Monday, 21 May 2018

Healing from Diastasis Recti Part 2

Healing From a Diastasis Recti Part 2

As a pelvic health physiotherapist, I am constantly learning new things in my industry. What we know from science and studies is always changing and I want to share with you what I am learning.
A really hot topic that new moms are always interested in is the ab separation that occurs from pregnancy. What many fitness and even healthcare providers recommend is exercise. Rebuild those muscles and make them stronger. This is of course one element to heal a diastasis but I am learning that in fact it is much more than just exercise and should not be the first thing we do.

On my fascial course last year, we started talking about the role of fascia and how it plays a part in the function and movement of muscles. Fascia is what lines the muscles, organs, abdominal wall and needs to move freely. We need to consider how the fascia (or connective tissue) impacts the muscle.

So the discussion was that not only are we looking for how much the abs are separated but is the woman able to create or generate tension through the fascia and is there any restriction in the fascia that is impacting movement and function.

Listening to the ‘Birth Healing Summit’, we have to think deeper and simpler when working to heal a diastasis. What I mean by deeper is not just fixating on the gap. As a therapist, we need to focus on the internal/external obliques and transverse abdominis. These three muscles are connected to the linea alba, which is the fascia that connects the two sides of the “six pack” muscles.

We need to asses for and poor breathing patterns, ab gripping and posture as this can cause these muscles and thereby the fascia to pull on the ab separation. Tension and poor contract/relax patterns promotes the separation to stay open.

If there is tension in the abdominal fascia or muscles, it is going to be very difficult for a new mom to get connected to the area, never mind coordinate muscles activation properly to heal the diastasis. So if there is tension but our focus is on more strengthening this can be problematic. So starting your planks or other ab exercises may not be right first step.

So, here we come to the simple part. We need to get back to basics such as proper breathing. Learning to expand the diaphragm and ribs appropriately allows for expansion and stretch to happen in the abdominal wall and contraction in the abdominal wall on exhale. We need to be careful not to expand too much with belly breathing as this can create too much stretch. So a simple exercise such as breathing begins to introduce gentle movements post partum which can stimulate the fibroblasts (special cells that help with collagen production) to aid in healing.

We do not give enough credit to proper breathing techniques and remember this ladies the diaphragm is part of the core. It works synergistically with the transverse abdominis and pelvic floor. Having a good breathing technique sets the stage for proper core activation and proper loading during day to day activities to reduce stress on a healing diastasis.

The other key point brought up in this summit was the importance of touch by a professional. Not just touch to feel for the gap but also for tension points and adhesions. Remember in the last 3 months of pregnancy the muscles and connective tissue undergoes a lot of loading and can cause the fascia to get stuck in that loaded position and this can impact functionality. So yes fitness is a key but seeing someone to properly assess is also key so that the right foundation is built.

The Pelvic Health Lady

***For more information about the 9 things you wish you knew before giving birth..and still have time to learn before birth. Check out my FREE pregnancy guide. www.ecophysio.com/pregnancy. Click on the guide picture for instant access***

Friday, 4 May 2018

10 Things To Heal Ab Separation


10 Things to Heal Ab Separation

This blog is going to focus on the 10 things to heal diastasis. The purpose is to highlight key things we as moms need to consider. We are human it’s never just about the muscles as so many things are interconnected in the human body. To just focus on the “gap” between the abs is typically not sufficient enough to address the problem. These 10 things I learned came from the Birth Healing Summit from a talk by Jenny Burrel. I encourage women to check out her work for more in depth details.

  1. Nutrition and Hydration. Healing from a diastasis requires healing at a cellular level. In order for our fibroblasts to make new collagen we need good nutrition, especially protein. There are a number of different ways to get protein: shakes, supplements and home cooked food. It is important to take a look at what you are eating and I recommend seeing a Naturopathic Doctor to help go through not just diet in terms of protein, but nutrition from an overall perspective.
    • Also noted was the importance of vitamin A and Vitamin C. We do not store these vitamins but are using them up at a faster rate because often as new moms we are not sleeping well and this creates more cortisol (stress hormones) which uses up more nutrients. Do not take supplements without consultation!
    • Hydration: In order for stretched fascia (connective tissue) to heal it needs hydration. The space between the fascia is made up of mostly water. So hydrate ladies to keep the fascia healthy. If you are leaking urine…please do not stop drinking water to prevent leaking! See a Pelvic Floor Physiotherapist!
  2. Appropriate Loading vs strengthening. We need proper movement: contracting and relaxing of the abdominal wall to rebuild and heal. If you are planking or doing sit ups this is not the right first step. You need to connect with your ab muscles and apply the right amount of exercise, which may start with proper breathing.
  3. Improving breathing Strategy: in 99% of clients, I have to re-teach proper breathing. We often breathe too shallow and especially after pregnancy. We get used to not breathing as deeply because the baby took up space. We need to get the diaphragm back online. We need the abdominal wall to stretch and contract.
  4. Posture: How we position ourselves can promote muscles and fascia to get stuck there. If you have a gap and you are slouching that puts a lot of load on the abdomen. This can make it challenging for healing and for proper range of motion.
  5. Bowel Function: Individuals who are constipated put pressure on the abdominal wall unknowingly. We need to consider our toilet habits and our gut health. This again needs to be looked at by a pelvic health physiotherapist and a Naturopathic Doctor, especially if you had a c-section and were given antibiotics. The gut bacteria, needs to be considered as important for many health reasons.
  6. Learning to Manage load Daily; using proper form and breathing is not just for exercise in fitness class. You need proper technique lifting your kids up, picking up groceries, doing laundry, putting the stroller in and out of car. These daily functions need consideration for healing.
  7. Fascia Tensioning: so in order to have proper muscle function, the fascia that connects the muscles needs to slide and glide freely and you need to be able to pull tension through the fascia as well. Physical therapy can help teach you how to do this.
  8. Less stress: this goes without saying, reducing stress is so important for overall health and it can impact diastasis healing. Why? Well cortisol the stress hormone slows down healing. There is this romantic view of how raising a baby is suppose to look. This is not reality. We need to ask for help. We need a support system. Ladies you cannot wait for someone to notice or ask you if you want help. It is our job to ask for help, to ask for what we need and stop comparing ourselves to everyone else.
  9. Soft Tissue Therapy: this goes back to the tension and function of muscle and fascia. We need hands to touch our tissue and see what is happening.
  10. Downtraining the nervous system: This ties in with stress. We need activities to let out the steam, to counterbalance all the demands a new baby has on us. For example: taking time for self to have a hot bath, meditate, go for a walk or even hang out with friends without the baby. If our nervous system is wound up, we will have tension and in all likelihood stress hormones in the blood

I hope this has given you a more expanded view.

The Pelvic Health Lady