Diagnosing a diastasis and what you can do about it

In my last post we spoke about a commonly overlooked reason for a post pregnancy pooch that you cannot seem to lose no matter how much you exercise or diet. This separation of abdominal muscles causing the bulging appearance of the stomach is called diastasis recti. This post will cover how to check for a diastasis and some of the things you need to consider if you have this condition.

A test to determine a diastasis can be done by yourself at home or you can speak to your physiotherapist or gynecologist who will check for it.

Diastasis gaps are typically measured in finger width. So you could be diagnosed as having a diastasis which is 2 fingers wide or 4.5 fingers wide. I will not go into how to self-diagnose as there are many videos and tutorials available online. Here is one that explains it quite clearly: diagnosing a diastasis.

If you have a diastasis there are a few things that you need to know:

1. This does not mean you will never have a taut tummy ever again; you will probably just have to exercise with some modifications and avoid certain exercises altogether.
2. If people around you- your doctor or family and friends try to tell you that this is normal and just the way all women’s tummies look after a baby it is NOT true. A tummy with a wide gap (diastasis) looks distinctly different from just regular flab that accumulates around the tummy.
3. A tummy with a diastasis tends to dome or look like a bump when you either get up from a lying down position or any movement which cause you to jack knife or bend from the hip thigh joint.
4. The traditional Indian post-partum ritual of tying a saree around the tummy may have been dismissed by many as outdated and pointless (I am guilty of saying this as well) however there seems to be some merit in the practice. Providing support to the sagging tummy by splinting helps to provide some support to the weakened stomach muscles and restricts you from bearing down or creating intra-abdominal pressure. However it is important to note that along with splinting it is essential to start strengthening abdominal muscles, otherwise it is of no use and your tummy will continue to pooch out as soon as the splint is removed.
5. All women who have been pregnant have had some degree of muscle separation, for some the gaps reduces naturally, typically for first time mothers, women who have already been exercising prior to getting pregnant while for older moms, second pregnancies, multiples the diastasis may be wider and not heal naturally.
6. If your gap is less than 2 fingers wide this is considered normal after pregnancy and should heal by itself by doing diastasis safe exercises before moving on to regular exercise. If the gap is more than 2 fingers or more following “Tupler technique” will certainly be of help. This is a non-surgical technique developed by Julie Tupler (a registered nurse) which is considered to be the gold standard of diastasis healing throughout the world.
7. Doing exercises that involve jack knifing or rolling up (like when you get out of bed) or any exercises that cause your abdominals to stretch out like back extensions will worsen the conditions.
8. Pilates exercises can be modified to suit conditions like diastasis. More importantly the emphasis on using the pelvic floor muscles in Pilates exercises makes it very suitable for post-partum fitness. However it has to be said that not all Pilates exercises are suitable for people with a diastasis. It therefore becomes very important to find an instructor who understands post-partum anatomy and can guide you through exercises that are safe and suitable.

Whether you are a new mom or someone with an older child it is not too late to try and heal your diastasis. Finding the right instructor who can work with you and who understands the condition is important. Enjoy your baby and work your way back to a fit body slowly and safely!

Post Natal Fitness and Pilates

So you’ve survived the roller coaster that is pregnancy, welcomed your precious bundle of joy into the world and are slowly beginning to wonder when you are going get your body back into pre-pregnancy shape or any recognizable shape for that matter!

First off enjoy your baby and the time that you spend with him/her, these are important moments in both your life and your baby’s life that you will never get back.

In today’s world with all the bombardment of social media and celebrity pre and post baby three week “miracle” transformations from flab to fab it’s easy to start thinking that this is the norm and all new mothers will (and should) snap back into their old bodies in the blink of an eye. This is not so and it is not necessary either.

A few things that are important to remember as you attempt to ease back into a fitness routine:

1. You NEED to get a doctor’s OK to start exercising- your gynecologist is the right person to give you this advice. They have seen you through your pregnancy and will be able to advise you when it is the right time for YOU to start exercising. The text book 4-6 weeks doesn’t apply to everyone. Having said that, simple exercises like Kegels can be done almost immediately after delivery if you are up to it.
2. Each body and each pregnancy is different- what may have worked for your friend or for you in your first pregnancy may not work for you now.
3. Get enough sleep, in the first few years most mothers are sleep deprived and there are days when the last thing you want to do is exercise when you are running on 3 hours of sleep. Sleep is a crucial part of your body’s recovery process.
4. Proper nutrition is vital not just for you but for your baby especially if you are breastfeeding. You can lose up to 500 calories while breastfeeding! Simple home cooked meals that are nutrient rich and low on empty calories are important.  Especially in the Indian context where new moms are regularly faced with wanted and unwanted advice from well-meaning relatives on what foods will increase breast milk supply (This seems to be an obsession with all the older women in most families!). A lot of these home cures are heavy on sugar, fats and are basically desserts in disguise and will take you further away from your efforts to lose weight or stay healthy. It’s also very important to stay hydrated both from a breast feeding point of view and also to avoid constipation.
5. It is also important to understand that your body has undergone some major changes in the last 9 months. Your ligaments (the scaffolding that holds your joints in place) have loosened up to enable the baby to pass through your pelvis. Going straight into high intensity exercise may not be advisable initially as you are likely to injure yourself.
6. Start slowly, listen to your body and know when to stop or alter your exercise intensity.

Pilates is a great choice for new mothers for many reasons

1. Its focus on developing core strength is exactly what you need after pregnancy.
2. It restores a more neutral alignment in your spine
3. It is rehabilitative especially if you have conditions like diastasis recti
4. It’s a great way to reconnect with your own body, many times a difficult labor and delivery leaves women with both physical and mental trauma that leaves them feeling that they are not in control of their own body.
5. Pilates exercises strengthen the pelvic floor muscles which are stretched and weakened during pregnancy and child birth. A weak pelvic floor leaves many women with urinary or fecal incontinence and sometimes more seriously a pelvic organ prolapse.

In the next post we will go into more details on how to engage your pelvic floor muscles, what exactly is a diastasis recti and how to exercise safely without worsening the condition.

The more important thing is to remember that your exercise routine post pregnancy should be something you look forward to and enjoy, something  that doesn’t exhaust you to the point you are unable to rise up to the challenging demands of motherhood!