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 The traditional Indian post-partum ritual of tying a saree around the tummy may have been dismissed by many as outdated and pointless (I am guilty of saying this as well) however there seems to be some merit in the practice.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!

What is the difference between Yoga and Pilates?

Many people ask if Yoga and Pilates are similar so I’m going to go through the similarities and differences in this post.

Yoga is more mind-body-spirit
I am not going to do a Yoga Vs. Pilates write-up because honestly that really irritates me when I see fitness professionals dissing forms of exercise that they don’t believe in. If millions of people are following any form of exercise over many years clearly there must be some benefit right??

So here goes; both Yoga and Pilates focus on breathing and a mind-body connection. Pilates exercises were originally derived from different forms of physical arts such a gymnastics , martial arts and yoga. (which is why some of the exercises in Pilates look similar to Yoga poses).

Both offer benefits such as better posture, better sleep, increased flexibility, better balance, stress release.

Yoga is much older, originating in India and was developed thousands of years ago. Pilates was developed around the early 20th century by a German named Joseph Pilates.

Yoga emphasizes a mind-body and spirit connection whereas Pilates focuses on just the mind and body aspect. To put it another way I would say that yoga is all about how you feel and Pilates more about how you look. Not to say that you don’t feel good after a Pilates class 🙂 it is just not meant or expected to be a be spiritual experience.

Diaphragmatic breathing
While both forms focus on breathing in and out at specific points in the exercise, the way you breath in Yoga and Pilates differs. Yoga focuses on breathing into the stomach (diaphragmatic breathing) and Pilates into the side and back of your rib cage (posterio-lateral breathing). Also in Pilates you breathe in through the nose normally but breathe out through pursed lip (like blowing out a candle).

Yoga involves getting into and then holding the asana (static postures) before transitioning into the next pose. Pilates is a series of fluid movements all done using the core muscles in the trunk of the body to stabilize the body through any movement. It aims at creating “dynamic stability”.

Yoga is all about channeling energy through the body through different poses or asanas in order to keep the body supple and flexible. All Pilates exercises are focused on building core strength, long lean muscles and stabilizing the body and bringing it into a neutral alignment .

Larger Pilates equipment-Reformer
Yoga is done using our own body weight as resistance and done on the floor. Pilates has exercises that can be done on the floor but also a wide variety that is done on large equipment like the reformer, Cadillac, chair, ladder barrel etc.

Yoga is more than just an exercise; it is a holistic approach to fitness, hygiene, lifestyle and nutrition. Pilates is more about physical conditioning and developing core strength, and is increasingly being used in rehabilitation and physical therapy.

Pilates focuses on the body’s neutral alignment
I’m sure there are more differences between the two. However increasingly the line between the two is also blurring where people want to combine the benefits of the two forms resulting in ‘Yogalates’. Individually too both Yoga and Pilates are evolving. From classical yoga to Ashtanga Yoga, Hatha Yoga and more recently Bikram Yoga etc. From classical Pilates to more contemporary approaches such as STOTT , Fletcher and Winsor Pilates.

Finally the way I see it, some form of exercise is better than none! If you are confused sign up for one and then the other do it for a few months and then see if you like both or just one and pursue it.

Disclaimer : I am not claiming to be an expert on either, these are just my observations through my limited experiences!

How does Pilates help with back pain

Many people who have back pain and practice Pilates benefit greatly from it. So what makes Pilates so effective in alleviating back pain?

Pilates exercises target basic structural imbalances in the body that are generally the reason for back pain. Lack of core engagement, pelvic instability, muscular imbalances, poor posture, and lack of body awareness all effect the back; this is exactly what Pilates helps improve.

Deep Core muscles of the trunk
The muscles that support the trunk (abdominals, back, hips and pelvis) are called core muscles. Lack of core muscle strength can be equated with a tree that has a hollow trunk and is trying to support heavy branches! Together the core muscles provide support and stability for the spine. As part of developing core strength Pilates teaches how and when to activate and release muscles.

Pilates focuses on deep muscles like the Pelvic floor muscles (think kegels), transversus abdominus (a built in corset!), deep muscles in the shoulder, and psoas (used when you bend at the hip); while these are not muscles of the back they are important because the prevent undue pressure on the spinal column especially in movement.

Improving posture is essential to a pain free back (other than the fact that you will look taller and slimmer!). Posture is how your body parts are aligned with each other. The ideal points to check for alignment are ankles, knees, hips, shoulders and ears. While standing in one place and keeping good alignment is not not too difficult, the challenge is to maintain good posture as you move around through the day at work or at home. This is what Pilates exercises teach you…maintaining alignment and stability as you move or ‘dynamic stability’ (I just love that phrase!!) .

A man in front of his PC with his cervical spine hyperextended

A simple example is when people do ab crunches I have often heard of complaints that the neck hurts more than the abs! This is because typically the position of the cervical spine (the back of the neck) is not correct and as you lift the shoulders to curl up its the neck that’s doing all the work rather than the abs. Pilates will teach you how to align your neck in this movement so that the abs are targeted instead of the neck.

Pilates increases flexibility. A healthy spine should be able to bend forward, backwards, bend from side to side and twist. The deep supporting muscles once strengthened protect and work along with the spine to allow us not only to increase the range of motion but appreciate the subtle movements that the spine is capable of.

Pilates increases body awareness. What I find the most exciting is that from the first session onwards people walk out with better body awareness. Pilates teaches us to look at our body differently and pay more attention to how we carry ourselves through life. Something as simple as pulling the ears away from the shoulder can diffuse tremendous tension that builds up around the neck and shoulder causing aches pains in the back of the neck and head.

Finally to quote Joseph Pilates “The art of *contrology proves that the only real guide to your true age lies not in years or how you THINK you feel but as you ACTUALLY are as infallibly indicated by the degree of natural and normal flexibility enjoyed by your spine throughout life.”

*Pilates was originally called Contrology.

The man was truly ahead of his time…