Coaching Thoughts About Healing Diastastis Recti (DR)
Each woman is going to be very individual in her body's response to pregnancy, childbirth, and postpartum recovery. My best advice is to get checked out by a women's health physical therapist to really get the specific details of your situation and to understand the best protocol to heal effectively in your particular situation.
That being said, there are a few common themes that we see pop up time and time again while coaching, so I figured why not share them with you here.
Does the gap (Diastasis Recti) really need to be closed?
Current research shows that the answer is actually NO. The gap does not need to be fully closed to be functional. What physical therapists (and postnatal fitness specialists) need to see is good tension created when the mom does a pelvic floor contraction. Additionally, the mom would also want to be able to engage her core and pelvic floor while doing exercises or daily functions that she wants/needs to do. A good pelvic floor contraction that creates tension in the linea alba is useless unless the mom is also able to apply this method to other areas in her life.
I always like to think about what the mom must do on a day to day basis. Does having DR affect this situation? If the answer is yes, then we have work to do! If not - I'd advise not to stress too much about having some abdominal separation.
What is demanded of your body from day to day?
Do you need to lift up baby, carry baby, perhaps lift and carry toddler, hold feeding poses, get groceries, get groceries back into the house, walk up and down the stairs, etc? In order to do these functions without back pain, pelvic pain, or risk of making a DR or pelvic organ prolapse worse, we do need to learn how to properly breathe and engage our core and pelvic floor.
What kinds of workouts do you love doing? What would you like to get back to doing? These are all factors we need to take into consideration after main function of the core and pelvic floor is restored. How much stress does your core need to be able to handle or withstand to do the things you love? This part is a bit trickier, but can be done while working with a coach who understands how to stress your body with the correct dose response of strength training and then allow you to recover and repair.
A coach would look specifically at what is demanded of your body in sport, fitness, or extra-curricular activities and advise from there.
Prevention in Pregnancy?
Although we stated above that DR happens with almost all pregnancies (and that is a GOOD thing - to make room for growing baby!), we can try to prevent extensive separation in pregnancy. This would mean avoiding exercises where you see doming through the abdominal wall during pregnancy (ex: crunches, pull ups, toes to bar, sometimes planks), and learning to breathe through movements and avoiding breath holding at all costs! We can instead load the core with squatting, pulling, pressing, and anti-rotation movements so long as the mom can keep her ribs stacked over her hips and keep breathing patterns normal. Unnecessary jumping, running, or other high impact movements are often taken out of the training protocol during this short (pregnancy) time.
I hope getting my coaching thoughts about healing Diastasis Recti down on paper was helpful for you! Let me know what other questions you might have.
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