doctor can prescribe universally to all women. Each of our bodies are different so one gal might have intact abs 3 weeks PP while another it takes 5 months to restore her core. At the time I saw my lady in San Diego I was 5 weeks PP and was doing transverse abdominus bracing, bracing with heel slides, and bracing with marching. It seemed appropriate for where I was but based on my symptoms after running it was not enough. I needed a solution and a plan now. I drove down to Phoenix last week to see Dr. John Ball who has been my doctor for the past 6 years. I left Hudson with Ben for the longest stretch of time since he was born. Party time? The reality of mom trips are not as awesome as they sound: I drove 2 1/2 hours nervous for my condition, in a bit of pain, had to pump breastmilk every 3 hours either in a patient room or my car, and got coffee after pumping sessions to stay awake the whole day without a nap. I was rewarded with feelings of inadequacy in perfoming 5 second holds on all my core work. I spent 90 minutes perfecting 3 exercises that JB prescribed I do twice a day, everyday. My butt burned, abs and obliques shook like crazy, and I sweated all over the gym mats. It was embarrassing and a little humbling but I left the office with a plan and the will to execute it.
So here it is for those needing help correcting DR. Before I explain my routine let me reiterate what I’ve learned about DR. Looks aside, you can have diastatis recti that never fully closes but still have functioning core muscles if they are activated and stabilizing correctly. Basically you can have a gap in your stomach but if you have no back pain, pelvis or SI joint issues, and no incontinence most likely everything is in working order. Let’s look at this as nature’s way of giving some women a permanent “love handle” down the middle of our belly. I stress this to convey that the focus shouldn’t be on repairing ourselves aesthetically but functionally. The following exercises are performed twice a day with focus and attention to detail. They take me 30-35 minutes. The first few days I did them, I woke up sore so I knew I was activating muscles that had been dead for a long time. The difference between this routine and your traditional “core” routine is that these natural movements and restoratives poses work to engage the core muscles in a dynamic fashion as opposed to in isolation (which u see in crunches).
- Bird dogs: 4 x 5 sec, 3 x 5 sec, 2 x 5 sec, 1 x 5 sec. On hands and knees with neutral spine, brace your stomach, locking in your lat and pushing the heel away from body raise opposite arm and leg and hold. Come back to midline still bracing and back out again.
- Side plank: 4 x 5 sec, 3 x 5 sec, 2 x 5 sec, 1 x 5 sec. Top leg in front of foot (see photo), Lock in your lat on the arm that is holding you up and push up being sure to keep a nice straight line with your body.
- Mc Gill Crunch: 4 x 5 sec, 3 x 5 sec, 2 x 5 sec, 1 x 5 sec. Lie on your back, one leg bent, the other straight. Place hands underneath back. Keeping the same pressure on your hands: brace abs, create a double chin, and lift from the mid back, not letting your head pull you forward.
Any questions??? Just kidding as I’m sure there are many. I am fortunate that with running being my job I have access to great doctors as often as I need. I highly recommend you find someone with the knowledge to help restore your core if that’s what you’re dealing with. If it’s mainly looks you’re concerned with, just own those stretch marks, loose skin, and “baby” pooch and “keepitreal” along with me in “journeywithsteph.” Just remember Rome wasn’t built in a day, so healing and restoring strength to your core will take time, patience, and consistency.
Would love to hear from you guys on your experience with DR.