The Healthy Post Natal Body Podcast
The Healthy Post Natal Body Podcast
Diastasis; The Depth of the gap is more important? And "Does diastasis cause digestive issues?" again
On this week's episode
"The depth of the gap is more important than the width!" is a common phrase you hear these days from "diastasis recti professionals" but is it actually true?
Can diastasis recti cause digestive issues? One "diastasis specialist" claims it could "because muscles aren't working properly and you need muscles to move food through the digestive tract". Let's talk about this a bit because a LOT of women have digestive issues post-partum and, obviously, a lot have diastasis as well. But are they linked??
The importance of picking your goal and focusing ONLY on that. I talk about a client with a shoulder injury whom I started working with this week.
"In the news this week"; This from the Daily Mail (one of the go-to websites for people about health related news, which is a bit of a shame to be honest). A soup and shake diet to beat Type 2 Diabetes. A good idea? And, does it work because the diet is magic or is there something else going on?
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Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert, peter Lapp. That, as always, would be me. Today is a From the Vault episode. Yeah, and, as I said, once every two weeks, I'll dig up one of the older episodes because I get loads of questions that can be covered by these things. The depth of the gap is more important than the width of the gap. It's a phrase we hear a lot now with regards to diastasis recti. Is it actually true? Do now, with regards to diastasis recti Is it actually true? Do you know what the answer is if I ask a question like this, and can diastasis actually cause digestive issues? We see a lot of that these days as well. Is your IBS caused by the muscles aren't working properly? You need muscles to move through the digestive tract and all that type of stuff. That's what I'm covering in this episode. Next week it'll be a new one, peter at HealthyPostnatalBodycom. If you have any questions or comments, have fun with this one. Anyways, I hope you're well.
Speaker 1:I am joined by Kitty, bobby and Buddy, as we are going to bring you some interesting stuff. Let's just get straight into it, because I don't have a lot of time today. I'm still knee-deep, being polite, knee-deep in translations of the program into Hindi and Spanish and all that sort of stuff and, to be honest, I'm starting to regret it a little bit. It's getting, it's a lot more work than I thought it was going to be, but what can you do? We plow on right. So the depth of the gap, diastasis recti, is the depth of the gap more important than the width of the gap? You hear this a lot and you hear this a lot from diastasis recti professionals. Now, are they right? Because they're saying that the depth of the gap, when you engage the muscle because, as you will know, you'll no doubt know the way to measure diastasis recti is you line your back a little bit, just nice and relaxed, you put some fingers along your linear elbow, along that middle line, and you raise your head and you try to engage your muscles, try to get that to squeeze, hopefully, feel some resistance and push back on the way up and feel some squeeze from from the side.
Speaker 1:Now we measure two things. When we're measuring the physical side of things, we measure the width of the gap and the depth of the gap, and the depth of the gap is one of those. Yeah, we measure it, but we don't really know what it should be. One knuckle, two knuckle right, it's a bit all over the place. To be honest, it's much more difficult to measure that properly and all that sort of stuff than the width of the gap. It's because the width of the gap is you can just measure in centimeters and straight up.
Speaker 1:Um, is the depth of the gap therefore really more important than the width? Well, yes and no. Uh, I would say this is one of those yes and no sort of deals. How long is a piece of string? Sort of deals.
Speaker 1:The width of the gap gap isn't everything, but the depth of the gap is kind of an indicator as to how well your tva, your transverse abdominis muscle, is, muscles are working right. And if you are a single-minded, narrow-visioned sort of diastasis recti specialist, then the tva is everything. Um, it is not. But you know that is where the focus for a lot of people focusing on diastasis recti recovery is. A strong TVA will determine, will partly determine, how flat the belly is and all that sort of stuff. Whether that means that the depth of the gap is genuinely more important than the width of the gap is well, I would dare debate that with almost any personal trainer that says that it is. There are more muscles. Again, if you just focus on the TVA in your diastasis recti recovery, you're not really going to heal your diastasis recti. That's kind of what the problem is with that. It's more important. What's more important, what isn't.
Speaker 1:I always say the diastasis recti is the width of the gap, the depth of the gap and muscle activation, muscle functionality, muscle functionality is everything, but that is the key thing. The width and the depth, I'm almost not interested. I mean, I measure for people so I can show them progress and all that sort of stuff, but I'm genuinely not that interested in how wide your uh, you know how wide or deep your gap is, because we have to get the muscles working anyways. Right, it might give us a decent starting point, but you not even that. Not even that. Really, it's one of those that you always need to work on your TVA postpartum. You also always need to work on your obliques and all that sort of stuff. Postpartum. You also need to work on your pelvic floor postpartum. Your glutes, your lower back, your posterior muscles, your rhomboids and all that sort of stuff. They all need to be worked. Your lats need to be worked. Your rear delts need to need work Because part of healing diastasis recti is sorting your alignment Right.
Speaker 1:I've spoken about this before. If you're out of alignment, it's going to be difficult to heal your diastasis recti. That's why in the Healthy Postnatal Body Program, we do such a ridiculous amount of glute work compared to some one or two other programs. It's a ridiculous amount because I really focus on that because the glutes are big muscles and getting them to fire up properly is essential in your recovery.
Speaker 1:If you're only looking at the width or the depth of the gap of your diastasis recti gap, you're missing the point of what you should be focusing on. So is the depth of the gap more important than the width? No, not really. I mean that is marginal. Most people that say that don't really know why they're saying it Would be my argument. Yes, it gives you a better indication as to how the TVA functions, but you know you need to get that fired up anyway. So most people's TVA doesn't function all that well. So, yeah, the temptation is for people to say this and, of course, as it always goes, when enough people start saying it, more and more people start repeating it and it and more people start repeating it, and it leads to this group thing that you see in the fitness community and you see it almost everywhere. Every economist will tell you the same thing. Anybody who's ever seen the big short, that movie withve carell and various other people, will know the dangers of, of of groupthink. Um, if everybody just jumps on the oh, it's really the depth of the gap we have to worry about. You're still missing the point. It's overall muscle functionality that you're looking at. When I, when I assess a client for the first time, I don't just measure the depth and the width of the gap. I also see whether they can squeeze their glutes properly or not, and I would argue that that is significantly more important than just going by the depth of the gap. So take these things, these simple slogans, with a grain of salt.
Speaker 1:Diastasis recta is a fairly complex issue because there are many, many muscles involved in this. The death of the gut matters? Yeah, sure it does, but does it really? I don't get excited by it. That's all I'm saying. Secondly, which I heard from the same I saw this on the same website as a diastasis specialist I spoke about last week because I looked into the program a little bit can diastasis recti cause digestive issues.
Speaker 1:Now we hear a lot of women postpartum. They have trouble going to the toilet, they have a lot of bloating, whatever. They have a lot of digestive issues. They can't stomach certain foods anymore. And you hear a lot about because I have diastasis recti, I now also have more bloating and it hurts and I don't go to the toilet regularly and all that sort of stuff. I'm stuck, I'm constipated, all that sort of stuff.
Speaker 1:Is that caused by diastasis recta? Well, this one diastasis specialist air quotes said, and I quote well, it could be because muscles aren't working properly and you need muscles to move food through the digestive tract. Now, this is of course true. You need muscles to move food through the digestive tract. Now, this is of course true. You need muscles to move food through the digestive tract. But that is not the same muscles, those are not the same muscles as we're using To engage our core. I hope everybody Listening to this will think Wait a minute, pete, I'm sure my large and small intestine, kind of they're not being switched off during pregnancy.
Speaker 1:No, they're not. They're not put under that much pressure during pregnancy. So sometimes there is a crossover between people who have digestive issues and people who have diastasis recti. That Venn diagram of postpartum women is pretty much. That's pretty much a full circle. That does not mean diastasis recti causes digestive issues. That is not how it works.
Speaker 1:If you're looking at bloating and all that sort of bloating is not caused by diastasis recti, it just isn't. Diastasis recti is not a cause of bloating. Bloating can lead to diastasis recti, so it goes in the other direction and it definitely. If you bloat a lot, you'll find that your diastasis recti recovery is a lot tougher because of the constant pressure on the core. But that doesn't mean your diastasis causes it. Same with constipation and all that sort of stuff. Constipation is not caused by your diastasis recti causing your small or large intestines to not function well. Constipation is caused by various things, usually food related. So diet depends on what you eat, whether you get enough fiber, whether you get enough water and all that sort of stuff. There might be one or two other things happening, but it's not caused by diastasis recti.
Speaker 1:So when anybody tells you that muscles aren't working properly, when you have diastasis and you need muscles to move food through the digestive tract, that is a quote that is genuinely. I swear to god, that's a quote from their website um, they're not understanding that there are different muscles at work through these processes, um, so, no, diastasis recti does not cause digestive issues. To. To keep that nice and short, which you'll be pleased and all right, because it means it's almost inevitably fixable. What I always tell people to do, um, is eat enough whole foods, and same as all the dietitians on the podcast I've said this before eat enough whole foods, you get your fibers in and all that sort of stuff. You drink a decent amount of water, uh, take a pre or probiotic and all that sort of stuff if you need them and likely you'll have no digestive issues anymore. Maybe a bit of bloating, but that's because of your reaction to food. So certain foods you have to have to maybe get rid of for a little bit for for a while. Right, the importance of picking your goal and focusing only on that goal.
Speaker 1:So I I have this corporate client that I spoke a little bit about last week and I went into the office and one of the guys came up to me and they said I need an exercise program and I have rotator cuff injury. So shoulder injury, so we went into the gym. Um, so shoulder injury, so we went into the gym and, um the he could not lift a one kilogram weight sideways with one of his arms. His shoulder was just not having it. The shoulder was completely and utterly messed up. It's one of the weakest shoulders I have seen and I train people who have injuries all the time. That's kind of that's kind of what I do these days. He just could not lift a two kilogram weight. He also couldn't lift one kilogram weight. We had to go into a cable machine and drop to 500 grams and then he struggled to lift that and he couldn't do anything above his head. So he couldn't do like a shoulder press or anything like that where you just grab a weight, press it above your head. He had two kids and he could not physically lift a child above his head because his right shoulder is that messed up that it just wasn't having it.
Speaker 1:Um, so I said to him okay, I'll put a program together for you and you know we'll. We'll start working on this a little bit. What else? What else exercise wise, if anything, what else do you do? And said he goes running for an hour every day. I said, well, in an ideal world you do these exercises for your shoulders about 15 minutes a day. You can't do. When you have that bad an injury you can't really do 45 minutes to an hour. It's a small muscle group and 15 minutes will knacker the shoulder out in the beginning. It's more than enough.
Speaker 1:So I said to him okay, you go running a little bit and all that sort of stuff, I get it, you keep your sanity. There's guys in high stress in work environments, obviously a wife and a couple of kids at home, so there's a lot happening in the house as well, and he needs to clear his mind. But I said you have to then do the shoulder routine before you go and run, because I want the shoulder warm and exercise before you go running because, contrary to what a lot of runners seem to think, your shoulders are actually quite active when you're running. Um. So I said to him do that first. And he said well, I really prefer running over exercise. I said yeah, but you can't move your shoulder right and if you can't move your shoulder, then that has to be the priority. In the same way that he also wanted to put a bit of a bit of muscle on. But you can only do that once you've fixed your shoulder. We cannot, and that might be 3 to 4, 5, 6 months in his case. It'll take a little while. It'll get a little while. It'll get better within three to four weeks, but to have it back to normal three to six months.
Speaker 1:I said you have to stick to your goal, and I find this a lot with people who are working on diastasis recti-related stuff as well. A lot of women hate their belly or they hate how it feels, or they hate how it feels or they hate how it looks. Right, it's usually one of one of the two. Bit above, maybe. And then, instead of doing the 10 15 minute exercise every day, or three, four days a week that we, for instance, have in the healthy postnatal body home program um, the the home sessions, uh, and then exercising twice a week, doing the strength sessions for anywhere between 20 and 40 minutes, they say, yeah, but I like to run, I like to. I would prefer to do that over fixing the thing I don't like.
Speaker 1:The problem with doing things that don't get you closer to your goal is that a year down the line, you'll probably still feel unhappy with your belly in this particular case, when it comes to diastasis recti, because it doesn't feel well and it doesn't function well. Of course it could also, if you're doing the wrong things it could also really hinder your progress and make things a little bit worse and make it more difficult to recover. But predominantly the idea that you can just do what you prefer doing instead of what you have to do is a rather childish one In my middle-aged white guy opinion. It doesn't make sense to do it If you're unhappy with the way your diastasis recti, your belly, looks and feels. That's where you focus it. Exercise wise. At least Fix the injury first before you go do something else. I like to go running, yeah, but not when you have diastasis recti Right.
Speaker 1:Get your diastasis recti done first. That's where all the focus is. At least don't do anything that makes it feel worse. So just stick to your goal. It's the fastest way to get to where you want to go. You can't just turn left and right when you're driving to the supermarket. You kind of have to follow the route and you know the fastest way to get from A to B is to just follow the sound path and that is follow the program Right. So you follow a program that says well, I'm going to heal your thymus. That's the program you do.
Speaker 1:You don't then do that program. You do a bit of running, you do an aerial acrobatics class, you do Pilates, you do XYZ, and in the meantime you drift away from that program because you don't have the time for it anymore, because that means that nothing will help, because you've forgotten the basic, you've forgotten your biggest goal. That's why I like to write down my goals and so that every day that I think to myself of I'm going to do this, I see my goal hanging there and go oh yeah, but I'm supposed to be doing, supposed to be doing this. This is where my focus is this week, and it can change. It can easily change, of course it can, but it's important to remind yourself of what your goal is and then focusing only on that goal. Um, where are we? Where are we? That is a question.
Speaker 1:20 minutes of waffling about nothing done already in the news this week uh, this was something that was sent to me. I don't tend to read the Daily Mail because it frustrates me too much. Not because it's I mean, well, many people have issues with the Daily Mail and I have many, many but a lot of the things that they publish just really frustrate me because they usually they usually just agitate me a little bit. Anyways, 850 calories a day diet, the NHS hope will help beat diabetes. Soups and shakes to be prescribed to try with 500. Okay, exaggerated number Type 2 suffers of the disease per week, with average patient losing more than two stone in clinical trials. Okay, this kind of ties into the stuff that their favorite GP, their favorite doctor who's not actually a doctor, michael Mosley, keeps peddling the 800 calories a day. So there is a this soup and shake diet that can reverse type 2 diabetes is to be offered on the NHS is what they're saying. They did a trial and results from about 2,000 pages show it helped them lose an average of more than 2 stone, just over 2 stone, and more than half of those almost half of those who tried to diet managed to reverse their type 2 diabetes. Now, this is always the case with regards to and we've known this for a while with regards to type 2 diabetes. So it's nice that the nhs is also coming on board that weight loss will can reverse type 2. Right, we've known this for a while. It's not new. It's a couple of professors and all that.
Speaker 1:Jonathan Valabji, I'm not sure I pronounced that right. Apologies if I didn't. He's a diabetes and obesity chief at NHS England, you know, and he says this is phenomenal and blah, blah, blah. You know, and he says this is this is phenomenal and blah, blah, blah. Now the way that this is going to work. They're basically saying we're going to give you soups and sachets of shakes uh, even the soup is sachets, by the way. Uh, it's all instant stuff. Um, and they're saying that, okay, because you have a high BMI, they're only doing this for people with a body mass index over 27, over 25, for people from black, asian or minority ethnic groups. They're saying that, okay, we'll slash your calorie intake to just 850. You lose a ton of weight quickly, which you would, of course, because if you're, you know you're dropping to 850 calories and lose a lot of weight too strong. And chances are that you know you'll reverse your type 2 diabetes, which is a good thing, right, I don't dispute that at all. Um, that's a good thing. Again, you pick your goal right.
Speaker 1:People with type 2 diabetes. Their main goal should be get rid of the type 2 diabetes first. I also get why they're doing soups and shakes because they're straightforward. Straightforward to follow, right, you get a box of sachets and it says Monday, tuesday, wednesday, thursday, friday, et cetera, and that's what you have. You have your breakfast, lunch and dinner laid out.
Speaker 1:If you ask people because the question I was asked wouldn't this be better to do this with proper food? And the answer is, of course, yes. I mean it's an absolute no-brainer that 850 calories of real food rather than soups and sachets or sachets of soups and all that sort of stuff, meal replacement stuff, real food beats this hand down. The problem is getting people to eat only 850 calories of real food is complex. It requires cooking and all that sort of stuff. So you want to make it simple. Personally, again, I'm always saying that 850 calories is low, but I get why they're doing it. They think people can essentially stick to this simple diet for three to six months and then they're done with it. So the weight has to come off.
Speaker 1:The reason diets don't work for many people is they try the wrong diets, too highly calorie restrictive, and they try it for too long a time where the diet is too complex. So they had to find a very simple way to do. It is, generally speaking, eating 850, only eating 850 calories a day for soups and sachets. Is that a good idea? No, it is a terrible, terrible idea to do this if you are just a normal, healthy person. The interesting thing is that the pilot study that they were running, the average weight loss was, they're saying, according to the, the daily mail's going to this article was 13 and a half kg. So sorry, I thought it was 12 and a half, 13 and a half kg, and they.
Speaker 1:Then the next line is usually dietary interventions produce a couple of kilos of weight loss over uh, over six months. I'm assuming, assume they're referring to the same period. Yes, technically that is true, but the reason is not because these guys are on some sort of magic diet. They are. This is, um, because these guys are on some sort of magic diet, they are this is this works. Let me put it this way 13 and a half kilos in six months equates to about two kilos a month, which is about a pound a week. I can get anybody to lose that, and they don't even need to drop to 850 calories.
Speaker 1:The reason normal weight loss is only 2 to 3 kilos over the course of 6 months is because people don't stick to the diet, and that's what they don't tell you in this particular article, or they don't highlight it much is it has to be supervised. The diet has to be supervised by practice nurses, basically GP nurses. You have to have regular check-ins. This is why working with a personal trainer is so effective if you have a good PT. This is why my 400 pound client is now 250 something pounds and will be below 200 pounds by this time next year, because he has accountability. He has me asking hey, are you sticking to your plan? Are you doing what we agreed you would do? Do you find it manageable? Do you need a bit of help? Is there anything I can help you with? Is there anything I can be of assistance with?
Speaker 1:If you just leave people to it and they diet by themselves, so and that includes weight watchers and all that sort of stuff then yeah, they'll lose two to three, four kilos over the course of six months and they might not keep it off because they go back to their old habits. Right? The? The magic result of 13 and a half kg in six months is is that's a 500 calorie a day deficit? That is not an 800, right, because you know, if you're 500 calories in deficit every day, you lose about a pound a week, right? 3500 calories is about a pound a week. So you then don't need to be on 850 calories, only you, just, you just don't. The 850 calories works and it's dramatic, sure, but it's not really required. Um, you're not really required to be that low unless your base metabolic rate when accounting for exercise is only 1,350 calories and most people are near the 2,000 mark, maybe 1,800. So if you are near 2,000 calories a day, it's your base metabolic rate, so the calories that you need to maintain your weight. If you drop that to 1500 calories, you're going to lose a pound a week, which is roughly 13 kilos, 12 kilos in six months. That is manageable. There's nothing even remotely difficult about this. If you have the guidance of someone who knows what they're doing and you have a bit of accountability. If you have the guidance of someone who knows what they're doing and you have a bit of accountability, I get. Well, like I said, I get why they're doing satiating soups and I'm in agreement that you know.
Speaker 1:Keep it as simple as possible for people. There's a reason. You're type 2 diabetic quite often if it's clearly linked to your weight, say, if you're 400, 400 pounds, like I said before with my client who was, was 400 pounds. Um, there's a reason you're 400 pounds and it's not because you made good food choices right, it's not because you're used to making good food choices. So as my puppy snore in the background, by the way, just in case you're wondering what that weird noise is um, if you are used to making bad food choices, you have to make it really simple for people, which is why people like the keto diet and all that sort of stuff. Because it's simple Eat meat, eat meat, take supplements, that sort of thing.
Speaker 1:This is simple. This is simple to follow. This thing is similar to that. It's simple Eat your sachets, weight watchers, and slim fast. Slim fast is similar to that. Weight watchers is terrible. Slim fast is terrible, but drink these shakes. It's simple. Drink three of these shakes a day, or however much. It is 800 calories or 1,000 calories, whatever your target is and you will lose weight. Yeah, if you stick to that, of course you will. Then, of course, you know you need to reintroduce real food later on, and that's where people need even more guidance.
Speaker 1:So if they're going to do this, you know they're saying here that gp will refer people to the system after three months on the shakes and soups. They will support it to transition back to eating ordinary food, as long as that transition on the way back is properly supervised and people are educated properly and people are given the support including cooking classes and all that sort of stuff, and even, in some cases, people that when you're talking poor people, people near the poverty line and all that they might need financial help to help. Especially electricity bills and all that sort of stuff are skyrocketing and turning the oven on can be expensive. I track my electricity use pretty easily. Those of you who know me will know this. I'm pretty anal about that sort of stuff, so I track that and you know I can see some of the benefits. You don't want to spend £90 a month on electricity because that's easily done if you're on benefits of £70, £80 a week. So as long as they help with that, this will work and it's, generally speaking, a good idea.
Speaker 1:It's not great for people who do not have type 2 diabetes and even for those with type 2 diabetes it is not necessary to drop that low. Whether the shakes are well designed or not is almost completely secondary. I don't think that's particularly interesting. The shakes I don't give a shit what's in them. Anything you have to add water to before it becomes food becomes edible. Any powders that you're eating. It's not real food. Let's be very clear about that. But for the time being, you pick your goal. I have type 2 diabetes. I want rid of it. Hopefully this will be available to you soon. Anyways, that's it for me for the week. I've managed to waffle for 33 minutes.
Speaker 1:Peter at HealthyPostnatalBodycom, if you have any questions or comments, I would love to hear from people in China and Taiwan and Kazakhstan and all that sort of stuff. Peter at HealthyPostnatalBodycom, tell me your experiences. Tell me you know, teach me something. Tell me your experiences about the healthcare system, postpartum healthcare, postpartum habits. Obviously, I did this interview about Sally and Sue with GM Whitley a long time ago now. I might dig that up again in the near future, although I'll be interesting to hear what cultural differences there are, how you manage it, how it goes and what you think I should do next with healthypostnatalbodycom. Anyway, have a tremendous week, take care of yourself and I'll check in on you again next week.
Speaker 2:Bye, now take care of yourself and I'll check in on you again next week.
Speaker 2:Right bye now. I'd rather be alone. I'd rather stay home. I don't wanna run into you, I'd rather stay awake In my hideaway. Don't need another taste of you. Bye.
Speaker 2:You set me on fire to keep yourself warm. You left me on the floor just crying out for help. You're calling back, but I don't want you for myself. You fucked it up too many times. Put me through hell Still. I just can't stand to see you with somebody else. With somebody else oh, it's somebody else. Oh, it's somebody else. With somebody, with somebody. Saw you out tonight. I hoped I'd be alright, but now had too many shots. I can't control my thoughts. I still want you, but I don't control my thoughts. I still want you, but I don't want to. You Said you got tired, uninspired by me. You Set me on fire. I hope you're still. You left me on the floor just crying out for help. You're calling back, but I don't want you for myself. You've uptaped too many times. Believe you will still. I just can't stand to see you with somebody else. With somebody else. Oh, with somebody else. With somebody. Oh, with somebody else. Hmm, somebody. Oh, it's somebody else.