The Serious Injury No One is Talking About: Diastasis Recti

by Nicole Nexon, MSPT

This post made possible by the generous support of Chunkabuns

 

____________________

Sometimes I feel like exercise has become a dirty word in the mommy sphere. I can understand that.

We get this message that we need to do everything – work, raise babies, maintain perfect households, create Pinterest worthy projects, not burn dinner… and erase any shred of evidence that our bodies have created life. Society settled on the idea that skinny = perfect and the backlash from that led to a movement of pride in our bodies. Which somehow turned in to “ real woman have curves “ and all kinds of craziness about skinny girls and curvy girls and…

It’s out of control.

And what has been missed in all of this is the truth of the matter – it’s not about skinny. It’s not about having curves or not having curves. It’s not about “mummy tummies” or thigh gap or muffin tops.

It’s about being healthy.

And not “healthy” in a way that has been co-opted by people meaning “stop eating junk food you fatty!” Healthy in way that allows people to live their lives in a manner they choose. Healthy in a way that allows you to lift babies and chase toddlers and carry laundry wherever you need to carry your laundry. Healthy in a way that makes you feel confident, that lets you sleep well and go about your life.

What happens when you’re injured…and you don’t even know it?

When I was pregnant with my second daughter, I began to feel a pretty distinct pain by my belly button. It was so specific that I was fairly certain I was developing an umbilical hernia. I brought it up with my midwife and was told it wasn’t a hernia. I was developing a diastasis recti – a split between the muscles and muscular tissue that runs down the center of the abdomen. The pressure inside from an expanding uterus/baby was just too much for the abdominal tissue to handle so the tissue and muscles were separating.

With my first pregnancy, I worked in an outpatient clinic that was less physically demanding. With this second pregnancy, my current position required a lot of physical lifting as a physical therapist in a subacute center for patients who were not sick enough for the hospital, not well enough to go home. I already had work restrictions due to the physical requirements of my job; working with those restrictions AND dealing with a developing case of Diastasis Recti made the restrictions even more difficult.

It was in this position that I recognized a growing group of people in need of support, awareness, and healing of Diastasis Recti: new moms.

Here were these women, trying to juggle new responsibilities, healing from the changes their bodies went through during pregnancy and subsequent post-partum recovery and there was little to no support or even awareness about the problems that Diastasis Recti presented.

Diastasis Recti can affect your body in some pretty drastic ways.

  • -Incontinence
  • -Irregular bowel movements,
  • -Lower back pain, spinal or hip injuries due to your abdominal muscle’s inability to support your body when you’re lifting or bending
  • -Pain during sexual intercourse
  • -Increased chance of sciatica or disc issues
  • -Increased chance of umbilical hernia
  • -Postural instability due to poor strength of the abdominal muscles

The effects are numerous.

Now it was MY body that was going to need to be supported.

My body that was going to need help carrying a car seat. A baby. My toddler. The laundry.

My body that was going to be more prone to injury- that would need me to completely rethink how I went about my day. I worked out through my pregnancy because I knew what was ahead of me. I knew my core was going to be compromised. I wanted to achieve a VBAC and I knew I would need endurance (among other things) to prevent a repeated OR experience. I went back to my books and read studies on exercise efficacy. I reviewed exercise programs for pregnant women, post partum women, and people who had just had abdominal or back surgery. I had a plan, and I HAD to be as physically strong as I could when I returned from maternity leave so I could perform my job effectively.

I ended up with a VBAC, a baby girl, and a three-finger diastasis.

*when I say “three-finger diastasis” I am describing how many fingers I can horizontally fit across the tissue separation. To find this, lay on the floor with knees bent and feet flat on the floor. Lift up your head slightly and contract your abdomen muscles gently. Find your belly button and make the “scout symbol” with your fingers…see how many you can fit in there. i.e. 1 finger, 3 fingers, etc. Check the same line down by your pelvis, and again up towards your ribs. Different points along your abdominal muscles may be different fingers of separation.

 


I feel blessed that my passion and my education allowed me to understand what my body needs to function well and heal from my condition. I am grateful for my colleagues and friends with whom I can discuss ideas or count on to help me with the hands-on techniques I can’t perform on myself. I know I am lucky to have access to the information that I have.

I want other women to have this valuable access to connections and resources that are out there for those recovering from Diastasis Recti.

I want women to know that sometimes “mummy tummy” can actually be caused by a medical condition.

I want women to know that the media are not medical professionals and there is a wide range of “normal” when it comes to our bodies.

I want other mothers to know that exercise and eating well are available to them.

I want women to know there are safe exercise routines that WON’T injure a body healing from Diastasis Recti. That recovering doesn’t need to be a series of scary, out-of-reach experiences. They don’t need to spend hours in the gym (Though you certainly can, if you enjoy it!).

Recovering means that you can take a walk, be it pushing a stroller or wearing a baby. You can do squats in your living room, jumping jacks, and eventually pushups and planks. (But until you’ve healed from your diastasis, it is best to do modified planks so that you don’t further separate your diastasis or have your abdominal muscles work against you or push on that separation while you’re healing!)

I feel sad when I hear people say “I can’t workout because…”

I feel sad because they are being taught that only the big efforts count.

That’s not true.

I work with people for whom sitting at the edge of their bed is enormous effort, and standing requires assistance of others. When you see the enormous joy on a person’s face brought by these small yet enormous victories, you begin to understand the true beauty of the movement our bodies are capable of. What may seem like a small victory may be an enormous triumph-a giant step towards hope and healing.

Misguided emphasis on skinny and perfect or the fear of never being _____ enough WILL STOP US in our tracks.

Enough.

You are enough.

It’s ok to start small.

It’s ok to fail.

It’s ok to not be perfect.

It’s ok to be YOU.

It’s not about meeting someone else’s standards.

It’s about taking care of yourself, teaching your family that our bodies are a great gift and we should treat them well. It’s about understanding that you are worthy of the time and energy it will take to begin, to HEAL, and to build healthy habits that facilitate that healing and well being.

Let’s get moving, because moving not only transforms your body, but it transforms your mind, no matter what size jeans you wear.

Some Exercises to Get You  Started:

Some Other Tips to Start Healing:

  • Sitting with the best possible posture: (Pull your belly button in towards your spine. Keep breathing while doing this. Pull your shoulder blades onto your back. Keep breathing!)
  • Kegels/pelvic floor exercises (contracting the pelvic floor muscles-the ones you use to stop your pee, if that makes sense!).
  • Standing on one foot while brushing your teeth while pulling your belly button in towards your spine.
  • Stretching before you get out of bed.
  • Taking a walk or parking further from the store.
  • You can climb your stairs.
  • Swim.
  • Dance.
  • Work out with a DVD program or take a class.
  • If pregnant, getting an abdominal/belly support band to help support your abdomen and relieve pain you may be experiencing.
  • If in post partum recovery, gently binding your belly to help pull the muscles together and support you in those first few weeks of initial birth recovery.

starting pt image

arms image

leg image

plank image

Where am I now? I’m down to a one finger split at my belly button. I am confidently back to work full time with no restrictions. I’m still doing pelvic floor exercises and modifying my workouts to protect and strengthen my abdominal muscles so I don’t re-injure or reinforce the Diastasis Recti. I’m teaching my daughters that exercise and eating well are ways to treat your body with respect, to give it what it needs so when you need your body to work for you, it will. I’m teaching them that strong is beautiful, that healthy allows you to follow your dreams, that food is a tool and a pleasure and size is just another physical trait that varies from person to person.

Final thought… can we all agree to stop using the words “mummy tummy” ? Please? Your tummy is awesome, mommy. Growing a human is beautiful. A body that shows the results of growing a human is also beautiful!

For more information on Diastasis Recti click here.

*You are strong, and Chunkabuns knows it. Check out their “Mom Strong” Tee-shirts (and matching “Strong Like Mommy” shirts for baby! ♥♥♥) and other clothing options for mom and baby at www.chunkabuns.com

 _____________________

nicole nexon image
Nicole Nexon is a mother of two, working full time as a physical therapist. Nicole has her master’s degree in Physical Therapy, and has been working for 9 years in both the inpatient and outpatient fields of physical therapy. She is a complete nerd when it comes to the human body and wants to encourage others to take the opportunity to treat their bodies well at whatever stage of life they are in. She is also a Beachbody coach and has found it to be a great platform to spread her mission of health and wellness. In her spare time, Nicole enjoys traveling and snowboarding. You can follow her at www.facebook.com/nicolerosenex )

Exploring The Potential Emotional Impact Of The Prenatal Ultrasound

This post made possible by the generous support of My Baby’s Heartbeat Bear
IMG_4531
This article originally published on mybabysheartbeatbear.com on January 2, 2016.

 

The day has come to say hello, to see the one who’s still so small.

A heartbeat will bring many tears, but still will come all the fears.

Will she grow strong and tall? Will we lose him… and my heart will fall?

Are there two or three? Will my birth choice be mine to make free?

My arms ache to hold you. My heart aches to know you.

Above all else though, I know you are mine.

I will love you in every way, no matter what the doctor will say.

Today is the day that I will see your face, tiny and real, you will move to a place

A place in my heart I had never found…

Until today’s ultrasound.

-E.MacDonald

Ultrasound

Ultrasound Day:

Seeing a heartbeat.

Seeing multiple heartbeats.

Not seeing a heartbeat at all.

Revealing a gender.

Fighting the urge to discover the gender.

Learning devastating news.

Counting ten fingers and toes.

There is no denying that a pregnancy ultrasound will change your life.  While most women may check it off as just another day of pregnancy, even seeing a healthy little baby swim around should spark a light of life-changing emotions. The miracle of life is one our society tends to shrug off and sometimes the effects can cause us to become unaware of how we truly feel towards seeing this tiny human being on a screen.

Technology is a wonderful (and scary) tool.  We learn so much in a matter of moments, whether it is a healthy or unhealthy pregnancy, if baby is growing well, whether vaginal labor will be a safe option, if the gender we dreamt of is what exists, and if everything is okay with the mother.  Primarily a diagnostic tool, the necessity of prenatal ultrasounds may be heavily debated but there is no doubt that as routine as they have become, the prenatal ultrasound is a significant moment in the lives of parents-to-be while providing information to care-givers to help the parents make informed decisions.  Along with this education comes the anxiety and fears before the truth is learned.  And what’s worse is that after this brief moment of time, the heart and mind will create a new laundry list of emotions based off of what was discovered during the ultrasound.

Let me state this: There is no right or wrong emotion to feel – Sadness to be pregnant, panic to be pregnant with multiples, triumph to have a healthy baby past a certain date, pride that you created this being, even confusion on whether to keep or adopt.  Emotions are a very personal thing, and you have a right to not feel guilty about any of them.

It is ok to let the tears fall.

A Healthy Pregnancy:  A healthy “typical” ultrasound will have you crying tears of joy; especially if you were terrified going into it.  It can also leave a woman experiencing an unplanned pregnancy in agony, as she will be filled with choices, fears, and guilt.

Multiples: Multiple heartbeats found on the screen may lead to disbelief, panic, excitement, and many many questions. Fear of placenta(s) and sac(s) and nutrients may dance through your mind endlessly.

An Unhealthy or High Risk Pregnancy:  Knowing you will be closely monitored may either be reassuring or cause further anxiety.  When the baby or mother is at risk, the emotional rollercoaster typically picks up quite a few more passengers. Bearing the weight of your own emotions, along with your family and friends will become all encompassing. Reaching out for support and having a safe sounding board to cry to will allow you the ability to have the healthiest version of this pregnancy possible.

A Miscarriage: Expecting to see a flicker of blinking light on the screen where there is none can be devastating.  It doesn’t matter if you are 9 weeks or 15 weeks when you see that the life you thought was growing has stopped. You are no less of a mother. It does not matter that others say, “The next one will stick” or “At least it ended this way instead of a sick baby.”  There was life within you.  Mourn in the ways you need to.

A Pending Loss:  To learn that your child will not survive the pregnancy will bring forth unexpected emotions – Joy that you will still have time to grow and love this baby, but so much heartache that you will never know him earth side.  There will be anger and fear, but hope that things will change. There will be days of normalcy, but so many of confusion and pain.

sono-300x206

A Genetic Marker or Cause for Concern:  Sheer panic may occur; heart-racing fears and a lifetime of scary images may cross your mind.  Stress will be unavoidable, but handling it well will be needed.  Further testing will be done, causing more emotions, more tears, and more prayers.

Gender Disappointment:  Gender disappointment is real. (Ask me how I know.) No one should make you feel guilty for your feelings of desire toward a certain gender. You know that you will love the baby that is growing, and that he was meant to be.  However, the heart will mourn the fact that you will not have ribbons and bows and tutus.  Taking the time to let go of those feelings will help you welcome the baby you are growing without resentment or sadness.

Placenta Complications:  A healthy baby.  A healthy mother. But a placenta that is covering the cervix or attached to the uterine wall improperly. This is a recipe for a mess of emotions.  Knowing everyone is absolutely healthy is reason enough to yell from the roof tops, but knowing there is absolutely nothing you can do to prevent a cesarean section from occurring will bring about lots of birth emotions and fears.

Fetal Positioning:  While at a normal 20 week ultrasound, there is no need for baby to be in birth position, if your midwife or doctor suspects an awkward position later in pregnancy, an ultrasound will be done to verify.  If you are planning a natural birth, this ultrasound may send you into panic mode.  There is always time, even during labor, for baby to turn correctly, but the fears will be real.  Letting go of stress will help the body relax, chiropractic care, specific exercises, and manual manipulation are all available to help.

No matter what you learn during your ultrasound, your pregnancy journey will be changed.  Sorting the emotions will be an ongoing (and hormonal) battle that can potentially affect your labor and delivery. Taking the time to accept your feelings and live through them will benefit your mind body and soul.  Try to handle your emotions by talking through them, living a healthy lifestyle, practicing a mind-centering exercise such as yoga, seeking acupuncture or chiropractic care, and finding support.  Your pregnancy and baby will be all the stronger if you can do this.

May your ultrasound be filled with many happy emotions, but be real with yourself.  Do not hide or feel ashamed with any emotion that comes rolling out.  Find support if you feel alone in your emotions.  Share your fears and sadness right alongside of the joy and excitement.  Let sorrows be known and heartache be felt for you will not truly experience the highest level of happiness until you have worked through all of your other emotions.

_____________________

me
Elizabeth is mom to four breathtakingly-beautiful children, and wife to one lucky man. She is a research writer, blogger, and a ghost writer of books.  As a natural-minded woman, Elizabeth takes pride in spreading factual information that may benefit other mothers and future generations.  She has spent the last seven years (and counting) growing babies in the womb and/or with breastmilk.  When she is not writing, she enjoys drinking wine, running, cooking, reading, homeschooling, and loving her family and friends.