The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
Back Pain and Diastasis: Too many people still don't see the connection!
This week I am returning to the age old subject of diastasis and backpain.
I saw a post on Threads this week from a VERY knowledgeable neurosurgeon that I follow, where she posted that she was surprised that after having had diastasis surgery her lower backpain was also gone.
And I just thought; "Well, if she doesn't know about this connection then I clearly haven't spoken about it enough".
So that's what we're doing.
Remember, everything..EVERYTHING, is connected and isolating small muscle groups does not work when you're dealing with postpartum recovery!
Just a reminder that 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.
Though I'm not terribly active on Instagram and Facebook you can follow us there. I am however active on Threads so find me there!
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 this week
Hey, welcome to the Healthy Postnatal Body Podcast. With your Postnatal expert, peter Lap, that, as always, would be me. This is an original, original episode. As I said last week, I'm moving stuff about and so, like you get a fresh new one once every two weeks and you get a repeat from the last five years that I've been doing this podcast or something like that, one that I think is relevant. The other week, this, my friends, is a fresh one and I'm afraid to say we're talking back pain and diastasis again After a post I saw online from a very, very, very well-respected lady that I follow, a healthcare professional who was surprised that her back pain was fixed after she had diastasis surgery.
Peter:So I think we need to have a little chat about this, right? Because apparently there are still quite a few myths going around. So, without further ado, here we go. Hey, welcome to the Alfie Postnator Buddy Podcast with little old me. This is the podcast for the 20th of April 2025. And today is a gloriously sunny day again, thank God. I have a cat on the bed next to a Teezy. They've never done that before, so I'm very, very happy with that. And you know, buddy and Lola are also in the house somewhere snoring and growling at the world. So if you hear anything in the background, that's probably what that is. I hope you're well. I hope you're absolutely crushing it this week and I know a lot of these subjects come up regularly. But we're doing back pain again Because I saw a post from a lady actually she's a neurosurgeon that I follow on thread and she's absolutely amazing and she had a post that said what surprising things did you find after surgery or after medical intervention or postpartum or whatever it was.
Peter:And she said she was surprised how her low grade back pain, which was always kind of there, had healed after needing diastasis recti surgery. So after getting surgery to recover her diastasis Now I don't know how bad her diastasis recti surgery. So after getting surgery, so to recover her diastasis Now I don't know how bad her diastasis was or anything like that, I don't know anything about it, but it's right. So I'm not saying she could have healed it with exercise or anything like that. She needed surgery. She got surgery. Awesome, right. I'm all for that sort of thing. By the way, If you need medical intervention, you go get medical intervention. There's no shame in that.
Peter:I do say, most of the time diastasis can be resolved through exercise that's kind of what I'm saying the right exercise. So I know, for instance, this lady is very active and she jogs a lot and she exercises well and all that type of stuff. So I'm not making any judgment on whether she could have healed it. Naturally, she had the surgery and she found her low-grade back pain was gone and she was surprised by this and that, to me, was one of those things that shows you that even a lot of medical professionals and she's a ridiculous expert in her field there's a reason I follow her on thread. I don't follow many people on social media within the medical community, so you really have to kind of know what you're talking about before. I'm interested and she's one of those people.
Peter:But she was surprised how her back pain resolved itself and I thought, wow, that does show you that a lot of people still don't know, or indeed still don't accept because that also is also the case that there is at least a link, a correlation between diastasis recti and back pain, low-grade back pain, especially right. Um, and it goes beyond the if your core isn't working, your back compensates, which is true, and I'm all over that. I've done I did interviews with David Jeter about this specifically. I've done five or six episodes about back pain and postpartum back pain and all that sort of thing, and the link between it's very clearly established when you work in this field all the time. It is so clear. So part of it is your core doesn't do the work that it needs to do, your back usually overcompensates and therefore you have back pain.
Peter:Now, part of it, you could argue there's an imbalance argument as well. We know, for instance, with diastasis, that a lot of people that have it also have glute activation issues, which again, and that goes for a lot more people so I'm not just talking about postpartum women, by the way right, a lot of people with back pain have that because their core isn't doing its thing or their glutes aren't quite doing the thing, and therefore you know the back is overcompensating or there's just an imbalance. Stuff pulls on each other, everything is. Stuff pulls on each other. One muscle pulls out on on, yeah, on on on each other. One muscle pulls on the other. Everything is connected, right? Um, when we're talking about your posterior chain, you know, think of thing that knee bones connected to the, that type of thing. That's how it works with muscles as well.
Peter:Right, everything is supposed to work together, and when one part isn't quite working the way it should, it means something else will have to fulfill that function. So if you, for instance, if you I don't know if you squat or something like that, then uh, and I don't know, your glutes aren't doing what they're supposed to be doing. That means muscle will have to do a little bit more work to get your back up off the ground, so to speak. Right, and for a lot of people, when I say, for instance, so that cue squatting is quite a good example of this a cue that a lot of people, a lot of PTs give to people, is to squeeze the glutes on the way up. I'm not saying this is a bad way or a good way to do it. I know some people are really, really opposed to it and I personally don't mind as much. Whatever works for the client is fine by me.
Peter:But for a lot of people, when they try to squeeze the glutes, so to speak, they actually tighten, tighten it up, but they also tighten their lower back. They can't isolate that glutes. They can't isolate their glutes well enough for that cue to be focusing on just the area that you want to be focused on. So that means that at the bottom, as you're coming up out of your squat, your lower back is squeezing more than it maybe should do, and that's why some people feel back pain when they squat and all that sort of thing. It's because their glutes aren't quite doing what they're meant to be doing. So you can see there in that little example, if your glutes aren't meant to be doing but your back is, then doing it, it means that, even if you have diastasis, that that back problem there in that specific instance, won't be caused by the gap at the front of your body, right In that gap between your stomach muscles.
Peter:Right, and I know I'm oversimplifying this, don't send me emails. I'm fed up of emails saying oh, you oversimplified it. That's the point. The point is to keep it simple, right? So this is quite often why physios and I've spoken to one or two people I know. Anthony Lowe, for instance, is still a big well, he's not a big fan On my podcast he said that queues don't work and there was a study that showed that they don't work and all that sort of thing.
Peter:I think he's changed his mind on that now Because you know you have to queue something, right, you have to tell people what to do. You just have to make sure that their understanding of what you're trying to get them to do is the same as what you're trying to get them to do, because, of course, if you, if, if your client doesn't understand exactly what you want them to do, then they're going to do the wrong thing, thinking that they're doing the right thing. Right, this is obvious, right it's? This goes for absolutely everything in in everyone's little world. So cues are very beneficial, if as long as you get the right cue.
Peter:So, if someone says, squeeze your glutes but actually what these people are? They're not capable of squeezing their glutes without also squeezing something else, so to speak, without also tightening something else, then you might well get an adverse reaction. And, like I said in this case, if you get that because your gluteus is firing up, then that is not directly linked to the gap at the front of the body. So is there, then, a link between? This is what some people are then arguing. There is no link between diastasis recti and back pain, because it comes from something else, and that is, of course, also not true. Right, the links are very, very, very clear because, like I said before, everything's connected.
Peter:Half of the time I'm estimating this half of the time you spend doing the healthy postnatal body program. If you do the program health, half of the time when you do any sort of postpartum uh sort of training, it's kind of spent on the glutes one way or another, because they're just so ridiculously important in in your postpartum recovery. They are essential for alignment. So a lot of postpartum people have a bit of a pelvic tilt, um and and fixing that helps bring everything into a bit of alignment, leading to that gap to get a little bit tighter, so to speak. And again, we're just focusing on when I say the gap, I include muscle functionality in in that right it's easier to use a muscle correctly if that muscle is in the right location, so to speak, if that muscle is working at the right angle, right.
Peter:It's the same if you do, if you do a bicep curl, for instance, but you bring your elbow all the way forward, that bicep isn't quite doing as much as it could do. If you keep your bicep tight beside you, right, and that is right. If you keep your bicep, one bicep curl. So if you do that, do it with me people, right, if you sit there and you curl up nice and steady with your elbow tight to your body, then you feel your bicep move up and down. If you then bring that all the way up, if you bring that elbow up and down, if you don't bring that all the way up, if you bring that elbow up and away, you feel that bicep less well. It is the same for any core work. It's the same for any direct core work with regards to your obliques and your tva and everything else that you're working on.
Peter:If the glutes are not working properly and your body is out of alignment and that sounds more scary than it actually is, but um, then it's a bit more difficult to heal, to work your core properly and to heal your diastasis as well. Right, and when everything is out of alignment and again your glutes aren't firing up properly, again your, your back is doing more work. Your lower back is either doing more work than it should or it's just unhappy with the position that it's usually in during the day, and you see this a lot with people who are still pregnant. When you're really big, towards the end, you've got that pregnancy waddle happening, so your belly is sticking out to the front, your hips are more forward and you're almost leaning back a little bit. So you're like banana shaped, so to speak. You're walking around shaped like a banana, just bent in the middle, but pointing forward rather than back away. That then leads to that back just getting a bit tight because it's squeezed into a smaller space than it usually sits in. If you're listening to this and you push your hips forward and you lean back a little bit, do you feel your lower back tightening up? Well, if you walk around like that all the time, you can imagine that you're going to have one or two back issues right now.
Peter:If you then say, okay, when we heal everything, when we fix everything and that means that includes doing all the physio work and that includes doing your pelvic floor stuff and that includes doing your glute exercises and all that type of fun stuff so if you do a proper postpartum recovery program and you work on all that, then your diastasis goes away and your back pain goes away. Right, because everything, like I said, everything is connected. It doesn't mean that one causes the other, but everything is connected in the body. We need to move away a little bit from the diastasis. It's a TVA issue. It's a transverse abdominis issue. I've spoken about this before as well. We don't isolate muscles in that way. It is not in my opinion. It's just not useful at all.
Peter:So what this lady was saying with regards to diastasis surgery she couldn't believe it. It is healed. Yeah, because in that case her back pain and of course she's is caused by another bit not doing what it's supposed to be doing. So when you then diastasis surgery is essentially a tummy tuck, right, let's, let's be really clear about this they just grab everything and stick it back together where it should be, and you can imagine that that is like tightening a belt up. If you have a very loose belt that's also loose at the back, and then you yoink that together and you put it on the last pin that it's comfortable sitting at, and that all gets tighter and more stable.
Peter:So to think that if you have low-grade back pain, that that would not be resolved by that particular surgery shows you just how disconnected a lot of people are that are really, that they're even into this field, that they didn't realize. Oh yeah, shit pardon my french, but uh, shit, I didn't know that this was, uh, this was connected. This is absolutely crazy. But for anybody working in the postpartum field, this should be a straightforward, uh, straightforward connection that you're just like yeah, of course, right. So if you, if you're considering surgery right and, like I said before, I'm not saying you shouldn't if you're considering surgery, this one of the questions your doctor, your surgeon, should be asking is do you also have back pain? And if so, you know, then they can have a look, and they, you know, then they can have a look and they can say he or she can have a look and say, okay, this will help or this won't help, depending on what the cause of your back pain is. Right, if you're walking around with slipped discs all the time, that is not caused by diastasis and therefore the surgery is less likely to help, so to speak. Right, it will probably still help a bit because it's tighter. But you know, there you go. That's me drifting away a little bit.
Peter:So this is one of those things that we have to realize that postpartum recovery, that for postpartum recovery, absolutely everything is connected and we really really forget that. So back pain is connected to gluten activity. Gluten activity is pretty much a given postpartum right, unless you did loads of stuff during the pregnancy, of course, right. Let me caveat that massively by saying if you do the right things during the pregnancy, then postpartum recovery is significantly easier because, as I've mentioned before in other episodes, that activation stage at first four to six weeks, you can pretty much breeze your way through that because you've already done that bit and everything is firing the way it should done that bit and everything is firing the way it should um. So then you move straight into the strengthening, uh strength and uh conditioning stage of of of the muscles, the the next four to eight weeks, and then you're done right. Then you go your merry way and you should be all things so.
Peter:So it is possible, if you do the right things, uh during the pregnancy for your post, and your diastasis isn't too bad and you you had a relatively straightforward pregnancy and birth and all that type of stuff and your diastasis isn't too bad and all that sort of thing, then your first four to six weeks is significantly shorter. A lot of people in that position, their whole postpartum recovery with regards to dystasis and with regards to going back to the activities they used to be doing, not necessarily at the level they used to be doing it at right, but just at doing the activities again safely and all that sort of that is. That is an eight-week process. I've had people that only work for me for six weeks, because after that I was like, yeah, there really is nothing, there's nothing I need to do anymore. Right, you did everything right during the pregnancy. Everything was straightforward enough. You have a beautiful baby at the end and, and you know, you come to me six weeks postpartum and another six weeks later, yeah, go to the gym or go work with your with your own strength and conditioning coach or your tennis coach or or whatever swimming coach, whatever, right, as long as you keep.
Peter:That, then, means that when I talk about the uh, postpartum recovery stage being done, I'm talking about it from my perspective, as in, you don't need me holding your hand anymore. It's um, I am not saying you are fully back to where you were because that process takes significantly longer. Right, there's a reason the hbmv program takes, I think, up to 10 months now, or something like that, and why I keep adding more um, because you know it's and it's not just a value for money thing. There. There is an argument that that I have with people all. All the time is in.
Peter:You can keep training, um, the, the, the postpartum recovery, the, the rehab period should be up to the point where you're ready to be, so to speak, handed over to the next professional, which is just a normal personal trainer, so to. So, instead of working with a postpartum specialist after 12 weeks, I tend to hand people back after 12 weeks at least, my postpartum package is 12 weeks and again, I'm not selling it here because I only work in Edinburgh and surrounding areas yeah, but it's a 12-week package. So people come to me and they say, hey, I need to fix this. And then, yeah, okay, and after 12 weeks, yeah, you're done, you can go back to work with your old PT or your old coach or whatever. And here's a list of do's and don'ts, so to speak, for you, or a list of things to pay attention to, rather than do's or don'ts, and that's completely fine. But you're basically basically everything you do at that stage.
Peter:Once you hand it over, everything you do, as long as you take into account all the lessons that you learned during the program during the first 12 weeks, will help heal your diastasis, will help heal all your postpartum issues, right. That's why I say the rehabby stage is finished, you can go back to working with a coach, as long as you exhale properly on the effort and all that type of stuff. Everything you do squatting, tennis, swimming, bicep curls, shoulder presses, everything you do as long as you do the basics right, will help heal your diastasis. If you're then looking at elite athletes weightlifters, powerlifters and all that type of stuff going back to the sport judokas, that type of thing that takes a lot longer because they tend to brace a lot instead of when they exert themselves and that bit takes a little longer. Before you're ready for that, holding your breath and boom, right, I'm having a lot of pressure on the core. You need to work up to that a little bit, but for, say, tennis players, it's significantly easier. For normal gym goers and normal people humans, so to speak. So non-elite athletes, yeah, you're completely fine. That's it.
Peter:Everything you do, including from lifting, travel systems and all that will help heal all your postpartum issues, as long as you get the basics right, and that means your back pain to get back to the back pain thing will also go away. If you find you still have back pain two, three years postpartum and you think you don't have diastasis anymore because you don't have a gap anymore. That is the time to go back to a postpartum coach that knows what they're talking about, because something isn't working quite right. Not a scary thing, not in a scary way. It could be one or two appointments you could be done, it's just about. There's usually then an activation problem somewhere. I call it activation problems and I know physios lose their mind when I do that, but you know, you know what I mean. Right, something isn't quite working the way it should, and that could well be that example that I gave you. If you squat and you say tense your glutes, that you're tensing more than just your glutes, squeeze your glutes, you're actually squeezing your lower back as well, that type of stuff. So you're not quite getting that right because you haven't been shown how to do it correctly. That's all it is. Anyways, that's my waffling time up.
Peter:I didn't expect to talk this long on this particular subject, but there you go. That's Dinky snoring in the background, by the way. I'm not going to stop. I'm not going to edit that out. Here's a new bit of music. I'm back next week, peter, at HealthyPositiveBodycom, you take care of yourself. Bye, now I'm out. Got a clip on my lips about to open them out. Tenonist of faders, tell me what you're about. I need you to try and explain what's going on. What's going on, cause it feels like I'm bleeding out. Oh no, tell me what's going on. Tell me what's going on. I feel the pressure of a lifetime killing me, watching blood, take a bow and then trip your feet, walking in circles, just to watch them walk the other way. Tell me why we have to keep up with this misery. The years start complaining now. Got my heels in the dirt sweating down, got a bad, bad text in my mouth and I can't find it all. What's going on? Tell me what's going on. Yeah, bye you.