I’m having a hard time writing a post on diastasis recti (DR). Why? Because it is a musculoskeletal issue that has various components. The average woman seeking treatment in physical or non-supervised treatment programs spend hours learning about form and exercise. And you want it in 1,000 words.
I think it would be easier for me to explain how a diastasis recti happens in the first place. If you are reading this and don’t have this condition — DON’T HANG UP! The info in this article is about how your body should be all of the time so that you don’t develop this, or other pressure-based conditions like pelvic organ prolapse, varicose veins, constipation, hemorrhoids, hernias, and high blood pressure to name a few.
I know you want me to tell you how to fix it. And I will. But my answer is not going to be: Do these four exercises for five minutes three times a day for ten weeks and then call me in the morning. One of the reasons people have a difficult time correcting their own ailments without surgery is because they are not changing what they did that caused it in the first place – and I don’t mean what they were doing the moment before the ailment happened. Fixing DR is the same as anything else. It is not a situation caused by pregnancy, or a giant baby. It is caused by carrying high pressure in the abdomen. Trying to do exercises to fix a pressure-induced issue while continuing to hold your body in a way that continues to create high pressure will never work.
If a pressure-based ailment has developed in your body, then your entire body needs to be aligned so the pressure goes back to the correct homeostatic values. We have become a spot-treatment kind of culture. An “I’ll give my health at least 60 minutes-a-day” kind of population. An “I’ll spend more money on my clothes than I on what’s under them” kind of population. But if you are really interested in fixing your DR for good, you need to learn what caused it and what you are doing, right now, that is keeping the split in place.
So, are you ready?
Diastasis recti: A musculoskeletal injury, where the rectus abdominus tears at the connective tissue, separating it from the linea alba – a collagen cord that runs from the bottom of your sternum to the front of your pelvis (click here for a picture).
Ok, science class! There are three main cavities in the body and probably more than that if you loved Now&Laters as a kid.
The cavities include the thoracic cavity, which houses your heart and lungs; your abdominal cavity, housing your guts and possibly a baby-to-be if you’re lucky,; and finally, your pelvic cavity. If you grew up in a more natural way, walking long distances per year, squatting to bathroom and birth, barefoot, and were well rested, the position of these cavities would be aligned like this:
Alignment is different than posture. Posture is about how something looks. Alignment is about how something works. So, to work on your alignment is to pick a position that improves performance, not necessarily aesthetics. The above-pictured alignment of the cavities is very important because the pressures within the cavities are affected by various positions.
So let’s talk about pressure.
The best way I can explain pressure is like this. If you have 20 small children and put them in a small room, the pressure will be very high. If you wanted to increase the pressure you could either add more kids or make the room smaller. You could also give all the kids candy.
The only way to decrease the pressure would be to 1) remove some of the children or *stuff* from the space or 2) get a bigger room. Preferably at someone else’s house.
Now back to body alignment, or more importantly, how alignment affects inter-cavity pressure.
After decades and decades of sitting, shoe-wearing, sucking in the stomach, and various postures that we have selected for aesthetics or cultural reasons, this has become the common stance for most Western populations:
The most important thing about this picture, at least for our discussion today, is what is happening to the abdominal cavity. When the ribs lift in front, they drop in the back. Pinching the back of this “abdominal balloon” places the contents under greater pressure. And like things under great pressure, they try to escape. Because the spine bone makes a strong boundary in the back, your guts (or your baby, if there’s one there) have to go…somewhere. The choices are up, down, or forward. Or any combination of the three. In diastasis recti, the forward pressure on the uterus causes the uterus to push forward into the muscle. And it’s not just babies. High pressure abdomens cause all sorts of ruckus.
Here is a fun pic showing how things escape the abdominal cavity:
A hiatal hernia is when the organs move up through the diaphragm and party with the heart and lungs. Hint: It’s no party. And, FYI, neither are the other two.
The pic might be a little silly, but these hernias (especially the hiatal) can be life threatening situations. And if you happen to have one of the more minor ones then take it as a red flag. Pressures are not as they should be in your abdominal cavity (and neither is the alignment).
If you are ready to say buh-bye to your DR, or your “fill in the pressure ailment” the solution starts with whole-body posture. Before you do a stomach exercise, a pilates roll-up, or try any other type of solution, you need to change your pressure gradients. And before you can do that, you need to see how to recognize the body positions that make IAP (intra-abdominal pressure) worse. So, students, what do you see here (don’t cheat — see what you see first!):
And once you’ve checked out my super-duper postures and bedhead (yes, I took these about 10 minutes after rolling out of bed after sleeping for about two hours less than I needed…please don’t zoom in), let me know if you saw this:
You probably noticed that the title of today’s post has the ominous words “Part 1″ in the title. So this is where we end today’s presentation.
Your homework, my dear students, is to study these pictures – and understand the differences between them. Focus particularly on the rib shearing and pelvis thrusting, and not so much on the bed head, which technically isn’t an alignment issue.
The second part is to start to look for and recognize these postures as you are out and about. Once you learn how to see these alignment snafus, you’ll start noticing them everywhere and then eventually in yourself.
As for Part 2, tune in again to learn other high-pressure makers, some exercises, and what body parts play a significant role in the chronic knee-bending, hip flexing, rib shearing posture that so many of us are so fond of (hint: it’s the psoas, so read *this* too).
Till then, ta-ta. I’m going to go brush my hair now.