Do You Have a Diastasis and Not Know It?

For this week’s blog, I wanted to talk about the in-person workshops we've done for the past couple of months. I started doing some in-person workshops, little short-hour classes, at Broad Street Yoga in the town that I live in, Grove City, Pennsylvania. And they have gone really well so far.

The first one was on the pelvic floor and how to incorporate that into a flow and start at the very basics of learning how to be able to fully relax your pelvic floor, which is a big stumbling point for people sometimes. And then working on some breath work to get that stretch in full elongation of the pelvic floor so that you can use it when you need to. The participants also learned how to do some self-techniques to release the area, whether it be with the coregeous ball, which is a blow-up ball, to do some myofascial work with it or using tennis balls or the tune-up balls that we use a lot in our YouTube channel videos and that kind of thing.

So that was really good to just get a general sense of how we change little things throughout our day to help with that full relaxation. And then how to get that stretch and elongation through breathing because that is very important, and it transitioned really well into the next class we did, which was this past weekend and that was on Diastasis Recti.

I think from what I've gathered in seeing people in my office is that people often have Diastasis Recti and don't realize it and maybe they've struggled for years with low back or hip pain, and they're not getting a lot of good results. Maybe they have been told that they have a weak core, so then they jump into doing core exercises. If they don't address those weaknesses in their core from the separation of the abs – that's what the diastasis is, it’s a separation of your abdominal at some point along that midline of the erectus abdominis – jumping into core work blindly can leave you with some more issues.

So it's going to do the opposite of helping you with your low back or hip pain. It is going to hinder you. And something really important to note is to get checked or check yourself if you have a separation along that center line. Do you just cut out the exercises that are abs exercises? Is there something you just avoid or do you work on it to slowly to be able to stress and load the tissue? That's a common mistake because we do not want to just avoid things and kind of stop doing the things we love.

We see that in the office a lot in general. People will have a foot issue, and they're like, “Well, I just can't run anymore.” That is not really a satisfactory way to go about things. We want you to be able to return to the stuff you like and want to do, not alter your quality of life to accommodate your issues.

The First Thing We Did At The Diastasis Recti Workshop

So with the class we did this past weekend for Diastasis, the first thing we did was not core work or anything like that. It was learning to check to see do you have any issues with that abdominal wall. And often we check you right at the beginning with you lying flat and then having somebody palpate or you palpate on yourself in. Palpate means just feeling with your hands along the center line and seeing if there is a place that feels like it has a lot of give to it.

When there is an area on your center line there's nothing behind it. You go really deep, and it feels open, and we measure that in width. So how many fingers wide is that opening and how many fingers deep does it kind of dip down into your abdomen?

An interesting thing, this past weekend, is that we have people who had some opening and width and depth to it, either up high, more at the belly button area, or lower. So there's not a specific place. It could be anywhere along that center line that you're going to have the issue. And a lot of times, if your ribs tend to naturally be wide and out, the rib flare that we call, it would look like a barrel chest appearance. You might have your separation at the belly button and higher, and then if you're having more of the lower issue, you might have the ribs more constricted.

So those are things to look for.

How Asymmetries Can Affect You 

When we were in class, we went over the significance of do you have that rib flare? Do you have that barrel chest appearance, and is it symmetrical? Do you have one side of your rib cage that flares out in one side? Because that asymmetry is also going to affect how your core functions. That is a red flag that we need to do some balancing out to help open up the one side because that could mean that some of your abs that attach onto the rib cage are either tethering down one side in a way that's making it appear flared and a little bit asymmetrical. So that's going to translate in how you move, how you support your spine, all of those kinds of things. It also will affect the pressure down onto your pelvic floor.

So often people with some asymmetries or some weakness in that center line of their abdomen are also going to have pelvic floor issues or prolapse issues. Prolapse is when you have like different organs from your abdominal cavity that kind of protrude down past the pelvic floor – so your uterus, your bladder, those kinds of things. That would be something that your OB-GYN could check, but a sign that you might have is you feel a lot of heaviness or pressure, or when you are trying to insert a tampon, you feel like there is something in the way, or if you have prolapse from the rectum, you might have issues with going to the bathroom and you would need to get those addressed.

Any type of pressure issue in your abdomen, which is a hole or opening the abdominal wall creates, is going to give you issues when you create pressure to go to the bathroom or do those kinds of things. So it is all very interwoven in how things kind of play on one another. So even if you weren't connecting them, you were not really worried about your leakage issues that might be playing a role in why you're having leakage, and you really should try to work on addressing it.

What To Work On First If You Have Diastasis Recti

We start by giving that pressure somewhere else to go. So instead of down on the pelvic floor or out through the hole in your abdominal line, we worked on different ways to mobilize your rib cage and open up the fascia around the rib cage, but also opening up and working on the fascia and muscular attachments of the abs. Because your abs, your internal obliques, your external obliques, your transverse abdominal, those three core muscles that support your spine and low back – we think of them as the side abs – those side muscles, they're actually attaching into your low back.

So we work on freeing that area, getting nice good tissue mobility, because they attach onto the rib cage. So think of them as tethering that rib cage down in maybe an asymmetrical pattern or just not letting it have its full range of motion.

We now do our breathwork, so that we can get that expansion of the rib cage easier. We don't want to have our rib cage chronically stuck out in that barrel chest appearance, but we also don't want to have it cinched in and tethered and locked down as well. We want it to be supple and mobile so that it could do its job, so that it could swing out and wide for that 360-degree breath and then swing back in to create that pressure for your exhale, and trying to do something that you're going to exert yourself with.

You can also do that by using different props in class. So we use the coregeous ball, which is the air-filled ball that I use a lot in my videos. We actually tied it into some yoga type poses to help open up different areas around the rib cage and it muscles attaching in onto the rib cage.

So then we give ourselves some expansion and room for the pressure to go, rather than out the front where you're having that opening of the abdominal wall.

What To Work On Next If You Have Diastasis Recti

And then after you do the breathing, which is how we started our pelvic floor class, with the intent to stretch the pelvic floor out diastasis class, we did the breathing with the intent to give that pressure somewhere else to go. Then, we addressed slowly loading those tissues and constantly checking in with yourself to see if you were able to maintain good integrity of that center line.

So, if you think of that center line of the abdomen, it's the fascial attachment between one side of the six-pack muscle and the other side, and those called your rectus abdominis muscle. Think of that center line as silly putty and whether or not you were pregnant or you gained a bunch of weight or think of that silly putty that is expanding, it is stretching that thick, silly, putty out and that really thin and wide and then it gets less structurally sound and then it's likely to tear open.

And that is kind of what happens with that Diastasis action. I explained how it doesn't have to be that way. I gave myself a Diastasis because I was very internal oblique dominant before I ever had kids. And I did a ton of core work because I loved to work out, and I worked out not in a good way and gave myself a bit of a Diastasis from doing imbalance core work. So not from having kids, but from overdoing it on imbalance core work.

And so with that, I've learned to slowly load the tissues and be able to engage my deepest core, my transverse abdominis. Instead of letting my internal bleaks take over and draw things apart, I've been able to if I use my cues and think about it, I confirm that center lineup and exert force without having an issue.

Then you can slowly, progressively do harder core work, but check in with yourself by using your hand and feeling along that area to make sure that you're not pushing it too far so that you're separating it more. You can do that simply by putting your hand on your stomach feeling along that center line.

Remember that it's important to slowly progress the tissue so that by making those core exercises harder as you get stronger, it becomes more durable and able to do things. Because then, when you're in your regular day life, and you need to carry your toddler through the zoo as I did on Friday night, you're not straining it when you really have no other choice. Because let's be honest, what you're doing in the gym should be to make your general life easier.

I have patients who will maybe lift the same small weight for years in the gym, but we want to be progressing the weight and challenging the muscles and making it real-life appropriate. If you're using tiny little five-pound weights and in your daily life carrying a 30-pound laundry basket, that doesn't really make sense, and it's not what the challenge that your muscles need to simulate what you're going to be asking of your body to do in day-to-day life. So we want to get to that place where we're building and being functional for what we're trying to do and ask of ourselves later on.

Knowing Where Your Weakness Lies Helps With Diastasis Recti

The other thing I forgot to mention is that depending on where your weakness lies, like for mine, it's that rib flare, then I tend to have to focus on engaging the upper part of my innermost core to bring things together rather than middle, and I tend to hold it on the middle incision at the waist belly buttons section naturally with that engagement.

So learning how to tether in my ribs when I'm doing stuff really helps me to firm up that center line. And if you are opposite of that, you would focus more on maybe firming up the lowest part of your board, and you can target different exercises to different areas of where that diastasis is at.

Conclusion

So if you have any questions or if you're not sure if you have diastasis, lots of people have it who don't realize they have it, let me know or find a provider who can assess you and make sure that the exercises are targeted for what is your issue.

If you have any questions, you can drop it in the comment section or you can send me a message through Facebook or Instagram. I’d be happy to do another blog about your questions. Also, if you want me to talk about something specific, let me know!

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