The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
How will you know when your diastasis recti is healed?
I had a wonderful email from someone in Mexico asking me the, seemingly straightforward, "When will I know my diastasis is healed?" so in this episode I spend 30 minutes answering that very question.
The issue with this question is that diastasis recti has a specific definition (one that isn't wide enough, in my opinion) and therefore quite often women get told that their diastasis is "healed" when it actually really isn't.
And you can also have the situation where the diastasis (the gap) isn't actually much of an issue anymore but, technically, you still have it.
So today I'm clearing it all up, whether you're an athlete or not. Whether you're into hill walking or a pro-tennis player..all will be clear :)
As always; HPNB still only has 5 billing cycles.
So this means that you not only get 3 months FREE access, no obligation!
BUT, if you decide you want to do the rest of the program, after only 5 months of paying $10/£8 a month you now get FREE LIFE TIME ACCESS! That's $50 max spend, in case you were wondering.
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And, of course, you can always find us on our YouTube channel if you like your podcast in video form :)
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Email peter@healthypostnatalbody.com if you have any questions, comments or want to suggest a guest/topic
Playing us out today; "Same goes" by Moses Kidd
Hey, welcome to the h LV Postnatal Buddy Podcast with your postnatal expert, peter Lamp. That, as always, will be me Today. It's just little me again answering an email with one of the best questions that I often forget to answer. But I get asked regularly and I've not covered it on the podcast yet how will I know when my diastasis recti has healed and I am recovered? It is a phenomenal question, trickier than you think it is. So, without further ado, here we go. Hey, welcome to the Healthy Postnatal Body Podcast for the 1st of December 2024. Christmas around the corner, everything is good, it's a year has gone past again, and et cetera, et cetera, et cetera. Thanks very much for listening, peter at healthypostnatalbodycom. By the way, I'll try to remember to throw the email address out earlier. You can text as well, of course. We've had three weeks of interviews, so it's about time to answer some emails and this episode. Basically, there's one email I'm going to answer Over the next couple of weeks. By the way, what do you have coming up? Just a quick, so it gives you something to look forward to.
Peter:I have two episodes coming up about supplements. Um, and by supplements I am talking uh, let me list them all that I'm covering NAD, NAD+, nmn. You might've seen loads of. I'm covering them because you might've seen loads of Instagram ads for them. Creatine protein, folate oh yes, folate folic acid, vitamins and iron. And just to see you know, I've had some questions about this stuff and just to see you know I've had some questions about this stuff. I see a lot of discussions about these things on the internet and a lot of ads, and I know how effective some of these ads are, so it's always a good idea to go over what is actually what with regards to these supplements. Do they work, do they not work and all that type of stuff. Are you wasting your money? That's kind of it's going to be a couple of shows, but there are so many weird supplements. Are there also something called Jude? It's basically a pumpkin supplement, pumpkin seed supplement, and we're talking about that, but there's so much stuff in there that that's going to take up two half hours, especially because nobody listens to a full hour of someone yakking about supplements. So we're making it two half hours so that it's nice and manageable.
Peter:Today, however, I'm answering what would seem like a basic question, but it's actually a really, really good one. I had an email in, and you know, as I am prone to do every now and again, again, peter at healthypostnighbodycom. If you have any questions, comments, or you would like to suggest a guest, or you would like to be a guest, just send me an email, right? It's much easier than using any of the podcast matching services that are out there. Just send me an email, right. Apologies, I had to clear my throat right, so let me bring up the email. Here we go. Hola, pedro, that is me. I am Pedro Greetings from Mexico. My name is. I never read out personal information on the podcast, right, and I've been listening to the podcast and doing the program.
Peter:My question is when will I know when my diastasis is healed? And this is such a good question and this is something that I actually regularly forget to cover, to be honest, which is why I love it Cool. So, very quickly, the answer kind of is it depends what you class as diastasis. So let me clarify that a little bit. Medically speaking, the definition of diastasis recta is a gap wider than two and a half centimeter, a gap along the linear alba, that line in the middle of your stomach. Wider than two and a half centimeters, 25 mil, technically. Anything below. That is no longer diastasis recti, but and this is the big so technically your doctor might well say, well, you don't have it anymore, so you're healed, which is, of course, not actually actively true. Technically it may well be, but it's not actually practically correct, right? Because it doesn't necessarily mean because some people, some women, bounce back air quotes after a few weeks and they no, no longer have a gap that's wider than two and a half milt. It doesn't mean that everything is working properly, right, which is why I always talk about how muscle functionality is a huge part of diastasis recta, whether stuff is working when it should be working. For any videos listening who always flip out when you talk about muscle functionality Some of them do not. All of them Well-functioning muscles Does the muscle do what it's supposed to do when it's supposed to do it?
Peter:Now, this then brings us to what some people call functional diastasis. It's a term I don't particularly like. I've gone into this before. I think it should be part of the whole debate that you know, technically, if your muscles are all doing what they're supposed to be doing, but the gap is wider than 25 mil, that's technically classed as functional diastasis. Like I said, I'm not a huge fan because I think it should be incorporated into the definition of diastasis itself, rather than saying, ah, but if everything is working but you still have a gap, there's functional diastasis. If it's uh, not working and you have a gap, uh, wider than 25 mil, then it's non-functional. And if it's not working but the gap is lower, then you don't have diastasis. You should. Your stuff just isn't working. I almost swore there, right, your, your muscles just aren't working properly. Now it's it's, it's part of the same problem. So in my opinion, we need to, we need to put that all in the same bracket.
Peter:Now, as I've spoken about many times, right, the reason most postpartum programs, especially those focusing on diastasis recti, diastasis recti is the reason that most of them are 12 weeks is a couple of reasons. One is you can stick to a 12-week program, but also because we can actually get quite a few good results in 12 weeks, especially if it's, say, your first child, the muscle functionality is pretty good and the gap isn't too big, say three centimetres, something like that. Within 12 weeks you can pretty much bring that back to normal and all that type of stuff. And it's nice because that is a nice way to rack up. Rack up successes, right, and on most online programs really really like successes, because that way you get your before and after pictures. Now a little caveat, right? Most of the time the gap, at least, goes kind of back to within normal range by itself anyways, right, 80% of cases within the first year go back to normal. I think it's like 50% or something like that after 12 weeks, or 60%, something like that. So chances are that would have gone back to normal anyways, which is why I don't do before and after pictures. I don't find them particularly useful. But within that first 12 week period you can actually get some tremendous result, which is one of the reasons we like to make it a 12 week program. Like I said, we also like it that you can stick to a 12 week program, whereas when I tell you that the HPMB program runs for like 9 months, I give you the 12 weeks free, or 13 weeks. Actually, if you play your cards right, so to speak, you get 13 weeks free, which actually takes you into the fourth month. So you get four months worth of programming and advice and all that free when you sign up. But because I think that first 12 weeks and there's, that initial stage of recovery should be free for everybody. I don't think we should pay 100 or 200 or even 500 pounds for that 12-week stage. That is the essential stage right Now. Without that stage, chances are you're going to run into issues a year down the line Because, like I said, 80% of diastasis might heal within the year.
Peter:But that only looks at the gap right. That doesn't include muscle functionality because that's not actually been measured. As far as I know, there isn't a study out there. I know someone was working on on one with regards to, I think, a Norwegian PhD student I can't remember what her name is, sarah something and she was working on something a few years ago, basically the effectiveness of certain exercises, on the status of director. I don't think she was doing, I think she was just covering group exercise and crunches and all that type of stuff and I can't remember her name, which is annoying. And I will try to get that for like the next couple of weeks and when I do a blog about this I will put it in there with a little link. Okay, but nobody tests muscle functionality. So that 80%, which comes from the British Journal of Sports Science, I believe, I will link to the article in the podcast description because I don't have it in front of me right now, but I know the 80% is right.
Peter:That only looks at the gap and it doesn't look at muscle functionality. So what we are looking for, of course, when people ask me, when will I know when it is healed, what they're talking about is usually when can I do the things I always want to do? I always wanted to do the, the the like. When can I live life in a way that I don't need to be concerned about a weak core or a weak tummy, or there'll be in a gap there and it's feeling uncomfortable, right? When will it be strong enough again? It's really difficult to put a time frame on that, so I tend not to right. Like I said, the HPNV program goes much further than just a three month, much further than just a three month. But the way you know when it is healed is basically when everything feels okay again. And this sounds so annoying because that is a very personal thing.
Peter:So I say a couple of things that I think people women should be able to do postpartum. So the gap should be less than 25 mil, or 25 mil or less. Let me put it that way Now, obviously, on our YouTube channel, there's a video of me showing you how to measure diastasis recti without just using your fingers. Right, we need a tape measure for that, otherwise how will you know whether it's 25 mil or not? Right, 25 millimeters or not? You can't say it needs to be two and a half centimeters and then say that is two fingers, because I have big man fingers and you might have teenyy-tinesy elven fingers, like you might be bjork and, and you might have teensy-tinesy bjork fingers and your, your three fingers will be 25 mil, whereas my two fingers will be 25 mil. So you have to use a tape measure for now. So it needs to be within normal range. Now, normal range, again, 25 mil. But for you, if normal is is is two centimeters or less, then in an ideal world you'll be there. Right, the depth of the gap.
Peter:We talk about this a lot because we don't have the width of the gap for diastasis recta, but also the depth of it. You need to feel some resistance when you put the finger in and you squeeze it together. You also need not just the fingers grabbing your finger, like your baby grabs your finger, but there also needs to be some pushback. Now, a lot of that can be tricky because for a lot of women that can be tricky, especially after child two or three, because even though everything is close together and functioning well enough, they that fascia sheet right which is along the lineal bud, so that line that runs from um, from your sternum, straight down along the line of your belly button and all that sort of stuff, to your pelvic floor, to your pelvic bone, to your pubis right, that straight line, so basically in between your breasts, down your belly button to your vagina, that straight line. That's where we're looking.
Peter:It can happen that that fascia sheet, which is not a muscle, got stretched so much during pregnancy that that either takes a long time to heal or it doesn't quite go back. When I say healing, I mean go back to where it used to be, or it either takes a long time or it just kind of doesn't happen, even though the gap is small and you feel enough pushback when you put your finger in and you activate the, you squeeze your muscles or you lift your head and all that type of stuff. Again, look at the measuring diastasis recti video for that. I will link to it in the podcast description and you might have full muscle functionality. But that way you can still look.
Peter:I've had clients that are like athletes, that if they exert a tremendous amount of pressure, as in they hold their breath during a motion motion that middle line still pops out a little bit because that sheet hasn't really recovered and that that sheet gap is quite deep. You don't really see it unless you start poking your fingers in. That gap can still be there, but that's's more a sheet issue, fascia issue, rather than a muscular problem. Right and other than aesthetically it's not really an issue. But you can also have a completely flat stomach and the muscles aren't doing what they're supposed to be doing. So you want to make sure that the gap is within range. That doesn't mean a flat stomach, by the way, right, that just means the gap is within range. Most people don't have a flat stomach anyways. But most people don't have a flat stomach, prenatal, to be honest, and I'm not talking about fat, I'm just talking about the shape of the belly and bloating and all that type of stuff. So it feels within, within normal range, within that 25 mil, and the muscles are doing what they're supposed to be doing in a way that makes you feel that what you are doing is actually comfortable and you're in control of it. That is predominantly what you're looking for.
Peter:Are you in control to do all the things you need to do, and you kind of should be able to do? So certain things you should be able to do, in my humble opinion. You should be able to pick your child up from the ground. You should be able to hold your child up a little bit. You should be able to play with your child. You should be able to run For a little while. I'm not talking about 10K or 15K. I'm talking about you should be able to run for the bus without stuff feeling like it's weak. You should be able to lift the weight above your head. How heavy that is doesn't matter. It depends on shoulder strength, but I mean you should feel like your core is supporting you as you do that. Note how. I don't say you should be able to hold a plank for a minute, Right, that is a completely different fitness goal. I'm talking about life goals when you can do all those things.
Peter:If you like Thai boxing, you should be able to go to the gym train. Do your training sessions. Go to the gym train. Do your training sessions and feel like you're in control of the movements you are doing, that doesn't mean that your core is super strong at that stage. I'm not telling you that your core needs to be super strong. I'm telling you that it is healed when you feel like you're in control of stuff. So if, for instance, compare it to tennis players, which is something I'm fairly familiar with A tennis player should be able to run, to turn and to hit a ball whilst feeling like they're in control of their core and everything is working properly and all that type of stuff. That doesn't mean they should be able to compete at Roland Garros, right. That doesn't mean they should be at that level. They should not necessarily be ready for Wimbledon. That is more strength and conditioning, right, you can. But if you've, if you're at that at that ground stage where you feel like you're able to do the basic things that you need to do to function in life, then everything else is strength and conditioning. Your diastasis is healed and you can just move on to your strength and conditioning coach. Who can, who can get you through the next.
Peter:If you like, um, if you like hill walking and all that type of stuff, hill walking is one of those exercises, that one of those forms of exercise that is actually can be really quite intense on the core, and anybody who's given birth will be able to tell you this. Because if you need to take big steps every now and again and and push yourself up off like a step up, almost like the step up exercise think of it like climbing two, two sets of stairs in, in, in, in a row, right, that big step up if you exhale your way through it, some some people are, some women, especially postum women are just not able to do that at a basic level and because they'll have leakage or their core simply they'll lose balance and all that type of stuff. Be able to do at least some of that without feeling weak, feeling like your bladder is going to explode, you're like you'll wet yourself, feeling like you'll lose balance every single time, and all that type of stuff you should. That doesn't mean you should be able to climb Ben Nevis, but you should be able to do the basics and then you can work your way up to Ben Nevis. That is the hill walking equivalent of, say, that tennis player. Right, if you like to go to the gym, you should be able to. This is why the Healthy Postnatal Body Program is full of squats and lunges and all that type of stuff. Those are things that you should be able to do. You should be able to get up off the ground without having any issues, not necessarily a hundred times. That then becomes a fitness thing, but from a purely a is my diastasis okay. If you feel in control during those motions, then your diastasis recti is healed insofar that you can then really focus on strengthening everything up, going about your merry way, and the rehab part of it is done. Right, that is the physio element of that. Is is kind of done then, and then that's when you move on to strength and conditioning. Obviously, like I said before, that is part of the healthy body program, right.
Peter:But for other programs that say stop and that 12 week stage, that is where they should kind of get you that 12 to 16 week stage. After 12 to 16 weeks you should be able to do most of the things you need to do in daily life whilst you're feeling like you're in control of what your core is doing. And in a lot of cases, depending on how wide the gap was when it started and all that sort of stuff. That gap would then essentially also be within normal range. And again, normal is for you. But of course that is assuming you have a decent starting point.
Peter:If you come, say, 10 years postpartum, after three kids or something like that, and you have diastasis rectum which is about five centimeters apart and your muscle functionality is quite poor and all that sort of thing and you can't do some of these basic things that you want to be able to do, then that recovery process takes a lot longer than that. 12 weeks. Right, it's slowly, slowly catching monkey, but you should. When you feel in control and the gap is within range and you get a bit of pushback, when you put your finger in there, you get a bit of pushback. When you put your finger in there, you get a bit of pushback. So not just the grabbing, but you feel like you know things like your TVA are also activating properly and all that sort of stuff. And I've done episodes before on muscle isolation. We don't do much muscle isolation as part of a good diastasis program. Then that shouldn't be where the focus is right. It should all work, but you should be able to pick your child up, that sort of thing. That is then the stage where you feel, hey, my diastasis is healed and I can just do whatever I want to do and just build up my core strength a little bit more if I'm required, but fundamentally your diastasis isn't a problem anymore. That is really, that's where you want to be. When you feel like your diastasis isn't a problem anymore, that's when it's done, that's when it's healed, that's when it's fixed. And if you then decide that you want to do additional stuff, then you go do additional stuff.
Peter:As I've always said, diastasis recta is not, contrary to popular belief, a lifelong condition. I've seen the Facebook support group statements. I used to get them emailed to me an awful lot. Once diastasis is healed, it's healed. That doesn't mean you can't get a new one, but it's healed. It's healed in the same way that if you break a leg and the leg heals, then that leg is healed. It doesn't mean you can't if you jump off a building, that leg can't break again, but that would then be a new break, right, that would then be a new fracture.
Peter:And that is how we treat diastasis as well. It's once it's healed, it's healed, and then you go your merry way, and in an ideal way, in an ideal world, world. You always make sure you stay on top of you, never ask your core to do more than it can actually take, unless you have a second or third child or you have an injury or something like that. But right, you need to build that, the level of effort you can, the level of effort you ask from from from core. You need to build that up a little bit. But that is just a strength and conditioning thing.
Peter:Like I said, that is Roland Garros versus playing a match at the local tennis club, and that is pretty much done. That is when you know your diastasis is healed. So it's not I can compete at Roland Garros level. It is the hey, I can hit a ball and I feel okay sort of level. I can do that for I don't know five minutes, ten minutes, however long, and everything feels like it's within range and all that sort of stuff. Those two things have to go together before I would say that your diastasis is healed. I would not say that if it's within 25 mil, your diastasis is healed, because it just isn't.
Peter:The gap is within range, but the gap and I've said this before the gap is the least important part in my opinion about diastasis recti. The gap is the bit I care the least important part, in my opinion, about diastasis recti. The gap is the bit I care the least about. I always measure with my clients. Of course we do, but it's not the bit that I actually care about. I care about getting to the stage where everything works properly and then they can do all the things they want to do again. And that gap will, because this is a beauty right. Once all your muscles start working properly again, the gap will keep closing, even if you do bicep curls. Bicep curls obviously are not a direct core exercise but if you exhale properly through them you will and you engage your core properly through them, you will slowly but surely be helping heal your diastasis rectum and bringing that gap closer together. So that's why I always say the muscle functionality element is significantly more important to me than what the gap is. But that doesn't mean you still need to be working with me.
Peter:So, for instance, I've got a client who is postpartum second child. She started with me eight weeks postpartum C-section, eight weeks postpartum and we're currently in week 10 of two-stage. She had a holiday. She had a month's holiday in between. So say, with the home routine she's on, say we're in week eight or something like that. By the time we do another, we have another 10 sessions to go. Right, Like I said, holiday in between. So she bought 24 sessions. We have another 10 to go. She's on 14.
Peter:By the time that five week period and it'll be Christmas, so say six, seven week period is finished, she can go her merry way. Everything will be working the way it should. Stuff is almost within range already anyways. But even if it isn't what she then does going forward, assuming she kind of does the things that I teach her to do, that gap will heal anyway. By the time that lady is eight, nine months postpartum.
Peter:I'm saying, yeah, nine months postpartum, she won't have a, everything will be within range and she will already be able to do most of the things she needs to do. Just before that, when she stops working with me, then it's just a case of strengthening up and it'll close up and by the time she gets to that eight, nine-month stage, that's when her diastasis is healed. So I hope that helps. I hope that makes sense. First of all and that's a half hour, that's a half hour, and you know if it's just little me, I do like to stick to a half hour. Peter at HealthyPostNatalBodycom, if you have any questions or comments. Here's a new bit of music and I'll be back next week. Bye now.
Speaker 2:I'm gonna listen back to the radio, to the radio, biding my time to hear the tune that hits my soul. Finding the words was always the hardest part for me. A dispatch from the heart. You'd have to believe. Till then, if the same goes for you, it goes for me. We fell in love and wound up on our knees. Wound up on our knees. If the same goes for you, it goes for me. I don't know about you, darling, but I play for peace.
Speaker 2:Guitar solo. I'm gonna fall asleep to the radio, guitar solo. I'm gonna fall asleep to the radio. I'm hoping the moon and stars will be my chaperone, looking to find the answer in a dream. A memo from my heart. You have to believe. Till then, if the same goes for you, it goes for me. We fell in love and wound up on our knees. If the same goes for you, it goes for me. I don't know about you, darling, but I play for peace. For me, scratches on paper, love letters in the bin Words really don't matter. I'll prove my love in the end. Until then, if the same goes for you, it goes for me. We fell in love and wound up on our knees. If the same goes for you, it goes for me. I don't know about you, baby, but I play for key. And I don't know about you, darling, but I play for key.