Friday, March 17, 2017

Working out with Diastasis Recti

Hi friends! Happy Thursday! What are you up to this morning?? I’m getting in a strength workout and am excited to start packing up for a little Sedona getaway. 

For this morning’s post, debated about whether I should put it on the family page. Then, I thought about the fact that I wish I would have known more about diastasis recti before I got pregnant. Also, abnormal ab separation doesn’t just affect postpartum mamas; women who have never been pregnant, men, and babies/kids can all experience a diastasis recti in their lifestyle. It’s extremely common, and I thought I’d share some of the things I’ve learned in my postpartum experience, as well as awesome resources if you have DR.

Tips for safe workouts if you have diastasis recti, or abnormal ab separation after pregnancy. fitnessista.com

What the heck is diastasis recti? 

DR is defined by abnormal separation of the rectus abdominis (the outer layer of our abdomen, aka our six-pack muscles). There is a connective tissue that runs down the middle of your core, called the linea alba, which can become weak and/or stretched out from a variety of factors, like pregnancy, poor posture/alignment, weak core, etc. Looking back on it, I can exactly pinpoint the things that potentially made my DR worse: standing with my giant pregnant belly while holding Liv and pushing my hips to one side, bad posture, + sneezing with so much force and gusto at least 50x a day (my allergies were SO bad in SD) without supporting my belly or contracting any muscles. I seriously let everything forcefully push out which made my linea alba crooked (!) and stretched out beyond its poor means.

DR is often referred to as a “mummy tummy” because it can cause protrusion from the abs. It can make you look pregnant when you’re not, and because the core muscles are weak, it can throw a lot of other things out of whack. Other symptoms of DR include back pain and pelvic floor-related issues, like incontinence. (Peeing when you sneeze is not normal and can absolutely be fixed. With treatment, you can fix it and it doesn’t have to be your new normal after you have a baby.) Also, it’s worth noting that people with large bellies don’t necessarily have DR, and people with washboard abs could absolutely have ab separation. It’s all about function, not appearance. 

If you think you may have DR, ask your doctor or a physical therapist to check you. There are also YouTube tutorials online, and Jess describes how to check for diastasis recti here. If you check yourself, be sure to be SUPER careful. If you have ab separation, if you push down on the center, you’re pressing on your organs. Not to freak you out of anything, but be super super gentle. Diastasis recti is usually rated on the degree of finger separation (usually a 2-finger gap or less is considered “normal”) but the degree of separation doesn’t indicate the depth of the gap (which makes a difference) and the strength of the supporting structures (makes a huge difference). So if you have it, take your degree of ab separation with a grain of salt, and focus on total body alignment and rehabilitating your core.

I had a 3-4 finger gap closer to P’s birth -I didn’t have it formally checked until after my surgery debacles- and it’s down to 2 fingers and close to 3 at my belly button. The depth has also reduced. I’m still working on healing my core -birthing an almost 11-lb baby has given me a lot of new things to learn about my body haha- and if I do too much, I can definitely feel it and see it the next day. After filming the HIIT workouts for Winter Shape Up, I looked super bloated for an entire week. 

Here are some of the things that have helped me:

-Seeing a pelvic floor physical therapist.

I had to see her to help me with other issues after P’s birth (which thankfully have all been resolved), and she ended up helping me with EVERYTHING. Pelvic floor PT should absolutely be offered and included in postpartum care in the US. (If you are having a baby, request a referral! Even if it’s just for a check-up and to make sure everything is good, chances are that you won’t regret it.) She gave me so many corrective exercises, modifications for my routine, and taught me how to get my body in proper alignment.

-Reading Diastasis Recti by Katy Bowman (as well as Alignment Matters), and reading as much as possible from her blog.

All hail, Katy Bowman, the one who saves core muscles, poor posture, and pelvic floors everywhere. She’s sharing her knowledge so generously, and it’s up to me to soak.it.up.

-Modifying the heck out of my exercises. I can do pretty much everything now, but I watch the oblique work (if they’re too tight/strong they can pull the abs apart even more) and modify core series. 

Here is a video with my usual modifications:

 

(Notice how I roll to the side instead of sitting straight up to transition. If you have DR, avoid all sit-up and crunching type motions.)

*Note: many of the programs I’ve seen online are a combo of the above exercises. I would see a PT to make sure you’re doing the exercises and engaging your core properly, and read Diastasis Recti. It’s all worth it. I am also a fan of the Tupler Technique (we used many of these strategies in my PT sessions) and have heard great things about MuTu.  

Tips for safe workouts if you have diastasis recti, or abnormal ab separation after pregnancy. Strengthen your core with these safe diastasis recti exercises. fitnessista.com

Exercises and tips:

-Diaphragmatic breathing. Fill your belly completely, but avoid letting your ribs move up as you inhale. Instead, think of your belly and ribcage as an umbrella: open it completely. As you exhale, close the *umbrella* and draw the belly towards the spine. You can also add a pelvic floor contraction + lift, but it’s important to make sure you’re doing these correctly. (<— reason 297338 why a pelvic floor PT will help you)

-Marches and toe drops. Keep everything else stable, your abs pulled in -if you feel anything pushing out, take it back and maybe just hold a tabletop position- as you lift each leg one at a time. Once this feels good and you maintain core stabilization, try toe drops. Start in table top and gently lower one toe towards the floor at a time. Make sure to breathe!

-Hip raises. Ground your shoulders into the floor and press your weight into your heels. Exhale and squeeze your glutes as you press up, and slowly lower down.

-Spinal balance. Make sure to keep your transverse abdominis engaged (really think about keeping the lower part of the abs pulled in, and breathe). To start, do one leg at a time, then one arm at a time. Once this feels good and you have the stability, try opposite hand and legs. Finally, add tiny pulses at the top.

Spinal balance

(Photo: Scott Hubbard)

-Cat cow. This is a great one for pregnancy, too! Start with your hands under your shoulders and knees under your hips. As you inhale, fill your belly and drop it towards the floor, exhale to press out the air, drawing your belly up and in. While you do this move, make sure that your obliques are relaxed.

-Giving myself time and patience. I know that going through all of these unique experiences of the past year have made me a better instructor and trainer. I feel confident providing modifications for women in various stages of life, which feels pretty awesome. Of course, I’m going to continue to read and learn as much as possible, but am thankful for all of the new knowledge this required me to learn.

If you’re a postpartum or expecting mama and you’re looking for a safe and effective postpartum fitness plan, PBB is here! I also have an advanced plan for mamas whose babies are over 1 year old and you’re comfortably back in the fitness game. 

What’s your all-time favorite core exercise? Any of my fellow mama friends working on healing their ab separation? 

xoxo

Gina

Tips for core training during pregnancy

Video: Grant Hunker

Location: BreakOut Studios

Wearing: Fabletics + Nike shoes (<— on sale)

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