Episode #08: All Things Diastasis Recti
Subscribe: Apple Podcasts Spotify Google Podcasts
In this episode, Dayna and Rhonda talk about all things diastasis recti…
What is it?
Can it be prevented?
Does the size of the gap matter?
Do I need to modify exercise during pregnancy to minimize strain on the abdomen?
What is coning/ doming?
What is a “healed” diastasis?
…Plus so much more!
-
Episode #08: All Things Diastasis Recti
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Hello everybody. Welcome to episode eight of the Pelvic Health and Fitness Podcast, where Rhonda and I are going to chat about all things diastasis recti. Woo. Yeah, yeah, Rhonda, why don't you start us off? What is a diastasis? Okay, so I find with diastasis, there's a lot about it online and there's a lot of fear surrounding it.
So just to start out with what it actually is. So in our abdomen and I'm going to do actions, but you guys can't see what I'm doing, but we have two sides of our abs. So if you think of like the six pack, so you have two sides of those abdomen muscles in between those muscles, we have a connective tissue layer called the linea Alba that kind of keeps the tension in those muscles.
So. When we're pregnant, it's natural that those muscles are going to expand and start to separate a little bit to make room for baby. So this happens in almost 100 percent of pregnancies, a very high number of pregnancies. And again, it's a very natural, normal process to happen. So after baby comes out in a certain percentage of the population, that gap after sort of like six to eight weeks of healing will naturally close and come together.
In some percent of the population that gap will remain so you end up having a little bit of a gap again between those two sides of the muscles that you might see it's often to see it with things like push ups or a sit up type movement where air can get pushed into that gap. So we can talk a little bit more about um, coning or doming that can happen between those sides of the muscles.
And again, just to remind you all, the biggest thing is don't be afraid of this gap. It's a very natural, normal thing and there are a lot of things that we can do to help heal it and also just get your focus off the fact that the gap remains. It's not as Um, big of a issue I guess, as maybe people were led to believe.
Anything to add to that? Yeah, for sure. I usually say mind the gap. Yeah. Like the, like the tube station, but don't obsess over the gap. Yes. Um, . Yeah, no, I like that you said it is absolutely normal. I find, and I don't know if you find this, I have a lot of clients that come to me that are coming either self-referral, Yes.
They're saying things like they want to prevent a diastasis or they have actually been referred by maybe another health professional. To try to prevent one or to treat it during pregnancy. And it really is just your body's way of creating real estate for that little baby. Yeah. So certainly there are things we can do to kind of minimize the strain through that tissue, that linea alba, that stretching, and also being aware of the
So, um, when we our body. So, we have our abdominal wall in the front, our back muscles in the back, pelvic floor on the bottom, and our diaphragm on top. So, I always just chat a lot about managing that pressure as a way to, um, limit the strain through that gap, and thus the pelvic floor as well. So, like, they're, they really are truly linked, but yes.
Do you get people that come trying to prevent it during pregnancy? Do you get that a lot? Um. Yeah, I do. And I, yeah, I guess they would come to me just worried that things that they're doing are going to cause it or make it worse. And that's the thing is I talked to them about, I always use the statement Brianna battles uses a lot, control the controllables and surrender to the rest.
So there might be certain things within our control, such as not putting an excessive amount of strain on those muscles that are already being strained from baby pushing out. So, you know, not doing things like sit ups through your pregnancy, being mindful of even just sitting up out of bed, trying to roll, those types of things, so that we're controlling the controllable of adding strain.
But then surrendering to the rest because every body is different and every body is going to respond to pregnancy and postpartum differently. So even if you do everything perfect, quote unquote perfect, you very well could still end up with a diastasis and a gap that remains postpartum. And that just is how your body heals.
Yeah, for sure. I think. Decreasing the fear is the biggest thing. It does, the, the diastasis does get a bit crucified out there. Um, so yes, I, during pregnancy, we're chatting a lot about how do we reduce that? You mentioned rolling to your side to get in and out of bed. Um, There are certain exercises like planks and things like that, where we're putting maybe a lot of extra strain, but it really is individual too.
Some people are very able to do certain exercises, maybe sit ups not so much. I mean, that's pretty, cause there is a level of, um, just because you can, should you, right? Right. We always want to kind of assess the tension through there. And like I said, that's more person to person, client to client. Yep. Um, But the gap will be there and we just want to make sure that we're managing pressure through that linea alba as best we can during pregnancy.
I'm going to chat about the breath here in a second. My biggest recommendation is usually using your breath for lifts and things like that. So that postpartum, that tissue can start to shrink back together and at least bring that gap a little bit closer together. Right. But I always like to tell people too, it's not going to be perfect.
No. If you're 38 weeks pregnant and you're reclined on the couch watching Netflix, and you go to sit up or you get up in that awkward 38 week pregnant body way that we do, you're probably going to see it. And it's okay. I don't want people when they see it. And what I mean by see it is we get this kind of coning or doming out in the midline of your tummy.
Particularly on a pregnant body, you're going to see that, like, between the rib cage to the belly button. So if you're listening to this and you've been like, Yeah, yeah, I get this very strange shape in my tummy. That's your diastasis. That is coning. That is doming. Um, we want to limit how much we see that.
Be aware of it, but not obsess about it. It doesn't have to be perfect to have good outcomes postpartum. Right. And I think that coning, doming, I always say to my clients, um, as with any symptom is just feedback. So I think the coning, doming is also, there's a lot of fear mongering about that. That as soon as someone sees that, Oh my goodness, I have to stop what I'm doing.
And I just did something terrible, which is not the case. You know, if you continue potentially to do that and it's a lot of pressure. You know, who knows, but it's information, you know, saying that perhaps a little bit too much pressure is getting pushed out into that area. And then it just is feedback for you to say, okay, maybe next time I'm going to be a bit more mindful to kind of roll and sit up, but also again, life happens.
And if you get up to go pee when you're pregnant in the middle of the night, don't then use that as a way to blame yourself for, oh my goodness, I must have caused my diastasis because that's just not true. No. That diastasis is it's. It's going to happen. It's there in a very high percentage of people.
Like it's like, it's very close to a hundred percent if it's not quite a hundred percent for sure. Yeah. Um, so what are some of the common adjustments or modifications with exercises that you'll make for your clients? during pregnancy who are either concerned about a diastasis or maybe you're just kind of roping it into their overall Exercise program some awareness there.
Yep. So similar to what you already mentioned I do go over the breath a lot in the first place and you know, not just for diastasis reasons But just for overall pelvic health um and just talking about the core canister and just learning that breath work to um Just feel that tensioning that that happens in the abdomen because I think I don't know if you agree It's still okay to like engage those muscles and you know work on that feeling of engaging your abdomen during pregnancy um, and then so we work on that to start and then I I am Um, I would say in the first trimester Not super picky with my clients.
I would say, you know, they're sometimes still doing planks and that type of thing. Um, I do monitor for if there's any, you know, if there's a gap happening and there's a bit of doming, we'll just sort of monitor that. But if everything looks good, in my opinion, first trimester, everything's a okay. Second trimester, we do start to limit.
So instead of doing a plank on the floor, usually I'll start to get them to do, um, on a bar, like on an incline. Position and yeah, pretty right from the get go. I say, you know, you can do a setup in the first trimester, but Do we need to, you know, it's again, the can I versus should I, so I find there's a lot of other ways to continue to engage the core muscles without necessarily doing that sit up motion.
Um, so yeah, second trimester we'll do incline movements. I still get clients doing overhead stuff, but sometimes I'll get them to do it in seated position instead of overhead, because I find, especially the more pregnant you get and the more the belly gets pulled forward, your center of gravity, the tendency to sort of like arch our back and like jutter rib cage out will continue to happen.
So then that. Again, control the controllable so that might put a little bit more added strain on the tummy Whereas I find if someone's doing a press seated that hyper extension of the back is less likely. So we'll do that. And then just sort of get, um, more, I guess, unique with what we do for core. So we'll do like side bridges.
I love, um, we'll continue working like glute strength. So like glute bridges, that kind of thing. And then doing like pal off presses. Um, I always call them like sneaky core exercises. So like a front squat, holding a dumbbell. you are engaging your core quite a lot. So you're still getting those muscles working, but in a way that's taking a bit of the strain that you would get with like a sit up or a plank.
Um, even things like kettlebell swings. Um, usually I'll just do like Russian style where you just come to eye level, all those exercises, engage the core. In a way that, again, is okay for pregnancy, but still keeps those muscles working. And then the third trimester, depending on client's comfort levels, some of them will just stop doing overhead.
Just again, with that, you know, control the controllables, take the strain off the abdomen. Um, If they want though, that's totally fine, they'll continue with overhead. And then, yeah, we just kind of get a bit more strict in terms of limiting some of those core type movements. Um, and yeah, just kind of monitor, I, I personally don't check for diastasis throughout pregnancy that often, unless a client says, do you mind checking?
And then we will, because again, my big thing is it's going to happen. So do we need to be obsessively checking all the time? I would say probably not, but if, if that's what they want to look for, then that's totally fine with me too. And we'll check it out. And then, yeah, just kind of keep that fine balance between still working those muscles, but not Not overdoing it and straining it and putting that added strain on an already taxed system.
Absolutely So some of the things that I often will tell clients to just watch for In the abdominal wall to if they are still continuing with those exercises. Those are all great exercises, right? We're again We're minding the gap, we're not obsessing over it. So we're giving you good strategies. You know, I, you said still engaging your core.
I do a lot of work with the transverse abdominis, which is our deepest layer. So underneath this six pack ab wall that we're talking about, that's separates, we get that stretch of the tendon in the middle, the transverse abdominus is kind of deep to that, and it really is best friends with the pelvic floor and can give a little bit of stability to that separation.
But also our transverse abdominus is helping during birth. Um, the uterus contracts, the abdominal wall will contract that pelvic floor. We want to relax. Um, more on that later, I suppose. But We want to keep some good integrity in that muscle, not only for support during, during pregnancy, um, to support that pelvis, the pelvic floor, this growing baby, uh, depending on what your load looks like, you know, do you have older children that you're lifting as well for your workouts, all of these important things, but then also to assist with that birth.
That's cool. So transverse abdominus helps with birth? It's, yeah, the abdominal wall will help contract with the uterus to push baby down into the birth canal. That's so cool. Yeah. So it just, it just changes, right? And I think we probably talk a lot about listening to your body. And I know you and I have had this conversation before.
I get a little maybe type A about what listening to your body means. What are you listening for? So some of the things I always tell people that would let them know is, you know, are you able to control that doming at all? If you're getting yourself into a position and you're thinking, okay, I'm, I'm doing this breath, you know, maybe you're picking up the blueberry or you're kind of thinking ribs to pelvis, whatever cue that you've kind of gone through with your health professional develop a little bit of tension because ultimately I think if you're working on a core exercise, we should be able to develop a little bit of tension in that system.
So if we're not even able to feel those muscles firing, we're probably going way beyond. Um, so are you able to do that? Does it minimize, does it change anything? So, you know, I often will have people do the head lift test. I, I will just point it out as a normal part of their anatomy. I'll be like, yeah, there's your diastasis and this is why it's okay.
And this is why it's actually beneficial. Making a nice home for baby. This is how we're going to protect that tissue. And I'll have them kind of like poke in there, see if what the difference is versus just kind of lifting your head and, and putting there's stumbling over my words, putting strain through the abdominal wall and then walking them through kind of a core contraction.
So think about doing an exhale, picking up that blueberry and now lift your head and seeing if they feel a difference. So now that kind of connects for them. I find that when we. And not that you have to breed this one specific way, but we can develop tension in that tendon when we do different strategies.
And now they've got an assessment tool for themselves as well. So they get into these different, let's say an elevated plank. They're like, Ooh, that feels, you know, maybe I see a lot of coning doming. I see it. You're not going to feel maybe as much squishiness as you go through later in your pregnancy.
But we use that postpartum to, you know, can I fully engage? Can I change something in my strategy here to maybe flatten that? doming out a little bit, especially if there's pain. If there's pain in the abdominal wall, um, I've actually had a few clients in the last couple of weeks that have had some pain right along where the rectus attaches into the linea alba.
Like it just, I had that too, actually on my left side, um, it just, it actually felt like ripping of muscle. It's not ripping, but it did feel like that. So certainly if you're having any pain or excessive pressure, um, in that upper abdominal area. Lower abdominals, I guess it doesn't really matter. You want to stop, but also paying attention to any pelvic floor symptoms that are coming up.
Are you feeling any heaviness? Are you feeling any pressure down into the floor? Any pain? Are you leaking? Because those are all just signs that we're not managing pressure through, through that canister. Right? Yeah, that makes sense. And I think that's the great thing too. about learning. I, I'm always impressed when people come to see me during pregnancy because the information that we talk about is just so beneficial for when they do, you know, go through the healing postpartum because they already kind of have an idea of what to feel for, what to look for.
Um, so when you see your clients postpartum, do you, do you assess for that diastasis right away at sort of that six to eight week mark? Or what does that look like for you? Yeah, I generally do. Um, I don't always necessarily, depending on the client, if they, if there's like specific questions about it, um, then I will just say, yeah, like you have this much to go.
I just really try hard to normalize what's happening in their body and minimize the fear. Right. Um, So I do. I mean, I think it's assessing that, uh, that abdominal wall when they come to see you is important. It's giving me an overall picture, very much a whole body. We're also looking at how your hips move and your back moves, right?
So yeah, let's check out the abdominal wall that just did a marathon. Yeah. Um. But I also will talk ad nauseum to the clients about what this means, like this is not going to look the same even in two weeks or up to a year. So what we see today isn't like better or worse or defining what your postpartum recovery is going to be.
It's just where you are right now. It's a snapshot in time and this is where we're going to work from. Yeah, and I think that I focus a lot with my conversations to early postpartum is again online, there's so many, you know, targeted sort of posts and ads for those early postpartum women to get rid of the mummy tummy because I think the mummy tummy is often tied to diastasis, right?
So, you know, the, the image of like a pooch, like a mummy pooch, right? Which I hate both of those terms because again, it's just a normal. Postpartum belly. Everybody has a different look when they have a baby and it's totally normal to look like you just had a baby. And so I talk a lot about similar to you that especially those early postpartum phases, your body still needs to go through tremendous healing, right?
So the look of it, yes, it can be frustrating. And especially if you're used to your belly looking a certain way. And again, I don't dismiss those concerns with my clients because aesthetics is. That's part of it, right? But just give yourself grace and just realize that your, your, the look of your tummy is going to change so much and the function of your tummy is going to change so much.
And there's no quick fixes as much as we want there to be. There truly isn't. It's time. It's yes. You know, going to see a pelvic floor physio, gradually working on strengthening and utilizing those muscles again in a functional way. We'll all help. But time is the biggest factor, right? Just giving yourself time to heal, which is often hard to hear because we want to just bounce back like society tells us to, but it takes time.
Like, I would say probably up to a year or more postpartum, your belly, the look of your belly is going to keep changing. Oh gosh, yes, we have to, we have to change this conversation, we have to. I don't know where along the lines it became that we weren't supposed to look like we had a baby. Like unpopular opinion, like, you might always look like you had a baby.
Right, you did, you did this monumental task. So, again, not, Everybody has their struggles with their image afterwards, a hundred percent. That's a whole topic, I'm sure. Um, but yeah, I hate the bounce back. I hate that term so much too. I hate mommy tummy. Um, yeah, it just puts a lot of pressure. A lot of pressure on women.
Yeah, yeah, for sure. Do you wanna, yeah, sorry, go ahead. Yeah, what I was gonna say is I say all the time to clients when they come to my six week and they come for their six week assessment. I also hate , hate's a strong word, but I do, I hate the term six week clearance because we've set women up already for.
So much poor expectation about what their body should look like or be doing at six weeks. Six week clearance is not clearance for everything that was happening in that body prior to even having a thought of a baby. It is clearance to start adding load back onto the body and seeing what happens. Yeah.
And kind of gradually adding that back in. It takes a year essentially to grow a human. It can take a year to heal from growing said human. Yes. Yeah. I always say to clients instead of, cause we think of it as a green light, cause again, that's what's sold to us. And I just heard a story recently of a C section mom that went to the OB and basically said, you're good to go at eight weeks to do anything you want.
And I was like, interesting. Okay. But I would say instead of a green light, let's think of it as a yellow light, kind of a caution light, right. To ease back into things. Instead of just go, go back to everything you were doing. I think language matters here too. Yeah. Because let's give that health professional the benefit of the doubt.
Did they mean a 200 pound deadlift? Or did they mean truly like, hey, go get groceries? And that, and that's the thing. That's where things need to change, right? So yeah, you're right. We can't fault the doctors. We can't fault the midwives for that advice because they, yeah, you're right. They might just mean go back to living your life, right?
Yeah. But in the world we live in today, where women are increasingly more active. And maybe again, maybe that's not their role, maybe then I would love for their role to be, you know, I would highly suggest at this point, you see a pelvic floor physio. And I would add, you know, now that I'm focused on the return to exercise piece, a postpartum fitness coach.
Especially if you're an active person, right? I would love that to be standard of care for all women. Oh gosh, we can hope. It's coming. It's coming. Um, so when you do that assessment early postpartum, do you want to just talk about the size of the gap? Because again, I think a lot of people get focused on, again, they might see pictures online or hear things online where, you know, seeing like finger width or a centimetre distance.
And again, panic when they're like, Oh my goodness, I have this huge gap. I'm not normal. Do you want to just touch on that? Yes. So the size of the gap, in my opinion, doesn't matter. Um, when I'm assessing somebody at six weeks, like any other measurement I take in the body, I'm doing this with your hip flexion.
You just don't realize that it's happening. I'm assessing, are you kind of, are there, is it completely back together? Are we anywhere kind of on that spectrum to like three, four fingers at its widest spot? You know, across your belly button, keep in mind that's a natural hole in your abdominal wall. So it does tend to be the widest across there.
And then I'm reassessing that as benchmarks, as we go through a rehab process. So we're seeing, does that gap change? That's one measurement of it only though, the most important measurement I think is the tension. in the Linea Alba down the middle. So I have had, and I'll be honest, it's a tough sell. to clients certainly had two, three fingers that they managed tension so well that you would not know they had a gap unless you stuck your fingers in there.
So they've got really great tension. They can handle load. There's no doming. They get this beautiful, like when I assess them initially, when you kind of push in, it's usually quite squishy. So if you're six to eight weeks and you're poking in there and you're thinking, Oh gosh, that feels. pretty gooshy.
That's normal. That's normal. Um, what we want to see most importantly, as opposed to that closing, is if we can get our fingers in there, can we make that squishiness more firm? So it has more of a, like, um, what would I describe it as like a taut elastic. So it's got some good resistance or tension through there.
That's what we want to feel there. And it is entirely possible to still have a sizable gap that is functionally healed. It works well. It's not causing any strain on the abdominal wall down on the pelvic floor. Yeah. What are your thoughts? Yeah, no, I love that. And I think so, you know, someone might ask, well, how, how do I develop that tension or what, what do I do to get that tension?
And I think a lot of people again, then think it's like, Oh, I have to do sit ups or I have to do crunches. And I think that's where sometimes the misinformation comes that truly just through, you might probably find this too, like through that initial assessment, working on just. breathing and again, connecting the pelvic floor, the transverse abdominus, you know, it seems magical all of a sudden they're like, Oh, because a lot of it is just that brain to muscle connection because for nine, 10 months, well, I guess the, the belly isn't that big for that, for that full length, but especially the end of the pregnancy.
Those muscles, we can't really use them the way they should. And the lydia alba, same thing. It's, you know, not being used the way it normally is. So that connection is kind of lost, right? So when we start to learn and connect to the breath again, you can within one session without doing any strength training.
Get some tension back in those muscles and that's that's where the retraining I think begins right is just getting that connection back. Absolutely. And I this again coming back to what I was saying earlier, I love the way people's brains light up when you show that I'm a big believer in knowing your body so I'll have them feel it.
And often there's a lot of emotion tied to that. They don't really want to feel it in or they're like, kind of, you see them make these kind of like grimace y faces, like they're almost grossed out by it or upset by it. And I will have them do a simple Kegel breath, pick up that blueberry, exhale. Let's try it again.
It changes in most cases, almost immediately, even if only a little bit. So now I've showed you, your body's not broken. We just need to reconnect it, right? We just need to work at it. And then I think it is very important that the education, because I have a lot of people who come in, mainly my later postpartum moms, maybe they didn't need any help and they are coming in a little bit later, that are terrified.
Because they have a gap to load it and to do any abdominal exercises. But the only way to heal that diastasis, maybe we should talk about that a little bit more, but the only way to, to develop that tension is to In an appropriate way, load it. Yes. And yeah, so going further with that, so I think I, I've actually seen this too with certain clients that getting that brain body connection.
So typically I assess, you know, especially early postpartum in like lying on your back. So lying on your back similar to you do like a bit of a head lift, kind of feel what's going on. Um, and then, yeah, I try to engage that core. Sometimes that isn't, it's too easy for some people, right? So then their body almost like it doesn't need to engage.
So it just won't, right? So sometimes I'll get clients then, okay, let's try hands and knees. Yeah. So get them on hands and knees. So get like a little bit of core stability happening already. And then get them to try the breath and then try to get them to engage and build tension in that linea alba. And then they get it and then they're like, Oh, that's what it's supposed to feel like.
So sometimes I know Anthony Lowe talks about this a lot where instead of deloading someone because we think, Oh, they must not be able to know how to do it. No, they do. It's just not challenging enough. So give them something a little bit more challenging on the core. And then all of a sudden that brain body connection figures itself out because it just needed a little bit more challenge.
Yeah. And I sometimes too will take them one gentle step beyond what they're able to tolerate so that they can see what that feels like and looks like in their body too. Yep. Yeah. Yeah. And that goes back to the fear thing, right? Because like you said, so many women are terrified to do anything and it's just, A very obvious reminder that, yeah, you're not broken.
You can still try these things again. If we see doming or coning, it's not like you just all of a sudden did all this damage. Just feedback, right? And, um, I know even, we've talked about this before, when you see that doming or coning, there's a certain, so you can kind of feel what's happening there too, right?
So if... If that doming or coning is a little bit squishy, I know Anthony Lowe talks about this too, typically that is okay also. Like I think if it's, you know, a hard dome. That's an indication that, yes, there probably is a bit too much pressure getting pushed into that area. But if you see a bit of a bulge, like air has to go somewhere, but you can still kind of squish it and it's pretty pliable, like that might be okay as well.
And I think, on a personal note, that's where I'm sitting, so I'm two and a half years out from my second, and there are some things I do where I still don't, and that's just that. Yeah, yeah. I'm not worried about it, I don't have any symptoms, I, um, Like, there's just certain things, I'm trying to even think what it is.
Like, it's odd movements, like, you know, trying to wrestle my way into a sports bra or something like that. Like, even just something like that where you're kind of twisting, I sometimes will notice that I still dome kind of right underneath my ribcage. Interesting. And listen, guys, I'm a pelvic physio.
These things happen. It's normal. I think there's a little bit of a misconception that, you know, because I knew all this that I don't have a diastasis and my belly work functions perfectly. It does function well. I just still have a little bit of a diastasis and I'm okay with that because I'm not afraid of it.
Totally. So if someone came to you and said, you know, is my diastasis healed? Because I think again, there's like a lot of misconceptions about what, what constitutes a healed. Diasesis, what would you say to them? Um, it's a bit of a tricky conversation, to be honest. Because, I mean, I would obviously assess them, and go through all of these things.
And I would tell them that, you know, if they come in and they have all these things, they're developing tension, they're able to, depending on how long, you know, they're, whatever load we put on them, they handle that well. but they lift their head or I can get a couple fingers in or whatever position we still see some doming.
I would consider that healed. Okay. There are, there are some people who I have had where I can tell that that's not the answer that they want. Yeah. right? They want the flat tummy. And there's also, when we're talking about tummies and abdominals too, like, I think they're, it's important to realize that diastasis isn't always kind of that, uh, some, some of us get like almost like a creepy look to the skin.
Like if we've lost a little bit of elasticity in the skin. Yeah. Or, um, I have a lot of cesarean moms talk about like the shelf. Yeah. And they think that I've had a few people think like that's because of a diastasis. Okay. Um, so I think there's a bit of a conversation about, around. What is the diastasis and what, what does that look like kind of aesthetically or functionally?
And what are some changes maybe at a tissue level? Right. So I'm always trying to kind of suss out. Because it, I, you know, it can be upsetting to somebody who is having maybe some trouble accepting what their tummy looks like, to then have, Physio say, Oh, that's completely healed. So we're done here because it's, it's, uh, trying to bridge that gap between understanding of what the function and the muscles are able to do, and maybe what you're going through in terms of processing, what's the changes in your body aesthetic as well.
Yeah. And that's fine. Yeah. And I think that's the thing. It's it's, there's a bit of like two different conversations there, right? So like functionally from a physiotherapy point of view, and if, if that client came to you and said, You know, I want to make sure my diastasis is like functionally healed and I can do the things I want to do without any issues, then yes, it's healed.
Ruin everything. That's what they always say. I don't want to ruin anything. I don't want to ruin it. Yeah, right. So in that, in that sense. Right, right. And that sense it's healed. But yeah, so I think there's a whole other layer to this conversation that could be probably a whole other episode that a lot of women seek out treatment for the aesthetic changes that they're looking for.
Right? And that's just there's so much more involved with that, that is completely beyond just, you know, healing that gap. I think it's a part of the story. It is. Right. I think abdominal healing and the abdominal wall rehab and the aesthetic of the abdominal wall and the tummy, it's all tied together. For sure.
But It's not the same all the time. Yeah. It's not always the cause of the other. And I think that's where, um, you know, if we kind of go down from there, that, you know, there's people that I follow online. So Brianna Battles and Lisa Marie Ryan, they're very open about their Dysasis journey. They had quite significant gaps, did all the retraining, got to a very functional standpoint where they You know, Lisa was doing muscle up.
She's a CrossFit person and still was unhappy with the aesthetic look of her tummy. So abdominoplasty, right? And so not that that needs to be like the very first conversation we have with clients, but if that, you know, that's, you know, full spectrum of care that if you're still very unhappy with the aesthetic look, you've got to a point of trying.
everything. I say like exhaust all other options. And it's been, you know, I think both of them were two years postpartum. So it's, it's not that again, quick fix, two months postpartum, I'm going to go have surgery because I wouldn't advise that for anybody. But yeah, if it's got to that point and that is the route you want to go, then I think we need to normalize that as well.
Right. If, if that's the decision you want to make. Go for it. Absolutely. But then also seek out physiotherapy to help that abdominal wall heal from that surgery. Yes. Yes. Absolutely. I think, yeah, there's help. Yeah. If you are truly unhappy with how you look, there are professionals that can help you with that.
And that is also totally fine. Yeah. For sure. Yeah, for sure. Okay. Um, I have a last question for you. Yep. What do you say to clients who say things like, Oh, I'm not going to worry about repairing it right now. I'll just wait until I'm done having kids. Yeah. Fix it then. Yeah, we sort of talked about this on our previous episode in terms of like pelvic floor healing and I kind of go the same route that we talked about then I personally am biased and I think physiotherapy is a wonderful service, no matter when right so I would say it's it's never a loss in between kids to come and learn about your body.
Learn about that core connection, breathing, learn about what is developing tension. What does that feel like? Um, You know, we can go through a tremendous amount of healing in a certain amount of time with that guidance, right? So I think it's, you know, to me a no brainer to come get some physio, get some work, uh, you know, learn to develop tension in those muscles, do some rehab, do some strength building to then hopefully set you up for a good pregnancy and then help you with that postpartum recovery.
But we've said, I think you talked about this in the previous episode, client centered care, so truly if that person feels that way, and they want to just kind of wait and hold off, that's a okay too, and there's, it's never too late. So if they don't rehab their muscles in between pregnancies, it's not like they're gonna be too far gone after that point, right?
There's still so, so much we can do. Um, yeah, it's, it's never too late. I mean... I've probably said it already a bunch of times, but I, pregnancy and birth is an athletic event. It's the athletic event of a lifetime. If you were truly out doing some sort of like, the Olympics are on, so it's very forefront of my mind right now, but if you went out and ran your distance and you kind of pulled your hamstring or you had something that just felt off, you would definitely go, or maybe you just were at a meet and so you follow up with your healthcare team afterwards.
Pregnancy really should be no different. Your body's going through massive amounts of changes, um, just to make sure that you are set up well for a subsequent athletic event. In this case, a pregnancy, I really strongly recommend if you are able to seek that treatment out for yourself, just to ease any.
extra discomfort during pregnancy, maybe ease your birth a little bit, but you're right. Muscles can learn, we can retrain it afterwards. So you make the decision and we'll be there to help. Yep. I love it. And again, that's why we're so passionate to get this information out there because even me as a physio, I didn't know a lot about any of these topics, went through both of my pregnancies.
Not knowing a whole lot. And so I just want, you know, more information for women that they have options. They have options through pregnancy. They have options postpartum. They shouldn't just be left high and dry to figure things out on their own. No options. I'm all about the options. Totally. Awesome. Well, that was a good chat, Dayna.
Yes. Have a good night. You too.
