Muscle for Life with Mike Matthews - The Definitive Guide to Diastasis Recti (Including How to Fix It)

Episode Date: November 28, 2022

Do you have or know someone who has diastasis recti? This is when the abdominal muscles separate, which causes abdominal pain, abdominal weakness, and visual abnormalities. It’s especially prevalent during the late stages of pregnancy and childbirth, and while this condition can resolve itself and often does, at least partially, there are things you can do to accelerate the process or complete the process if it has been a while and your abs have not gone back to normal, they have not fully closed. So in this podcast, you’re going to learn what diastasis recti is, how to check for it, and how to correct it. I'm also going to share some excellent exercises you can do to help fix it, as well as a six week training program, and more. Timestamps: (0:00) - Save up to 30% during our Black Friday Sale! https://buylegion.com/ (3:20) - What is diastasis recti? (4:59) - How do you know if you have diastasis recti? (7:19) - How can you fix diastasis recti? (8:48) - What are some things that help correct this? (13:18) - What are some breathing and pelvic floor exercises that help? (16:41) - How do you turn those exercises into a workout routine? (18:35) - What are some exercises that help with diastasis recti after child birth? (21:09) - Can diet help with recovery? Mentioned on the Show: Save up to 30% during our Black Friday Sale! Go to buylegion.com and use coupon code MUSCLE to save even more or get double reward points!

Hey there and welcome to Muscle for Life. I am Mike Matthews. Thank you for joining me today to learn about a problem that many women experience during the late stages of pregnancy and after they give birth. experts, but I'll just say recti. And this is a situation where the abdominal muscles separate, and that causes abdominal pain, abdominal weakness, visual abnormalities. And while this condition can resolve itself and often does resolve itself, at least partially, there are things you can do to accelerate the process or complete the process if it has been a while and your abs have not gone back to normal. They have not fully closed yet. And so that's what this podcast is going to be about. What this condition is, how to check for it, how to correct it.

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No matter how much forecasting we try to do, no matter how fancy our software is, there are always a handful of SKUs that just sell two or three times what we expect and run out of stock. So again, head over to buylegion.com, place your order, save up to 50% and have a happy holiday. All right. So what is diastasis recti? Well, it is the natural separation of the abdominal muscles during the late stages of pregnancy and childbirth. So it's a normal thing. It happens with all women. And in most cases, it does resolve on its own spontaneously in the weeks and months following delivery. But recovery times can vary widely. Research shows, for example, that around 60% of women still have some ab separation six weeks after childbirth and around 33% of women still

have some ab separation 12 months after. So what is happening here anatomically is the connective tissue that joins the two vertical columns of your ab muscles, the rectus abdominis muscles that stretches and it thins to make room for the baby that's growing. And so again, this is totally normal and expected when you are pregnant. And often after you deliver your baby, it will correct itself, but sometimes it doesn't correct itself or sometimes it corrects very slowly. And for some women, this is merely an aesthetic concern. They just don't like how it looks, but for others, it is a bigger problem. For others, they notice a lot less abdominal strength. They will have pain in their abdominal region, in their low back, in their pelvic

girdle. They will suffer from pelvic floor disorders. And so correcting separation can not only improve the ego, but also dramatically improve quality of life. Now, how do you know if you have diastasis recti? Well, doctors will diagnose it based on the width of the separation in your abs. So if the separation exceeds two centimeters at one or more points of that connective tissue called the linea alba, then they'll likely diagnose you as having diastasis recti. Now, studies show that separations typically measure between two and five centimeters wide, and they can vary in length from two centimeters to the entire length of your abs. But the separations most often occur around the belly

button. Sometimes it's above. In one study, 37% or so of cases were above the belly button. Sometimes it's below. In the same study, it was about 11% of cases were below the belly button, but most of them were right around the belly button. Now, fortunately, you don't have to go to a doctor to see if you have diastasis recti. You can do a simple test at home. So what you do is you lie down on your back on the floor and you place your feet six to 12 inches from your butt and you lift your shirt. Or if you're not wearing a shirt, then you don't need to do that. Make sure that your belly is uncovered and then raise your head off of the floor and support your head with your left hand. Don't pull your head up. Don't lift your shoulders

off of the floor. Don't crunch your torso. Using your abs, you want your abs to be relaxed. And then with your right hand, gently examine the areas above, around, and below your belly button, feeling for any gaps in your abs and the texture of the tissue down the midline of your belly. So using your fingertips, measure the length and the width of any gaps that you find. For example, if you can fit two fingertips horizontally in a gap, that's about two centimeters wide. As well as looking for gaps in your abs, you want to try to gauge the integrity of the tissue between your ab muscles. So under normal circumstances, the linea alba, that connective tissue in the middle, it should feel strong. But if it feels more like jelly, that's a

sign that you are not fully recovered yet. Okay, so that's what diastasis recti is. That's how you can self-diagnose it. Now, what about fixing it? Well, first, I should just comment that you should be able to resolve it at home if any gaps you find are five centimeters or less. So that'd be five finger widths horizontally placed or smaller. But if you have a gap that's larger than that, I would recommend seeing a doctor or a physical therapist who specializes in diastasis recti because you might need to do more than what I am sharing in this podcast. All right, so you've established you have diastasis recti and the gap in your abs is five centimeters wide or less. What can you do to help fix it? Well, the first thing is allow yourself time to recover before

you start doing intense exercise. I've heard from many women over the years who are desperate to get back into the gym and start working out and doing their normal kind of intense workout routine immediately after giving birth. And I understand that and admire the dedication, but it really is not a good idea. Most health professionals recommend taking up to six weeks to recover after vaginal deliveries and up to 10 weeks after a C-section. And that means no lifting weights, no doing intense cardio workouts. You really need to rest. But resting doesn't mean bedridden.

It doesn't mean you can't do anything, just no intense exercise. However, because we are talking about diastasis recti, the good news is you can start working on that right away. You can start correcting your posture. You can start improving how you move your body during everyday tasks, and you can start performing breathing exercises and pelvic floor and core strengthening exercises that can help close that gap faster. So let's talk about those things. Talk about correcting your posture and learning how to get up and lie down properly. So during the early postpartum period, so this is your first one to two weeks after giving birth, experts agree that it is very important to learn ways to improve everyday tasks that prevent you

from increasing intra-abdominal pressure. So that's pressure in your belly. And the most common ways to do that are adopting a relaxed, neutral posture and learning to get up and lie down without straining or crunching your abs. That's what you want to avoid right in the beginning. So as for posture, many women find that their posture naturally changes after they give birth. What they find is they tend to arch their back more than before, pushing their pelvis out in front of their chest and their knees, pushing their pelvis out in front of their chest and their knees, while others find that their lower back muscles overcompensate for their weaker abs, and that pushes their chest out and rotates the front of their pelvis toward the floor. And if you want to see how that looks,

if you're having a hard time picturing that in your head, head over to legionathletics.com, search for diastasis, D-I-A-S-T-A-S-I-S, and you'll find an article that this podcast is based on. And there are images in the article that will help you follow along with what I am going to be explaining, starting with the posture. Now, what should your posture look like? Well, there's no such thing as a perfect posture for everyone, but you want to go for a neutral posture. You want your shoulders, hips, and knees to be stacked on top of each other in a straight line. And that is going to help minimize the diastasis recti. And so then what you want to do is in a mirror, see what that looks

like, get into a proper posture so you know how it feels, and then just check it as you perform your day-to-day tasks. So you're brushing your teeth. Okay, check your posture, maintain that neutral spine, stack your shoulders and your hips and your knees. Don't hunch over. If you're carrying your baby, make a conscious effort to maintain that neutral posture, not jutting maybe your hips out to one side or the other. Now, I also mentioned getting up and lying down correctly, and this is important because you don't want to increase that intra-abdominal pressure. You don't want to strain your core muscles, your abdominal muscles, because that can worsen the separation in your abs. And so when you are lying down and need to get up, you want to bring your feet close to your butt,

maybe about 12 inches or so from your butt. So your knees are now up and engage your abs by pulling them toward your spine. So kind of bringing your abs down toward your butt. So your knees are now up and engage your abs by pulling them toward your spine. So kind of bringing your abs down toward your spine. And then you want to roll to your left side, placing your left arm flat on the floor with your palm downward, bring your right arm across your body, placing your right palm on the floor at about chest height, keeping those abs engaged, pulled downward toward your spine. You want to press through your right arm until you're sitting upright with your legs to your right. And then once you're up, use your arms to steady yourself. And again, to see what that

sequence looks like, just head over to legionathletics.com, search for diastasis, check out the article that this podcast is based on. Now to lie down, to go from a seated position to lying down, you want to do the same thing, but in reverse. You want to sit down with your legs to your left. You engage your abs, pulling them in toward your spine, place your right hand on the floor in front of your left shoulder. Take most of your weight on that arm, slowly bend your right elbow to lower yourself toward the floor. And then as you lower yourself, you want to slide your left arm between your right hand and your body until it's flat on the floor, palm down. And then once you're lying on your left side, you roll onto your back.

Okay, let's move on now to the next point, which is breathing and pelvic floor exercises. So to regain your pre-baby core strength, you are going to need to train all of the muscles that are deep within your core, including your transverse abdominis, which is the deepest layer of abdominal tissue, and your pelvic floor, which is the muscles between your tailbone and your pubic bone that support the bowel and bladder. Now, fortunately, most women can begin to train these muscles within a week or so of giving birth using very simple and not aggressive breathing and pelvic floor exercises like diaphragmatic breathing, which you can do by sitting upright and pressing your left palm against your chest and your right

palm against the top of your belly, just below your ribs, and then inhaling into your belly. So you feel it expand against your right hand, but not your left hand. Your left hand should remain still. And that just indicates that you're breathing deeply into your belly, not into your chest. And then once you have inhaled fully, you exhale while contracting your pelvic floor muscles. And a good cue for doing that is to imagine that you're peeing and then have to stop peeing. So those muscles that you would contract to stop peeing, pelvic floor muscles. Another good exercise is the TVA hold. And to do that, you sit upright, press your right palm against the top of your belly,

just below your ribs. You inhale into your belly so you feel it expand against your hand. And then once you have inhaled fully, you exhale while making a shh sound. And as you exhale, contract your pelvic floor muscles and draw your abs towards your spine. And once you have exhaled fully, you then hold that

position fully exhaled for five to 10 seconds. That would be one rep, so to speak. Kegels are next on the list. And those are just contractions of your pelvic floor muscles. Again, imagine you're peeing and you have to stop peeing the muscles you contract to stop peeing. The muscles you contract to stop peeing, pelvic floor muscles. So you sit upright and you inhale for about five seconds. And as you are inhaling, you contract those muscles and then you relax the muscles and exhale for about five seconds. That's one rep. And last on the list of these breathing exercises, these pelvic floor exercises, is the elevator. pelvic floor exercises is the elevator. Now, before you begin with this exercise, imagine the hardest you can possibly contract your pelvic floor muscles. So in the context of this exercise, we're going to call that your level three. So to do the elevator, you sit upright, you relax your

pelvic floor muscles and you inhale. And then once you have inhaled fully, you exhale slowly. So 10 seconds or so, 10 second exhale. And as you begin to exhale, you contract your pelvic floor muscles to a level one for about two to three seconds. So one on a scale of one to three with three being as hard as you possibly can. And then as you continue to exhale, you go to level two for two to three seconds, continue to exhale, and then go up to level three for the final few seconds of exhaling. And then once you have fully exhaled, you relax your pelvic floor. That would be one rep. Now, how do you take those exercises and turn them into little workouts and a workout routine? Well, let's talk about that. And before I do explain how to do that, I just want to say again

that most women should be able to do these things within the first week or so of giving birth. But if that doesn't work for you, if any of it feels uncomfortable, it's best to just allow yourself a little bit more recovery time. There should be no pain when you are doing these things or significant discomfort. And so as for the workout itself, you can do each of these in one workout. Every day, what you can do is 10 reps of diaphragmatic breathing with 10 to 20 seconds of rest in between those reps, followed by 10 to 20 reps of kegels, followed by 10 reps of TVA holds with 20 to 30 seconds rest between reps, followed by 10 reps of elevators with 20 to 30 seconds of rest in between reps. Okay, so it has been several weeks now. You have been recovering. You have been doing your breathing exercises, your pelvic floor exercises

every day. What else can you do? Well, multiple studies show that performing core and ab exercises can help to close the gaps in your abs. And while we are not quite sure what the absolute best exercises for diastasis recti are, we do know the most successful protocols emphasize exercises, train your transverse abdominis and avoid exercises that involve lifting heavy weights or plyometrics. So jumping. It's also worth noting that exercises that involve crunching are controversial, and I wouldn't recommend them, and so I'm not going to recommend them here on the podcast. So with that in mind, let's talk about some of the exercises that can help with diastasis recti and that you can start doing in the weeks following childbirth

once you've recovered enough to be able to do them without pain or discomfort. So the first exercise is a core brace. And instead of giving you instructions on all of these exercises, I'm just going to share the exercises with you. And if you want to learn how to do them, you can find instructions all over the internet. If you want my instructions in particular, again, just head over to legionathletics.com, search for diastasis, check out the article that this podcast is based on, and the exercises are listed. There are pictures and instructions. So we have core brace, So we have core brace, we have the pelvic floor tilt, the heel slide, heel taps, the dead bug, reverse plank, glute bridge, bird dog, alternating single leg lift, and the fire hydrant.

Okay, so now how do you take those exercises and turn them into effective workouts and an effective workout routine? Well, there are many different ways of doing it. And if you want to get six weeks of workouts all laid out for you, just again, head over to legionathletics.com, search diastasis and scroll down on the article toward the bottom of it and you'll see workouts that are based on the exercises I just shared with you as well as a six-week workout routine. But basically what you are going to be doing is continuing your breathing and your pelvic floor workout that I shared with you every single day. And then in addition to that, I recommend three to four ab workouts per week using the exercises that I shared with you. And best is completing your workouts in one go. But if you have to pause your training for any reason, you can just pick up where you left off. So if you only have time to do half of that day's ab workout in the morning and then the other half in the afternoon or the evening,

that's fine as well. And lastly, before you commit to these workouts and this workout routine, if you have any doubts about your body's ability to do these things, if you're not sure if you are ready to start exercising or if there's something that just doesn't feel right when you start to do it. Check with your doctor before you continue.

Now, what about your diet? Is there anything you can do there to help your body recover faster and help it repair the separation faster? Absolutely. There are two important things. One is the amount of protein you're eating because a high protein diet, of course, is better for building and repairing tissue than a low protein diet. And the process of fixing diastasis recti requires repairing abdominal muscles and tissues in your abdominal cavity. And so you want to make sure that you're eating enough protein. And that's going to be in the range of 100 to, let's say, 150 grams per day. 150 is maybe even a little bit high. 100 to 130 grams of protein per day is going to be plenty, regardless of your current body weight. Maybe you gained a fair amount of weight in your pregnancy. And if you were to follow the traditional high protein advice of one gram of protein per pound of body weight. Maybe you gained a fair amount of weight in your pregnancy. And if you were to follow the traditional high protein advice of one gram of protein per pound of body weight

per day, it would entail eating way more protein than you probably want to eat or need to eat. In which case you could think about your protein intake related to your ideal body weight, which would just be a healthy body composition rather than your current body weight. So if your ideal body weight, if your ideal body composition put you at, let's say 120 pounds or 130 pounds, or maybe 140 pounds, whatever it is, you could aim to eat one gram of protein per pound of ideal body weight per day. And that's a good tip, by the way, for anybody who is currently overweight or obese and trying to work out calories and macros and running up against this massive protein intake that

is supposedly necessary. Let's say a man weighs 300 pounds. Is he really supposed to eat 300 grams of protein per day? No, he does not need to eat that much protein. It probably wouldn't harm him, but it's not going to be enjoyable. It's only going to make dieting harder. So why bother? Instead, he could calculate a healthy body composition, which let's just say is around 15% body fat, anywhere between 10 and 15% body fat. And he could learn that maybe his body weight, if he were to achieve that body composition, let's say with some muscle, maybe he then would weigh around 200 pounds. And so he could eat 200 grams of protein per day, not 300. And so that's protein, making sure that you eat enough protein and calories matter too. You want to make sure that

you are not consistently in a calorie deficit, that you are not trying to starve yourself to lose that baby fat that you are still carrying because when you restrict your calories, you do lose fat, but you also impair your body's ability to repair tissues, to build new tissues. This is one of the reasons why experienced weightlifters in particular can't gain any muscle or strength to speak of when they are cutting, when they are restricting their calories for fat loss. And so then if you are trying to recover from the pregnancy as quickly as you can, you want to make sure that you are eating enough food, you're giving your body enough calories to do all of the things that it needs to do.

And so that just means eating maintenance calories. You don't have to maintain a slight surplus, but don't get aggressive with fat loss yet. You can do that, but give your body a month, two months to recover, work on the breathing and the pelvic floor and the ab exercises, work on fixing that diastasis recti, and then you can start a fat loss phase. Well, I hope you liked this episode. I hope you found it helpful. And if you can start a fat loss phase. Well, I hope you liked this episode. I hope you found it helpful. And if you did, subscribe to the show because it makes sure that you don't miss new episodes. And it also helps me because it increases the rankings of the show a little bit, which

of course then makes it a little bit more easily found by other people who may like it just as much as you. And if you didn't like something about this episode or about the show in general, or if you have ideas or suggestions or just feedback to share, shoot me an email, mike at muscleforlife.com, muscleforlife.com, and let me know what I could do better or just what your thoughts are about maybe what you'd like to see me do in the future. I read everything myself. I'm always looking for new ideas and constructive feedback. So thanks again for listening to this episode and I hope to hear from you soon.