In my last post I talked about the stressors which might lead to having an abdominal separation, and how a 2016 study found that nearly 60% of women have some sort of surface abdominal separation during pregnancy or postpartum. The last post also talked about some of the simple things we can do to avoid and reduce the chances for having a Diastasis Recti (DR).
But what if we already have one and we still want to create deeper strength, or regain stability through the whole core body? Should we just be popping back into crunches and planks? (A hint the answer is NO!)
Repairing a DR requires doing some targeted work on the deeper muscles of the core, specifically the TA and its partner the pelvic floor. These two form the walls and floor of the abdominal “soda can”, and their action is what gradually draws the surface walls of the rectus abdominus muscles (the six pack) back towards the midline where they can eventually rethread. The wider the separation, the more work these deep support muscles need. exercises like head lift crunches, and prone plank positions load the rectus abdominal muscles, but may not ensure adequate support from the base layers. The result? increased pressure pushing out on a layer which isn’t integrated, and a corresponding “tent” pushing forward. This is when the abdominal muscles bulge upwards away from the spine, pushing an already separated muscle farther apart. This winds up bring the exact opposite action than what we want for deep healing.
The solution? Well first remove those head-lift ab exercises, and yes that includes the yoga bicycle! Then go back to the beginning and find a way to reinforce the transverse abs before loading the center. How? This is where splinting comes in.
Splinting is a technique whereby we use a prop- like a scarf or even our hands to create the action which is lacking in the TA muscle group, so the surface muscles stay connected. Your TA fibers run sideways through the middle of your body, beginning on a wide fascia sheath in the front and then wrapping around to connect to the processes of the spine. Their action is to cinch around the core body and hold the organs and upper core layers together. To help them, we need to wrap something around our center, and use it to create the same gathering action. Like a spotter when weightlifting at the gym, the splint can then take up the force the TA isn’t yet able to create.
Here’s how it works:
Grab a solid scarf or yoga strap (note the scarf shouldn’t be able to stretch for this). Come onto your back (Sliding to your side first then rolling onto your back). Life your hips and place the scarf under your back, ideally directly behind the widest spot of your separation. With the hips back on the ground, cross the tails of the scarf over your abdomen, holding them with the opposite hands. Gently pull the scarf so it hugs (but does not compress) around your abdomen. This is your starting position.
Splinting the abdominal wall with a yoga strap
Now, beginning with abdominal breathing. Inhale and feel your belly, ribs, lower back, and pelvic floor expand. On the exhale actively draw these 4 points inwards towards the middle of the body, and up towards your head. At the same time, gently pull on the tails of the scarf so it cinches tighter around your abdomen- assisting the 4 sides in coming in and up. The point is not to do the action with the scarf, but to use it to further stabilize. On the inhale release and expand again, and repeat several times.
This is the basic splinting technique. But where it truly begins to shine is when it is employed in beginning abdominal work. Talk a single leg lift, one of the basic front abdominal exercises in the Om Births Ab Rehab program. Beginning on your back with the spine in neutral, exhale to engage the deep core (as above) and raise one leg to a 90 degree bend above your hip. The pelvis should remain completely stationary, and the front abdominals should remain steady, without doming or tenting upwards. Now if you are dealing with a separation, often as the leg lifts, the core will begin to dome up, putting increased pressure on the separated muscle layer. We help this by actively drawing the sides where things are widening together with the scarf. While splinting, I instruct students to try and pull their muscles off the scarf. Eventually, these actions together train the deeper core to engage in a supportive manner, which lets people begin to work into more challenging core work safely. The splint is meant to be a supportive tool- not a permanent crutch.
Once you understand the action the splint in assisting, you can find other ways to create the support, such as using your hands to bring the side waist together if you are attempting a head lift exercise (a note: I don’t recommend these until you have good deep control as they load the rectus abdominis which is the separated muscle)
Bringing the core together also isn’t solely the job of the Transverse Abdominis muscles. An often missed partner in this action is the support of the pelvic floor. The nerves enervating the pelvic floor also have branches which impact the TA, so if we truly want to TA to be functioning well, we have to incorporate the pelvic floor.
To incorporate the pelvic floor along with the TA action, think of drawing the front hip points together (as though pulling the scarf around them), and at the same time lift your navel towards your heart. Yes to your heart- not back to your spine! Pulling the navel to the spine misses the larger support action of the whole core, and also creates more lower back tenson by squeezing everything together. Never mind the way this action brings the focus to having a flat stomach, which in itself is not actually a sign of a strong core. Practice exhaling and gathering the pelvic floor in and up in coordination with the TA engagement until it becomes smooth and you are able to breathe easily throughout. (This is not a hold the breath moment!). Then incorporate the pelvic floor into the abdominal splinting and go back to the single leg lift or head crunch and see if you are better able to draw the sides of the waist away from the scarf.
You may note that all the exercises mentioned so far have been supine. This is so if the TA isn’t able to work effectively, gravity will still push things back towards our center. Once we have better coordination throughout the front abdominal line, we can begin flipping the pose over and progress into actions from table pose, or begin working towards planks. But until the front wall can support itself, don’t put that separated rectus abdominis in a position where it will have to hold all the weight without support.
Once we can feel the deeper abs engaging we can gradually lessen the work with the scarf and begin working into pelvic tilts, and single leg lifts without letting the abs revert back to doming or tenting. Remember, it was the lack of deep core support that contributed to the DR in the first place, so don’t go back there to try and fix it. Establish the foundation, and then build from there. In the Ab Rehab program the exercises gradually build from beginning to challenging levels. The way you know you are ready to progress is that when you add the next leg, or lift an arm in table, the core stays connected and engaged. This means it is able to provide the needed support. If at any point the core begins to tent again, and it can’t be corrected, then this is the limit of your exercise, and it’s time to return to an earlier level- or take a break.
I am always delighted when I see students back off the their own appropriate level. This inner guidance ultimately helps the body develop balanced and functional strength throughout. It also means you’ll be back to your daily movement faster, and in better form.
Key Takeaways
When beginning core work with an abdominal separation it is important to create the support needed so as not to further exacerbate the existing Diastasis Recti.
Splinting around the abdomen at the point of separation with a scarf or hands can help draw things back together
When splinting do not use the scarf as a crutch, try and create the action the scarf is create for yourself.
The front abdominals are not the only group involved in regaining core stability. The pelvic floor needs coordination also.
Avoid head lift core exercises until you can maintain a stable pelvis and abdominal center.
Once you feel you have deeper control, begin easing the squeezing action of the scarf and see if you can still maintain the form. If you can, then you might be able to remove the scarf, but if the abdominals begin to tent or dome, or the pelvis loses stability, you are better off going back to a braced or an easier exercise where control can be maintained. Slow and steady gets you moving faster.