Regarding the title above.....this is probably one of the commonest questions asked by FitPro's working with Post Baby clients with a healing Diastasis....
So, the best place to start is with the Anatomy and Physiology bit......don't groan.....knowledge is power 🙂
The above picture is brilliant for showing the other Aponeuroses (sheets of tendon - the white areas) that are also a vital part of this conversation. We also need to have a fair idea of the attachments of all the abdominal wall muscles anterior and posterior before we can have a hope of creating a strategy that helps rather than retards your clients progress toward either the gap closing or the tissue regaining a tension and strength that can withstand pressure. This knowledge will also help us create an truly holistic and suitable programme that can be progressed over time. So the above diagram is a great place to start.....
1. The Rectus Diastasis isn't just about the Rectus Abdominius! It's about the mid-line and total tension of the entire abdominal wall. That weakness/lack of tension that you can feel when you perform the 'Rec Check' doesn't just simply stop after the Rectus and can extend deep through all the layers of the abdominals - Rectus Abdominius, External/Internal Obliques & TVA.
2. START BY ASSESSING THEN RECONNECTING AND RELEASING THE CLIENT BEFORE GOING FOR THE STRENGTH WORK!! Release tension that holds the client in hip flexion/thoracic kyphosis - simply apply a mixed bag of strategies to get her back to optimal posture! These include working on the borders of the Diaphragm to release any tension there that might be holding the client in flexion, releasing the intercostals (muscles between the ribs so the client can have full inspriation/expiration as this is fundamental to getting the diaphragm to fire the Pelvic Floor and indeed getting the whole of core to work in synch. Also the external obliques attach to the ribs so any increased tension there might be adding to the pull away from the midline.
Typical Early Post Natal Posture
Also does the client need a strategy for releasing the pectorals, anterior delts, biceps??? If ever there was a poster child for Upper Crossed Syndrome, the Pre/Post Natal client is she! With all the above areas sorted, THEN WE START THINKING ABOUT EXERCISE TO STRENGTHEN!
Ultimately, the habits for the other 23 hours of the day that your client spends living her life out of your presence are more telling on her recovery than any traditional 'exercise programme'. Excess stress will hinder healing probably just as much as performing planks so HOLISTIC is the name of the game alongside with truly bespoke strategies for each woman for where SHE IS!
Devise a HOLISTIC strategy, that includes nutrition, posture correction, strategies for lifting, releasing tension that holds her in poor posture, correct faulty breathing, show optimal breathing strategies for diastasis, add a little massage and hands on stuff and then guess what....most Diastases will heal! It's just not rocket science.
Convince your clients to back away from the Bootcamp or any activity that makes her tummy pooch or makes her pee and we are heading in the right direction. Your Exercise progression need to flow from, supine to standing to prone! Supine and standing are safest, prone (on all 4's) will mean that the abdominal contents is pushing against the weakness.
And last but actually first, a deep appreciation of the relevant Myofascial Lines associated with the Rectus and the front of the body HAS to be part of the problem solving kit-bag......
Here are two 'exercises' that are NOT suitable for Diastasis Healing and great alternatives and WHY....
NO CRUNCHES, they're isolationist and not integrated and they build pressure against the weakened abdominal wall and Pelvic Floor. Try the exercise below.........
Pole Extensions (Start and Finish) With The Breath
How To Do It!
- Lie as shown in the first picture with a neutral spine and and the pole directly above your shoulders (you should be able to balance a ruler across the two bones at the front of your hips if you are in 'neutral').
- Say the word ‘SET’ quite strongly and feel what happens to your core. There should be an increase in tension. Keep this tension but continue to breathe normally.
- Take the pole back as shown in the second photo until you can feel your abdominals and pelvic floor activating. Stop the second you feel you are coming out of neutral pelvis - remember keep the tension caused by saying the word ‘SET’.
- Then, EXHALE STRONGLY to return the pole to the start position. Aim for 3 sets of 8 reps.
- We're reconnecting the abdominal connective tissues (muscles, tendons, fascia) with the Pelvic Floor and the breath - INTEGRATED FUNCTIONAL.
And NO PLANKING with a poochy tummy (the abdominal contents pushing against the weakness) .....a really re-connected PRONE VACUUM is just so much more appropriate and healing....
Prone Vacuum With Breath
How To Do It!
- Lie as shown with your arms as your pillow and TOES POINTED.
- Exhale for a count of 8 and notice what happens…..you should feel your tummy coming away from the floor, just let it happen naturally. And towards the very end of the breath, you should feel your Pelvic Floor and your low back tensioning and lifting.
- Congratulations, you have just reconnected with your entire core !
- Perform 2-3 sets of 8 reps.
- Although still working against gravity (albeit greatly reduced), we've made the reconnection much more mindful and emphasized that it's not just about pulling the belly button in, it's about getting the TVA to speak to the Pelvic Floor as it did before facilitated by the breath.
Huge thanks to FooFooFunClub Ambassador Kelly Bassett - a new mom herself with a wonderfully healed Diastasis - Kelly works in Brighton and you can find her at: www.fitnotthin.com