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***

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