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Diastasis Recti: Restoring My Core After My Third Pregnancy

October 03, 2014 8 min read

My story is not that of weight loss after pregnancy. I was blessed to have a fit pregnancy for all 3 pregnancies and keep my weight gain under 30 pounds for all 3 (and at 5'2, at a starting weight around 125 for each, that was a healthy pregnancy for me). The bigger issue here, the one that I have dealt with after my last 2 pregnancies, is an issue that MANY women deal with, many women don't even know they have, and one I know that I will have to manage from now on. I am talking about Diastasis Recti. Diastasis Recti is an abdominal separation of the rectus abdominis muscle that runs down your torso below your chest down past your naval. The separation splits this muscle into right and left halves. The distance between the muscle is stretched by the connective tissue or linea alba that connects the two parts. This is also the dark line you may see during towards the end of your pregnancy. A small widening of the midline is totally normal in pregnancy, and not call for alarm. In fact, about 30-40% of all pregnancies will result in a diastasis. In pregnant women, a diastasis is formed as your growing uterus pushes against your abdominal wall, aka your ’6-pack’. If your lower abdominals, or your transverse abdominals, are not strong enough to support the growing uterus and pushing on your rectus muscles, your ’6 pack’ becomes two 3 packs. In my previous post about diastasis recti and the exercises that make it worse, I go through how to check yourself. You can try doing this yourself, or if unsure, get a trained professional to do it for you. If you have a 2-2.5 finger gap or more, it's considered problematic and should be treated to not make it worse. Remember, what's between these abdominal muscles is this connective tissue, and with a separation, is now the only protection against your organs behind it. If you have a large separation, the key is to try and close the gap, or come close to doing  so, to not only gain your core strength back and avoid injury, but to keep yourself safe as well from hernias and more serious damage.

MY STORY

Before having kids, I worked at several fitness clubs around the NYC area, teaching classes and training clients. I would start my day at 5am and end if some nights at 10pm. I LOVED my job though. I was in great shape and had a wonderful, uneventful pregnancy. I taught classes and trained up until a week before I gave birth to my first in 2009. That first pregnancy and delivery threw me for a loop. I was not prepared at all for what was in store. After 24 hours of unsuccessful labor, I had an emergency C-section and the months that followed were long and emotional. You can read about that here. [caption id="attachment_55122" align="alignleft" width="248"]a year postpartum with my first in 2009 a year postpartum with my first in 2009[/caption] After I finally got a hold of myself and started to get back on the bandwagon, I felt amazing. It took a lot longer to get there than I previously thought it would, but I did it. I actually felt great and at a year postpartum with my first and my body was close to what it was before getting pregnant. I was 35 years old with a 1 year old baby girl. I managed to get through my first pregnancy with no stretch marks and no diastasis. But I wasn't in my 20s anymore either. My body had changed. I had to workout differently. Things that worked for me in my 20s were no longer making the cut, so I had to switch things around. I started with HIIT and strength training. It really helped me to build a better, stronger more toned body than I ever had before. Fast forward 2 years and BAM I was pregnant again with my 2nd! I was MUCH more prepared this time around. Delivery went off without a hitch and 2 weeks postpartum with my second, I felt better and more together than I ever did with my first so early on. At 6-8 weeks postpartum I started power walking and light jogging pushing my BOB duallie stroller along the way with my 2 babies in tow! I was working out, strength training and feeling great. But, somehow, despite how 'fit' I was at 5 months postpartum, around my naval, I looked like I was  still pregnant! How could that be? I was in great shape and felt strong, but something wasn't right. I researched, spoke to my OB and realized that I had diastasis recti. What the heck! I could do all the HIIT I wanted, but it wasn't going to help my diastasis, in fact many of the exercises were making it worse, most of all, traditional ab exercises. Regardless though of the DR, I wasn't going to just stop working out. Working out was MY time. It gave me peace. It gave me energy to deal with what may lay ahead in the day. It cleared my head. Every mommy needs her time to release! As a personal trainer, I used to train many postpartum women who did have DR, and I followed protocol in terms of the programs I designed for them, but at the time I trained those clients, I had not had a baby yet. It's easy to read up and get certified as a pre/post natal specialist and really help that clientele, but it's a whole other ballgame when you have gone through it yourself and really KNOW what it's like to have certain postpartum issues, a diastasis being one. For some reason when it came to my own belly, I never thought I would get it. I always had strong abdominals and in general, was a pretty fit person who ate clean, but it didn't matter.

At 5'2, with back to back pregnancies, not knowing I initially had a problem, not initially CHECKING myself after my second birth, and then with no real repair, my connective tissue became weak. Not to mention as well that I birthed 2 babies at this point, both close to 9 pounds each! That's a lot for a short petite woman who always carried up front, with a torpedo like belly! It put so much pressure, especially around my naval, that it stretched that connective tissue quite a bit after my 2nd. I was determined though to fix it. And fix it WITHOUT surgery.

As I researched diastasis repair and recovery, I came across Julie Tupler and her mission to get women (and men for that fact), to understand what diastasis recti is, how to recognize it, how to treat it and how to avoid it from coming back and or getting worse. She talks about it extensively here if you have the time to watch! She talks about the exercises to DO and AVOID with a diastasis and about wearing the splint. http://youtu.be/Pef6r6e5HRE After the birth of my second, I had a 3.5-4 finger separation at my naval. diastasis recovery photosOnce I figured out what the issue was, I started to do the Tupler rehab for it and belly exercises that helped to close the gap. I actually had great results with exercises and started splinting at that point. I continued to train as I normally would with modifications and actually got into the best shape of my life after my second. I still had somewhat of a gap between my abdominals, but it was getting SO much better. I would do the exercises to help with recovery and avoided many that made it worse. Around 7 months pp after my 2nd, I had finally taken my diastasis down to about a 2.5 finger separation. *As with the Tupler technique, I would do the following:
  • Core contraction - In a seated position, place both hands on abdominal muscles. Take small controlled breaths. Slowly contract the abdominal muscles, pulling them straight back towards the spine. Hold the contraction for 30 seconds, while maintaining the controlled breathing. Complete 10 repetitions.
  • Seated squeeze - Again in a seated position, place one hand above the belly button, and the other below the belly button. With controlled breaths, with a mid-way starting point, pull the abdominals back toward the spine, hold for 2 seconds and return to the mid-way point. Complete 100 repetitions.
  • Head lift - In a lying down position, knees bent at 90° angle, feet flat, slowly lift the head, chin toward your chest, (concentrate on isolation of the abdominals to prevent hip-flexors from being engaged), slowly contract abdominals toward floor, hold for two seconds, lower head to starting position for 2 seconds. Complete 10 repetitions.
  • Upright push-up - A standup pushup against the wall, with feet together arms-length away from wall, place hands flat against the wall, contract abdominal muscles toward spine, lean body towards wall, with elbows bent downward close to body, pull abdominal muscles in further, with controlled breathing. Release muscles as you push back to starting position. Complete 20 repetitions.
  • Squat against the wall - Also known as a seated squat, stand with back against the wall, feet out in front of body, slowly lower body to a seated position so knees are bent at a 90° angle, contracting abs toward spine as you raise body back to standing position. Optionally, this exercise can also be done using an exercise ball placed against the wall and your lower back. Complete 20 Repetitions.
  • Squat with squeeze - A variation to the "Squat against the wall" is to place a small resistance ball between the knees, and squeeze the ball as you lower your body to the seated position. Complete 20 repetitions.
DR 9-13   Sixteen months after giving birth to my second, I was pregnant with my third! I KNOW RIGHT?! Well, this threw my diastasis rehab back a bit, but I still splinted and did the Tupler technique as much as I could. After I gave birth to my third this past January, I started the exercises back up, but waited to splint until about 4-5 months postpartum. My physical therapist wanted to work on scar tissue around my incisions, and wanted to hold off on splinting until we saw an improvement with the scar tissue which we did! I started splinting and wearing it RELIGIOUSLY about 12 weeks ago. I went from a 4 finger gap at my naval, to now under a 2 finger gap. I had about a 2 finger gap below and above the naval before I started splinting, but now there is barely a gap at all! I couldn't be more pleased, and I still have several weeks to go with the rehab and splinting. You can see the splint I use and how it works in the below video: http://youtu.be/A7zE65cqjxs Listen, my body will always be a work in progress. My body has changed considerably in the past 5 years, after birthing 3 kids. I am however happy with the body I now live with. I am strong. I am active. I am a positive role model for my children and hope to inspire them as they so inspire me to be young and active. At 39 years young, I am the fittest I have ever been and work out more efficiently and effectively. I know with my diastasis, I will work till I have closed the gap or at least come close to doing so. I have changed the way I workout in terms of abdominal exercises to strengthen my core. I no longer do traditional ab exercises, but have replaced them with more effective exercises to strengthen not only my rectis, but also and more importantly, my transverse muscles. If you have a diastasis and have been told only surgery will repair it, I highly recommend getting a second opinion. Every case is different. I did NOT want to have surgery, so instead I started seeing an amazing physical therapist who also happened to train under Julie Tupler. She has helped me tremendously. I know with dedication, commitment and taking the time to help heal my body, I can correct this problem and build an even stronger core than I ever had before!     Want to see more workouts and information on health and fitness? Check out my Facebook and my youtube page as well!
CREDITS: *(Core Exercises listed above): Liao, Sharon (February 2012). "15 minutes and you're done: crunch-free abs". Real Simple (Time Inc.) Julie Tupler: http://www.diastasisrehab.com
 

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