The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
Diastasis recti a life long condition? Postpartum backpain is common but it ain't right.
One of the most heard statements people post online, and that I get asked about a lot, is; Diastasis Recti is a lifelong condition that you will always need to manage.
So in this episode I talk about why this is clearly ridiculous.
Also; Postpartum backpain is very common but that doesn't mean it's inevitable or can't be resolved. So that's what we're talking about for the other half of the podcast.
and, very briefly, why I don't think the type of diet you choose for weightloss matters that much and why I don't find it interesting. What works for you works for you.
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Playing us out today; "Deh Vieni Non Tardar" By Messages and Portaits
Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert, peter Lap. That, as always, will be me. Today we're kind of going back to basics Diastasis recti is it really a lifelong condition, as people tell you? And postpartum back pain why it's very common but it ain't right, and a little bit about why I don't do weight loss stuff. So, without further ado, here we go. Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert, peter Lapp. That, as always, would be me. This is the podcast for the 12th of January 2025. And now I'll actually speak into the microphone and your sound quality should massively improve, as if by magic. Um, that usually happens when I stop being a jackass. I hope you're well. I hope your 2025 is going, uh, all right if you're in la, I hope you're safe. Um, you know, I feel for you, I feel for what's happening over there, um, but we are going to talk about the basic stuff.
Peter:A lot of stuff online this week about, uh, diastasis, um, and a lot of comments that I've and that I've come across that were sent to me, about people that say a diastasis recti is a lifelong condition, that you'll always have to manage, and all that type of stuff. So that's where we'll start, because I want to be very clear about this. No, it isn't. We need to. We need to stop this, this, this myth that that it is something that you'll always need to manage, right? All women who are pregnant, uh, who have given birth by the, whether B, through C section or vaginal birth, will have A diastasis at that stage when they give birth. For a lot of them, it goes away after about six to eight weeks as in the gap closes. I'm just talking about purely the gap here, not yet talking about muscle functionality and all that. We'll get into that in a little while.
Peter:But when people talk about, oh, the gap will always be there, you always need to manage it. That is usually what they're talking about when they say diastasis is a lifelong condition, we know for 80%. I've linked to this study a billion times, so I'm probably not going to do it again in the podcast description, but it's all over the website, all over previous things. The paper in the English Journal of Sports Science that clearly shows 80% of all pregnancy-related diastasis cases resolve themselves within a year, whether that is through exercise or not. This study doesn't really show. It just said of the people they had a look at, 80% didn't have it anymore and the other 20% were predominantly people who were not exercising, who were not doing a rehab-style program. That is why I always say you know, you're better off doing the rehab style program and we'll bring that number way down.
Peter:But if 80% of cases don't have diastasis recti anymore after a year, what makes you think this is a lifelong condition? It makes no sense. It makes no sense. The gap, right. So? And if you do accept that 80% number, then you accept that the gap is back to within normal levels. That is what diastasis being healed actually means, right, the gap being back to within normal levels technically. And again we'll get to muscle functionality in a bit, because this is my big bug bear, which most of you will know, but still Right. So if you accept that 80% of cases of women, the gap goes back to within normal range.
Peter:So, where it kind of was prenatal, and what are you talking about? This is a lifelong condition? It can't be. All you could then possibly be talking about is muscle weakness, right? Then you say, oh, the muscles are still weak a year later. Yeah, okay, that I accept that can be significantly higher. But you know what the solution to muscle weakness is. I know I sound like a jackass when I talk like this, but really it is so simple sometimes that it baffles me that a myth like this still exists. The solution to muscle weakness is strengthening the muscle. I know, mind blown right, it sounds too obvious. Almost Strengthening the muscle resolves muscle weakness. It is. I mean, it should go without saying. And if muscle weakness, if you've strengthened the muscle, the muscle weakness, is no longer a problem, so why would diastasis then be a lifelong condition? The gap is within range, the muscles are back to normal.
Peter:So where is this lifelong condition coming from? Or something that you'll need to manage for the rest of your life? It's clearly nonsense. And just let that sit there for a bit. It is clearly nonsense. It cannot be factually accurate. Now, if you want to talk about the fascia sheet that stretches during pregnancy, along the linea alba, there's a little sheet that stretches as well and that can take a long time to go back to normal and sometimes it doesn't. But that is not a medical condition that you need to be aware of and that is genuinely not an issue for most people, right? That is not something that you need to worry about at all. The gap is within range, your muscles are working fine, everything else is hunky-dory. We're not talking.
Peter:And then, if you're then saying, oh, but I have stretch marks and all that type of stuff, which is also something I heard stretch marks and loose skin and all that sort of stuff let me be very clear have nothing to do with diastasis, absolutely nothing. Now, the reason they sometimes get thrown in there is because a lot of, um, a lot of people that go in for diastasis surgery also get excess skin removed and all that type of stuff. But that doesn't mean that the the thing is linked. It's just one of those. Well, whilst you're having your tummy tuck because that's essentially what diastasis surgery is whilst you're having your tummy tuck because that's essentially what diastasis surgery is whilst you're having your tummy tuck done, you might as well do the rest of the work as well, right? That doesn't mean that the rest of the work is linked too. So there is no lifelong condition to be worried about.
Peter:And if you have, as one of my clients says, if you no longer have diastasis to use the English phrase have instead of has if you no longer have diastasis, then you can still have loose skin and you can still get that removed if you're that way inclined right. I have one client who you can still get that removed as, if you're that way inclined right, and I have one client who's currently undergoing for that and they call it the mummy makeover, and I hate the term, but yeah, you know it is. This is what the doctors call it, because that's what people google, I suppose. Um, but basically that's just loose skin removal in, in her case, three kids later. Right, there's only so much you can do and you can't exercise skin away, right? This is something that is important to remember that there isn't a single postpartum program out there that says you can get rid of loose skin in that way. At least there shouldn't be. I know some people promise you the world, but it makes no sense to say that. So you know, please stop with this whole. It's a lifelong condition that you need to manage forever. You need to manage your core strength forever, but everybody should be doing that.
Peter:The brown belly that some people get, especially that some women get. So say, you have a child at 25 and then you do everything, right, you exercise, and you get a flat stomach, or, relatively speaking, flat stomach, you go back to normal range and all that type of stuff. The gap is no longer there. Your core is strong. If you then get a rounder belly again by 40, it's likely just muscle weakness, in the same way that it is for guys.
Peter:Women do not get a round belly by the time they're 40, 50, for different reasons and it's usually just sedentary lifestyle, not exercising enough. And I'm not saying there's anything wrong with a round belly, by the way. Right, and let's be honest, guys have it a lot more than women do. I see a lot more guys walking around with big round bellies, the bare belly look, than I do women, than I do women. But the reasons are the same. Assuming you did everything after your children were born, right, it's sedentary lifestyle, the core not particularly strong, you don't particularly exercise enough, you eat food, eat foods that blow, you carry a bit extra weight and blah, blah, blah. Right, and there's no judgment in that. I'm just saying that the reasons are the same.
Peter:That is not your diastasis returning, that is not your mummy belly returning, your mum thumb as, yeah, right, the term alone grosses me out. It's a horrible term, right, it's a mum thumb. It's nonsense. It's not a permanent medical condition. So let's move away from that please. There is no need whatsoever To be scared about diastasis and the lifelong impact that you will have, unless you're in a very, very small minority where people have severe, severe diastasis that can only be resolved through surgery.
Peter:And even then it can be resolved through surgery and you don't need to worry about it for the rest of your life. Because I've seen some, some people after surgery and man, they can do some amazing work on that. Stuff Now not available on the NHS for the vast majority of people, and it shouldn't be because exercise can heal it in my opinion. But, as in my opinion, it shouldn't be available on the NHS for the vast majority of people. But if you have the five grand to go private that's roughly how much it is in the UK oh man, they do wonders. I've seen some amazing work. You still need to exercise afterwards. So I always say start with exercise first anyway, but it's not a lifelong condition that you need to worry about. That was 10 minutes of me telling you not to worry about it, so don't worry about it, just move on to the next and move on, we shall.
Peter:The same goes for postpartum back pain. I get a lot of emails talking about postpartum back pain, what causes it and all that sort of stuff, and I've done podcasts about this before, I've done episodes and blogs and all that type of stuff. But now, what caused my postpartum back pain is one of those. How long is a piece of string questions, as in this, is so highly individualized that it gets very difficult for me to diagnose anyone. So what I'm about to say next does not go for you specifically, it just goes generally speaking.
Peter:For a lot of people, right During pregnancy, your center of gravity shifts. Your core, as we just spoke about a little bit, you know core gets a bit weaker because you know we need room for the baby. Everything stretches out a little bit. Your center of gravity shifts, your alignment shifts a little bit. Uh, your center of gravity shifts, your alignment shifts a little bit and for a lot of women this leads to what I call disappearing bum syndrome and you get that pregnancy waddle and all that type of stuff.
Peter:Now, if you don't, um, if you then postpartum, if you then postpartum and you start to experience some back pain, a lot of women get this during pregnancy already. It's, it's quite often it's it's the lower back is is being overworked or it's for want of a better phrase it's kind of being squished and it just doesn't like that anymore. Other muscles are not doing what they used to be doing and the lower back is just not getting the support anymore. Add on to that that when you postpartum, a lot of women have a buggy and you press that uphill and and downhill at least in in scotland, everything is uphill, right, um, and you carry loads of stuff and if the right muscles aren't helping out, the back is is taking a lot of the strain and that's where a lot of back pain comes from.
Peter:Now I've spoke about prams before and buggies, right and hand position and all that sort of stuff. I'm still trying to come up with like a universal solution that I can market. But your shoulder blades moving out of position as you're pooping, as you're pushing a buggy up a hill or something like that or something heavy up a hill, or you're carrying stuff and travel systems and all that type of stuff that is also responsible for your back taking more of the strain, because everything you're kind of it's like sitting behind a desk right that shoulder is out of position, you're pushing up and the lower back has taken a lot of strain. There's no core activation whatsoever and all that sort of stuff in that position and therefore the core isn't helping out at all. And by core I mean the front part of the core and you know, breastfeeding, all that type of stuff really weighs on it Quite often. Everybody knows that when you make food, you pop your baby on your hip and all that type of stuff and that again creates a bit of weakness here or there, and there's nothing wrong with that. Just to make it very clear, you don't need to stop putting your toddler or your baby on your hip as you're preparing stuff, as you're walking through the house. That's not what I'm saying at all.
Peter:The job is for the exercise specialist you're working with, for the personal trainer or the physio, whatever, whoever you're working with, to sort solutions out around your life, not to tell you to change your life. When there are things in there that that can't be changed, it's up to them to work with it, right, but that is those things do lead to. They can all lead to some sort of muscle weakness, muscle overcompensation even, and the lower back hurting at the end of the day. Right, that is completely normal, or at least it's very common that that happens. That doesn't mean it's right, but it can be fixed. It's the same as any urinary problems and indeed diastasis. It can be fixed through exercise. Urinary problems not necessarily, but I just did an interview with Dr Nigel Bayer and we did an interview about urinary incontinence. It'll be next week or the week after that that that comes out and that's why that's in my head. But other than that, you know, it's a muscular. Postpartum back pain tends to be a muscular problem, right, and therefore that can be fixed Again by strengthening up the bits that need to be strengthened up and relaxing the bits that need to be relaxed.
Peter:This is postpartum recovery, and a lot of people are selling this as a big secret and a lot of people are saying, oh, big secret. And a lot of people are saying, oh, this is, you know, this is very special. It really isn't. It's not rocket science, it really isn't. It's just not that complicated. I wish it was. You know when, when, when I was in uni, my, my, I went to I, and when I was in uni, I studied international economic relations. That's what my PhD is in and, trust me, that is significantly more complicated than postpartum recovery is. It's just not that big a deal. You kind of have to know what you're doing, sure, but fundamentally, the fundamentals are very, very straightforward. You still need to work with a specialist, right, it is still rehab type stuff, but it is not. Let's not pretend that this stuff is rocket science.
Peter:Postpartum back pain is usually caused by the same things, and all that is required is strengthen the areas up that are weak so that the lower back doesn't need to do too much stuff. And that is fundamentally where, where lower back pain, postpartum lower back pain, comes in glutes, core and shoulders, being out of position a lot, there you go. So, again, that can be fixed. It's great news, right. This is all positive stuff when things are. Things like diastasis recti can be healed through exercise. Postpartum back pain can be healed through exercise, and, again, for both of them, in 99% of cases.
Peter:I will stipulate that I don't want to get emails from people saying but I have a degenerative disc condition and blah, blah, blah, I get it. That is a completely different beast and you have another condition. But the basic I am healthy, I had a baby and now I'm weak and I'm sore. Oh man, that is bread and butter stuff. That is as I always say with regards to my clients, that I see face to face. And again, I don't do online training, so I'm not selling anything here. But with the clients I see that that is the yo sushi approach. I'm not sure everybody knows what yo sushi is. Basically it's one of those really crappy sushi places that, as food comes past on a conveyor belt, you grab what you want and then on to the next. That is what is conveyor belts sort of uh sort of PT Right, see someone for three months. On to the next. Go have a great life, go do whatever you want. No more back pain, diastasis, completely healed If not, or at least on the way to being completely healed. The rest will happen automatically if you keep exercising that type of thing and on to the next.
Peter:I have never come across anyone who, with the right exercise that had postpartum back pain for a tremendous amount of time and that is people with that could be includes people with three, four, five children, people that have twins, that still have toddlers to take care of. Really, you have to have a really pretty messed up pregnancy and birth for postpartum back pain to still be an issue after working with a specialist work or at least working with someone who knows what they're doing for for a few months this is not a year long. I don't work with anyone. I haven't worked with anyone postpartum for for years and years and years um to still heal their postpartum issues. I worked with some people for a very long time, but that's just because those people want to train with me and I like these people and you know why not stick around, so to speak. Right, it is always nice to have a very solid base of clients and then fit new clients in and about those regulars, but they're with me for general fitness. They don't come to me because they still have postpartum issues. That was dealt with ages ago and that's how postpartum training kind of should work. Those part of missions can be resolved and then you move on to the next.
Peter:And the moving on to the next bit is the bit that answers why I don't do weight loss stuff or don't do diet stuff. First of all, weight loss isn't my, isn't what I do. I just don't enjoy it. I've said this before. I um, but also I'm just not invested in in the in in in the diet thing. I don't think diet is particularly interesting for me, but I'm diet agnostic. I did an interview with Dr David Prologo a while ago 2021 or 2022, something like that and I know I've already brought that out of the vault, so I'm not doing this again. But if you look for it, you know to go to Buzzsprout or Apple and you type in Prologo, p-r-o-l-o-g-o, it'll come up, and it was a wonderful interview because he just says yeah, that's where I got the term diet agnostic from.
Peter:It doesn't matter what diet suits you best for weight management, at least the one that you can stick to. That's the one that you should be on Right. And of course, there are health implications, and I'm not saying anyone should be keto or anything. But I don't care If you come to me and you say, hey, pete, I want to do the keto diet for weight loss, okay. Or if you come to me and say, hey, pete, I want to do the keto diet for weight loss, okay. Or if you would say to me I want to do the high carb diet for weight loss, okay. It's just not interesting to me, so I don't tend to cover it a lot.
Peter:I'm much more focused on health and I am convinced, from a weight management perspective that people who predominantly eat whole foods predominantly being the key word there there, I'm not demonizing any foods predominantly eat whole foods. They tend the way tends to sort itself out because of the high fiber content and you make you make sure you also get some protein, enough protein in and all that type of stuff, and all of a sudden it's difficult to overeat on fiber and protein. It really is, because those are the things that make you feel full, right, so so I just I tend to not not comment too much on that. So when I get emails saying Pete, I'm now extra bound postpartum, I want to lose weight. What's the best diet for me? Yeah, I don't know.
Peter:Whatever one you can stick to, just make sure you get your vitamins in. Right, don't do any, don't cut anything out for too long. Want to go low carb? Go low carb. Really, it's completely fine. It's completely safe to do so. Wouldn't be my preferred way to do it, but you know you want to go Mediterranean. Okay, buy an Ottolenghi book. Okay, buy an Ottolenghi book. Right, go eat Indian food for a month. I've seen people do that. Go eat Indian food for a month. Amazing, home-cooked Indian food is phenomenal. Don't add too much ghee and all that type of stuff. And weight loss, yeah, will happen as well, because, again, you home cooking your food. It doesn't matter what your diet is. From that perspective, right, and for me, if you want a weight loss coach, then you go speak to a weight loss coach and they'll probably tell you something different.
Peter:It's just not that interesting to me and therefore I tend to not comment on what my clients say they want to do. I will say, because I've had one or two people comment that this week, that a two, three-day fast, four-day fast and all that stuff I'm not a big fan of, right, I think it's poor people cosplay, it really is. It makes me feel remarkably uncomfortable when people who can afford food say I'm just going to choose to not eat for four days because I'll feel so much better for it. Right, you don't meet poor people that say that, right, you can't afford food. Oh man, it's annoying. Someone says, yeah, I choose not to eat, right, but you know that is against personal preference. If you don't want to eat for four days and feel like crap for at least two of those days, then knock yourself out. Anyways, I'm starting to rant a little bit. I'm trying to avoid that, my 2025 habit.
Peter:Anyways, summarise Too long. Didn't read at the 25 minute mark diastasis recti, not a lifelong condition. Postpartum back pain is common but not normal and can be fixed. Right, that's fundamental. I could have done this whole podcast in two, in five seconds, but you know I need half an hour. So there we go. That should be done for the week next week. I'm trying to get. I'm probably going to move the day that the podcast comes out to a Monday, just to give myself some more time. I scheduled this all up in the air and all that type of stuff, and that Monday kind of suits me better. But I will have a look and a listen to see what people think and what the powers that be, so to speak, what they think. Anyways, that is me done for another week. Peter at healthy plus natal bodycom, or send us a text and, via the text, clink and all, click and all that sort of stuff. You take care of yourself. Here's a new bit of music. Bye now.
Speaker 2:ORGAN PLAYS O gioia bella Mediare amore Per caderta bella Finché Anzbund In ciel noturna Face, finché L'aria è ancora Bruna, choir SINGS, qui marmora e rouge. Qui scherza l'ora E con luce sussurro il coris. Laura, qui ridono I fiuleti, l'erba e fresca I laugh at the flowers. The grass is fresh. Oh, pleasure, love everything here is right, come my dear among these hidden plants, come come CHOIR SINGS, viva la rote in color, in color De rosa, I'm sorry.