A new client the other day when I asked her what might limit her PT potential :
Her: "Lack of motivation."
Me: "Could you explain that? After all, you are here and want to address your Diastasis and how you are feeling."
Her: "Well, I purchased an online DRA program and I thought that I was doing it properly, but I just was not seeing any changes, and I must not have been doing it right and often enough."
You know what we found in her initial evaluation and beginning of treatment at Embody?
1. She had had a C-section. Good healing, no pain. But no one had ever talked to her about getting the scar and tissues moving. I can think of no other MAJOR surgery where they wheel you back to your room, check on you, tell you not to lift (and then hand you your 8# plus baby!!!) and send you home without rehab or care to do what is essentially "mommy cross-fit"!! If you had knee or shoulder surgery, you would be referred to PT, AND if your surgeon was a specialist and wanted to see a great outcome, you would be referred to a PT who understands and works with that issue.
The abdominal muscles and tissues are multiple layers, and those layers must move to work optimally and efficiently. Not to mention good bladder and bowel function, and uterine and cervical mobility. Laboratory studies have shown decreased adhesions in subjects (OK...rats) that received mobilization of tissues early after abdominal surgery as compared to those who had the surgery but did not receive soft tissue work. We see the same in people. Occasionally, we see someone early days after C-section, but typically not until they are frustrated because their core strength is not returning or they don't like how their tummy looks. They have been told "Oh, you're fine. Just give it time" but they do not feel fine, and/or it's been months (or years!) and they want to feel and move better! And in some cases, they have abdominal and scar pain, or pain with intercourse, created by the scarring and lack of mobility. Never normal!
2. Because the layers of tissues could not glide and slide as needed, appropriate muscle contration could not occur. She had been attempting to do the exercises, however, the tissues and brain were not communicating efficiently. The msucles of the "core" (abdominals, pelvic floor, deep spine extensors, diaphragm, and up into the shoulder girdle and neck) must be able to work together in a coordinated fashion. If the tissues (including the fascial layers) can't move, pressure and tension will continue to be placed in the habitual area(s). After preganncy, the linea alba, which is the area that broadens during pregnancy and creates the DRA, needs appropriate tension and mobility for closure of the DRA. The deep muscles and tissues need to participate for Diastsis stability.
3. Just as in most clothing, "one size does not fit all." Online learning programs can be good for some, but not all. Not knowing how to contract muscles efficiently, how to retrain, what you are to feel, and not receiving cues or instructions that make sense to you can be super frustrating and de-moralizing. It can make you feel that you are not doing enough...when actually, your system is simply not responding to those instructions. As with learning a new skill, or learning to do an old skill a different way, retraining requires feedback and repetition.
The good news after this young mom's first visit? She walked out with knowledge and did not feel that she was not doing enough! She was able to stand and breathe in different ways and to lift without strain on her spine. Her scar had started moving differently, and she knew a few simple techniques that she could do with a one year old climbing on her, as well as a few abdominal exercises to begin (again, while her child was around...because her time is not always her own and waiting until the baby is in bed...and she is tired...is not a great time to exercise. We could see a difference in how her tummy looked, and that was important to her. The moral of this story?
1. A little bit of the the "right stuff" that is designed to meet your body and needs can go farther than a one size approach.
2. You don't need to spend hours working on retraining, unless you have the time and want to! In which case, let's do it!
3. The tissues MUST move to create proper tension and strength
4. Women are hard on themselves! It is not necessarily you....it is the program not being there for you!
5. We can create positive change at one month, one year, 11 years, and more. It's never too late to learn new ways to move and function!
If you have questions about your post-partum body, have had a C-section and would like to address it, or have other questions and wonder if Embody Physiotherapy had answers and solutions for you, sign up here to schedule a FREE 30 minute consultation, in person or by phone. We would love to speak with you and help you find ways to feel stronger and better.