Diastasis Recti Basics and postpartum neckpain..why a massage won't help!

This week I am welcoming new listeners and, since it's been a while, I'm covering some basics about diastasis recti.

What is the definition of it?

What is it really?

How to resolve it, which things to focus on etc.

And, most importantly, whyit's not actually something to be scared of and how it can, almost always, be sorted with exercise.

I also touch on postpartum neckpain; The causes, the actual solutions and the things you try that don't actually work.

As always; HPNB 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 :)

Visit healthypostnatalbody.com and get 3 months completely FREE access. No sales, no commitment, no BS.

Email peter@healthypostnatalbody.com if you have any questions, comments or want to suggest a guest/topic        

Transcript

New Monday Release Schedule

Peter 0:00

Hey, welcome to the Healthy Postnatal Body Podcast with your postnatal expert Peter Lap. That as always would be me. This is a podcast for the 25th of May 2026. And I said 25th? Yes, I did, because the podcast from now on will be going out on a Monday. And today I'm talking the classics. We're bringing all the classics back as you hear Buddy Pitterpatter in the background. We're talking diastasis recti, we're talking a little bit of back pain, and we're talking neck pain. Um so you know, without further ado, that's where we're gonna go. Here we go. Hey, welcome to the Healthy Postnatal Body Podcast with Little Old Me. I am uh I hope you're well. This is the like I said, the podcast for the 25th of May. And I made the decision to um to change the day of the podcast because my work schedule has changed a little bit and I'm all over the place on a Sunday. And you know, it's still technically the weekend. Uh and on my Mondays are a bit more quiet now. So I uh I have time to put the podcast out on a Monday. Now, Pete, I hear you think, could you not just prepare these things in advance? Yes, I could. And it would be better. Uh better for myself if I if I made four or five in one go. But um, you know, experience teaches me that that is not the way that's not the way my brain tends to tends to work. Anyhow, so a Monday it is. Um should be roughly the same time on a Monday evening when it comes out. And I know most of you listen during the week anyway, so so it's fine. Um, just so you know, it's now by design that it's out on a Monday, rather than you know, me forgetting to put one out or technical difficulties. Um Peter at healthypostnate on budget.com, by the way. If you have any questions or comments, I am here with absolutely everybody. Um Kitty Buddy, um Cookie's still here. Cookie was very sick this week, almost lost Cookie this week, but she's still here. So, you know, that's good news, right? And and Bob is here somewhere as well. Uh, all the puppies and cats I pay I

Why We Are Repeating The Basics

Peter 2:25

pay the mortgage for are here. I hope you're well. It's a nice sunny day, we're going nicely. I have picked up a fair few listeners in the last uh last few weeks, and it's been an error, it's been a while since um since I've done an episode on the basics. Um whenever I get a fair few new members or fair few new listeners, people haven't listened for a while, um, I get emails about the the standard subjects a little bit. And it's been a while since I since I covered since I covered them. Um and I had one or two emails uh from uh from people about uh diastasis or diastasis, whatever you want to call it, um vecti and um and some neck pain emails. Um people suffering from uh from from these things. Um and basically saying, you know, why asking why my approach is slightly different. Um when it comes to uh when it comes to diastasis, is my approach tends to be slightly different from some people, not not all people, right? But um so I'll just like I said, we'll just do the basics, you know. I'll just go very brief what is diastasis recti. Basically, um as we always say, um, again, my definition of this is slightly different,

Diastasis Recti As Muscle Function

Peter 3:55

so you have to bear with me a little bit. Most people will say diastasis recti is a separation of uh stomach muscles along the line of the linear elbow, which is a center line that runs from say your top your bit cage, that middle bit along your belly button to your to your pelvis, right? That is uh that is what most what most standard definitions of of diastasis is, and and then they're talking about the width of the gap, right? So what matters is the amount of separation, that's usually what they measure is how many fingers can you slot in. Um and then talking about how deep the gap is. Some people who go slightly further will say, Oh, but the depth of the gap actually matters more, and it's to do with the um resistance that the transfers abdominis, the TVA, uh that's that bunch of muscles that that that uh resistance that that that can produce effectively when you when you engage it, right? And um and that's where most people then kind of stop. Um so they're talking about the width of the gap and the depth of of the gap. Um technically, technically, they're right. This is always one of those sort of sort of things. The width of the gap, anything over two and a half centimeters or 25 mil is classes uh diastasis or uh diastasis, and uh anything below that is classes not, and that's that is the reason why I I like to bring it up because I don't like this definition very much to be honest. The big thing about testasis is not the depth of the gap or the width of the gap, it just isn't, it's the functionality of the muscles. Um and by that I mean for muscle functionality, I mean the right muscles doing the right things at the right time. So uh whatever you ask of the muscle, right? That the muscle, the right muscle, when you do any sort of movement or any sort of lifting or anything at all, um, that the right muscle does the right thing at the right time and is okay with the amount of load, as we call it, the amount of resistance, the amount of work, the amount of effort we're asking it to do. And then it can release again when the job is complete, right? Because we don't want muscles that are constantly working when we don't need them to work, right? So the muscle doing the right thing at the right time. Um, that is what I class as muscle functionality. The rest is all kind of we can go very deep on that, but we don't have to. It's it's not that useful. Uh I find it's not that useful for most people. Um and I find that is more important than the width of the gap. The reason that I class that is more important is because you know the muscles not doing the right thing at the right time, is what leads to things like back pain and all that type of stuff. I also find that part of this it is really difficult for the right muscle to do the right thing if it's not in the right place. Right? So that is when we're talking about muscle separation and all that type of stuff. If that muscle isn't, has has moved and is no longer where it kind of should be, um you can imagine that muscle isn't really doing what it's supposed to be doing. It might well work, but it might not be doing everything that correctly that you need it to function, um, without causing any discomfort or or or anything um or any pain. Right? And I know I'm oversimplifying this for people and medical professionals listening to this, and again, I know there's a few. Um I'm deliberately oversimplifying this. You are not the target audience, but it's it's um that's fundamentally why I think muscle functionality is more important. I also find that when you function on when you focus on the right muscle doing the right thing at the right time, the gap closes. This is not rocket science, right? When you focus on getting everything to work properly, stuff moves back to where where it should be. And with regards to the depth of the gap, the transfers abdominis and all that type of stuff, when that starts working, the depth also also becomes less. You can poke your fingers for people who don't know the depth of the gap. What people what people tend the way people tend to measure uh dystasis is with their fingers. So you go to your um in an ideal one, you give birth, um and six, eight weeks later you have your GP appointment, and then you get referred to a pelvic health physio,

Measuring The Gap Without Confusion

Peter 9:05

women's health physio, or any anyone like that, any sort of specialist, anyone will do, basically, anyone will do as a specialist in this field, and they will measure your your separation. Now, the way they tend to do this, and this is one of my bugbears, is they stick a couple of fingers along just above your belly button and just below your belly button, and see how many they can um they can squeeze in before you feel any or before they feel any resistance, they feel the muscles that are separated gripping the side of the finger. I always tell people, and I'll put a little video on, um, shows you how to measure this finger, like when your baby grabs your finger. That's that's the feeling they're looking for. And the more muscles, the the more um fingers they can squeeze in, the more separation you have. Now, that is what they measure. Then you can also, what people have started doing, and I'm not a huge fan of this, but is say, okay, but how deep can that how how deep can can those fingers go? And that is much more difficult to to measure. Um, but then basically the person puts a finger and waits until they and they ask you to flex your muscle, uh, muscles a little bit in your in your core, and no no one has any idea how to do that, and then they'll wait for any sort of resistance that they're feeling. Um, and like I said, that's why, and and and then nobody, nobody, nobody actually measures them, right? Nobody, as in they do it, but they don't tell you what the measurement is. So you might walk out, say, and have two and a half uh fingers separation, um, three fingers, four fingers, five fingers. It's all very common, it can all happen. Uh, and then no one then actually says, and it was X amount deep. Because it's not an easy measurement. Half a hand, half a finger, up until your third knuckle. You know what are we talking about? Um, and this is why I always say when you measure this stuff, you need a tape measurement. So you measure using your fingers, or the person who measures uses their fingers, and again, you can do this yourself, or if you have a medical professional doing it, and they say it's two and a half fingers, then you need to measure their fingers. Because what I come across a lot is that people uh, for instance, if I were to and and I'm a I'm a guy and I'm 6'4, and I have fairly big hands, I am and and and if I measure your separation and I say I have two and a half fingers, and you're a petite woman, and then and and you come home, and you say, I have uh Peter measured two and a half finger separation, so that's what I have. And two weeks later, you do a whole bunch of exercises for weeks that are supposed to help, and then you fit free and half of your dainty little fingers in there, then you think your separation got worse. Whereas what actually happened is your dainty little fingers were significantly smaller than mine, but big Ofi man hands, right? And and and that is kind of what the problem is. So we need to measure it in centimeters. So if somebody else measures you, you need to measure their fingers. If they don't have a tape measure, then they need to show you how you should measure it with your fingers. Your fingers will change in size a little bit. Uh, postpartum and then sizes of fingers, and if every woman in the world will know this, right? Um, changes with um weight gain, water retention, uh hormone changes, the size of your fingers can change a little bit. Um, and therefore, or even weight loss, right? Um the size of your fingers would change, and therefore you would be able to fit more fingers in. So you still need a tape measure, but they should be a but your own fingers are a lot more um reliable to measure with than someone else's, and then transferring that onto your fingers, so to speak. So in but anyways, in an ideal world, you get your tape measure out, and uh you measure what's the what the width of the gap really is. Um, and like I said, that's what I always say, that's what I say in the video as well. Yeah, it drives me nuts that people don't use tape measures for this, but fingers, because a finger is just isn't a measurement. Um, anyways, that that's that's how you measure it. Um what most people then do is say, well, that's the width of the gap, that gap, and that's how much separation I have, and and and that is the only information you then really have. You have no idea as to whether stuff works, that should be working or not. Right? And and like I said, fossil functionality is is a big thing. So I would always say that you you want to do a bit more than that. You want to do some exercises and see if the if you can feel the right muscle at the right time doing the right thing. Right? And again, pelvic floor physio, women's health specialist, or any any good postpartum personal trainer, any good personal trainer would be able to do that bit, right? Um, because it's not difficult to do some and some wood choppers and all that type of stuff, uh, some individual leg raises or and and just to see what you can get away with, even planks and all that sort of stuff, side planks, just to see if you're wood choppers, uh, downward wood choppers, all that type of stuff, is all a good indicator to see whether you feel the right muscles doing the right thing at the right time, right? So you want to do a little assessment. Uh, very regularly have I come across people that have had virtually zero um what we would call uh diastasis rectus. So the gap is below two and a half centimeters. Um the depth isn't particularly great either, and and the stomach is flat, but the muscles aren't working properly. Uh that happens a lot more than you think it does. Um and therefore, you know, you want to assess that a little bit and and and do some exercises. That is fundamentally all there's to it with diastasis rectum. Um what we do hear a lot is the the idea that this heals automatically is that is kind of just not true. It's it's it's it does if you only include the the width of the gap, right? So a hundred percent of all people who have been pregnant and carried the term one way or the other, uh, will have had some sort of separation. That is, and that I mean 100%, that is a hundred percent. Now, 80% of those would go back to the gap, the width of the gap being below two and a half centimeters within a year. Um for whatever reason, that's just time is a great healer, so to speak, and that that that gap narrows. For 20% of people, they need a bit more help with with the width, it will never come back by itself. The issue is that within that 80% mark, uh that 80% uh number of people, a lot of them, and I would argue hardly any, um most of most people in that 80% group, um, will have some sort of muscle issues. The strength is in the back, or it's not quite working properly, etc. etc. Um, and it can lead to back pain and neck pain and and and all that sort of thing. And it just leads to general weakness overall, right? Um this is why I always say uh 100% of women postpartum need some sort of exercise routine, some sort of physio, some but it's again can be uh pelvic floor specialist, um women's health specialist, a good postpartum personal trainer. It doesn't really matter. Um should be free, right? This don't get me wrong. I'm not selling anything here. I believe this stuff should be free. This is why I think it should be free, because 100% of women need it. Now, admittedly, you could say to yourself, and listen, I don't have time for this, and it's completely fine, but you should have the option, it should be available for you, right? That it seems to me a no-brainer that that that it should be. Um, because it's a condition, 100% of all people who've who've almost gone to term, um then and and and deliver the baby, um, 100% of them have this. So that's an absolute absolute no-brainer for me. Um

A Simple 12-Week Rehab Path

Peter 18:08

that is fundamentally the the basic of the basis of of of diastasis reactor, right? Um birth of the gap, gap, sure, depth of the gap, yeah, sure. Um, and the functionality. Now, the way to recover from uh diastasis, and and and it is it's just rehab exercises, right? It's so that means that if we treat diastasis like an injury, and I'm not supposed to doing this, and this goes for diastastasis in men as well, which is usually actually is an injury. Um I know um who was his face? It was on the podcast a long time ago, Anthony Lowe. He says it's it's not an injury, it's an adaptation, and and and I get what he's saying. I just uh and I think it's a convincing argument, as in during pregnancy, it is important that you get that that group of muscles separate simply because you need space for the baby, and not separating would lead to much, much bigger issues. Um, but after a while, postpartum, it it outlives its usefulness, and then we need to treat it like rehab from an injury, as far as I'm concerned. Um, and also the why doesn't matter, right? It's just words, it's not an injury, it's an adaptation. Yeah, sure, it sounds better, but it's fundamentally. How do we fix it? Is what the big problem is, is is is is what the big question is. Um, so how do we fix it? Is by first of all, you start the first four to six weeks with uh muscle activation stuff, boring muscle activation things. Uh, you do some squats, you do some reverse lunges, you do some um glute bridges, all that type of stuff. Side plank with dips, all that sort of fun stuff. Um, the HP and B program, again, free for the first three months and very cheap afterwards. But if you sign up for uh on day one and then you cancel it, you still get three months, completely free access. Um, is very clear on what we do here, right? Some glute bridges, some heel taps, all that type of stuff. Basically, just getting the right muscle to do the right thing at the right time. That's the first four to six weeks. After that, you function on strengthening up. When the muscle works properly, we can put some more load on it, right? We can uh make the exercises a bit more difficult and ask the body to do a bit more because now we know we're asking the right muscles to do the right thing at the right time and and and they're responding at the right time. Now we make it a bit more difficult so they strengthen up, right? That that's another I don't know, four to six weeks, something like that. All this stuff is a little bit how long is a pizza string because it depends on when you give birth, kind of birth you had, whether it was traumatic, whether your labor was easy. Um if you give birth 20 years ago and you've had diastys ever since, we can still repair it, but it just takes a bit longer. All all that type of stuff. So, this is all how long is a pizza string. Um and but after that second four to six weeks, after about 12 weeks, you can go back to your merry little life. Your your merry little life is great. You can go back to the gym, you can go swimming, because now what we've done is we've established that the body can do the right thing at the right time, and you are familiar with how things should feel. And you should be familiar with how things move. So that if you go swimming or running or whatever, that you know how things should feel when you move, and if you do that, then any exercise you do will help heal diastasis. Any single one of them, and that can that can be swimming and it can be resistance training. And all that type of stuff. The the specific exercise ma matters a lot less um after after that 12 week stage. This is why I tend to train a lot of people, work with a lot of people for like 24 sessions. People do like two a week with me. And um, this is only face to face, right? So I'm not selling anything anything. But um after 12 weeks, boom, we're done. Go back to playing sports, go back to your daily life, go back to not doing anything. Um, go back to your other personal trainer. That's completely fine. That's fine by me. At that stage, you're good to go. Because you know how things should feel, and everything, even bicep goals and bent over rows, at that stage will help heal you. Now, that's right, because you know how to do them properly, and you know how your body should feel, your core should feel at that stage. That doesn't mean at that stage you're you're completely recovered, but you're far enough on your way that anything after that, that there will be a full recovery after that, as long as you take the lessons on board with regards to especially like things like breathing and all that type of stuff. Um and that's fundamentally it as far as diastasis is concerned. It it is not rocket science, it's not a big scary thing, it's a pain in the bum, admittedly, but uh it can be, but it and it can feel embarrassing, but fundamentally there isn't an issue that can be resolved. That's the big thing, the big lesson I want people to take away with regards to diastasis. Back pain,

Back Pain Links To Core Control

Peter 23:35

funnily enough, often when we heal diastasis, a lot of the lower back pain also goes away because quite often lower back pain isn't actually caused by the lower back, it's caused by other muscles not doing what they're supposed to do. And like I said, we've taught the body to do what it's supposed to do at the right time, and therefore, you know, we're good. Neck pain is different. Now, I I get a lot of emails about neck pain, and neck pain is a little bit of a how long is a piece of string sort of situation. I think there are so many factors that I always tell people go to go go to see someone

Postpartum Neck Pain And Breastfeeding

Peter 24:15

face to face if you can. It's uh Kitty's noise in the background, by the way. Um and I'm not waking my dog up, right? You know these, you know this. Um so the neck pain thing is like I said, it can come from many things. Postpartum, there it tends to be two things stress, we all know that, right? Stress of a new baby and all that type of stuff, and old babies and husbands and work and all that sort of thing. Stress is uh plays a huge part. The second part is um carrying new baby or breastfeeding because during breastfeeding you quite often put yourself in a slightly weird position, right? The same goes for expression, but especially uh especially breastfeeding. What happens a lot is people women fold in on themselves a little bit, and that actually puts quite a lot of strain on the neck, but it's not as relaxing as as you think it is. Now the issue quite often when you when you give postpartum advice, or when you get postpartum advice at least, is that the advice they people are giving you is not practical, right? So I would say, well, you should breastfeed differently. Yeah, that's not happening. You have to breastfeed, you have to do that as easy as possible and make it as comfortable as possible. Um, and therefore you're going to do that in that way, right? A lot of the advice we have to give postpartum is to do with how you can still live your life, still do all the things that aren't great for you, uh, and then just say fix it. We'll fix it at a later stage. Um, but in the meantime, do you want to ease it off a little bit? So the natural action when you put your body in a certain position, so you fold in on yourself a lot, and if that causes a bit of tightness in the neck, the natural exercise to help alleviate that is to pull everything back into its original position. This is why a good postpartum exercise program isn't heavy on chest-related exercise, but is much heavier on uh back-related exercises. Uh pull motions instead of push motions, if you will. If you want to get a bit more uh PTE about it. Um we want to strengthen the backup so that when and and and your shoulder blades and um basically your scapula, your rhomboids, and and and all that sort of stuff, you want to make sure that that stays in position as soon as it's done being out of position, but it move back in position as much as as we can. So that if you're breastfeeding for X amount of time, uh several times a day, that you don't spend too much time in that position. And it's very similar to the rehab type stuff that we would give to people who are stuck at a desk a lot and have uh neck pain because of that, because it's not it's not that different, believe it or not. Um right, because the posture from someone sitting behind a desk is usually pretty terrible as well. So um, so what I would argue is that things like scapular wall slides are ridiculously useful. Bent over rows as well, you know, some backflies and all that sort of stuff don't go amiss, but things like scapular wall slides, and again the videos are on our YouTube channel, um are ridiculously good and they're easy to do. And you do three sets of ten every single time you've done your breastfeeding, three sets of ten doesn't even take that long, and this is just a bodyweight exercise up against the wall, right? So it's uh as Dinky gets very loud now with snojies. Um so that is basically where you start. Three sets of ten. It's bodyweight stuff, everybody's got a wall, and as long as you do them properly, you just pull everything back into the position we want it to be at, and that usually causes neck pain to go away much more effectively than say asking your husband for or your or your partner for a massage, right? Because then you just get a crappy massage and it alleviates or putting a heat pad on it, anything like that. The heat pad is not necessarily effective with actually resolving the problem. It brings temporary relief, sure, but it doesn't actually resolve the problem. And that is where we are kind of with with the neck pain thing. It is really with postpartum neck pain, right? If it's just caused by things like breastfeeding and all that sort of stuff, the treatment is the same as the stuck behind the desk sort of posture workouts, which are tons of them, tons of them are free online. And I'm just saying, you don't necessarily need a specialist for your postpartum neck pain. For your pelvic floor, yes, because that's way too complex. Um but for you for your neck pain, usually not so much. And you definitely just just so we're very clear, you definitely 100% do not need a chiropractor. Well, that's sinking a little bit. Don't spend your money on a chiropractor postpartum. You don't need it. That is not what this is. Um if there is actually such a thing as that is what this is.

Practical Fixes Plus Final Notes

Peter 29:55

I'm not a big fan. Um anyways, Peter at healthypostnatal body.com. Welcome if you're new. And that is it for today. Um if you have any questions, any comments, because Dinky is now finally quiet and moving. Um if you have any questions and comments, please do send me an email. I always get back to you. Um there's a link in the in the in in the podcast description as well. Now it's an automatic link that you can email. Uh if you click on that, you can email in. I've never tested it, but BuzzProut assures me it works. And I do get emails, I just can't tell where they're coming from. Anywho, here's a new bit of music. You take care of yourself.

unknown 30:34

Bye now.