Friday, September 14, 2012

Diastasis Physical Therapy

Note: I wrote this post on May 20, 2011. For some reason I never got around to publishing it, even though it was complete. Google searches on diastasis are one of the main things that bring people into my blog, so I wanted to push this post live. I did physical therapy for around 4 months after my twins were born. As soon as I stopped wearing my abdominal brace, my abdomen relaxed and went back to sticking out. The exercises did little to improve a tear as severe as mine. At some point in the future I will have corrective surgery. I have started a post discussing how diastasis has affected my current pregnancy which should be live soon. I hope that by documenting my journey others with similar issues are able to find some answers to their questions or insights about this issue, as there is not a lot online that isn't a sales pitch or marketing gimmick for an abdominal binder or surgical practice. I am blessed to have these issues, since they are a result of my beautiful children, but I still struggle with the changes I have undergone and how they make me feel about myself as a woman. I think this is only natural and I am not apologetic for my insecurities. 

Last Friday marked my first day of physical therapy for my stomach. I have two follow-up appointments scheduled, so I'm seeing the therapist every two weeks. She's given me exercises to do on my own daily, which I'll detail below, and I've been instructed to wear an abdominal splint 24/7.

In the 7 days since my first therapy session, I've managed to fit in the exercises five times. They aren't time consuming, or even what I'd call hard. But they do require that Joe is home to help mitigate fussy babies, and since he's had a couple of long work weeks and his MBA classes have started back up, well there hasn't been a lot of time for me to be alone. And at the end of the day I'm exhausted. But 5 out of 7 ain't bad. Right?

I definitely see an improvement in how much my stomach sticks out, but I can't tell if that's because I've been splinted for a week or if the exercises are helping. Or maybe both. I have a terrible fear that once I stop wearing the splints everything will fall forward again and I'll go back to looking 17 weeks pregnant again.

At 18 weeks postpartum, I have lost all of the weight I gained while pregnant. So that is not one of my issues. When I got to the therapist's office she looked over my stomach and had me do some moves which allowed her to check the severity of my diastasis. She told me that my abdominal separation is so severe that, while the exercises and splinting will help, the only fix for me is surgery.

I have two specialized braces. The Taut is the one I was told to wear for everyday use and the Tupler Splint is the one I was told to wear while working out. The only times I am supposed to take off the braces are when I shower and when I'm doing the prescribed exercises so I can connect with my body and feel where I'm supposed to be breathing from or pulling in from.

Hearing that surgery was my only option killed me. But after doing some research I've read over and over again that diastasis is correctable through splinting (which provides focused support to close that gap in the outermost abdominal muscle formed during pregnancy allowing the connective tissue to heal) and the prescribed exercises. So I'm holding onto the fact that I can fix this and I'm giving it time.

Here are the three exercises I was given to start with:

1.) Spinal Massage (also known as spine torture)

I have a 4" ball that I purchased from the therapist for this exercise. You start by lying on your back (lying down and sitting up you are to start on your side and use your arms to guide you like you would when you are pregnant) and placing the ball between your shoulder blades. Place your hands behind your head and let your head and elbows hang (don't hold up like you're doing a crunch). Knees are bent with feet flat on the floor. Let your body stretch over the ball focusing on closing your rib cage and pulling your ribs back toward your spine. Hold the ball in place until the muscles start to relax (approximately 30 seconds to 1 minute) then use your legs/feet to slide the ball down your spine in 1" increments and repeat the stretching/relaxing section by section until the ball reaches your tailbone. Roll to your side to release the ball and then allow yourself to lie flat on your back and relax the spine completely. Roll to the side and use your arms to sit back up.

{ the ball I purchased from the therapist }

The next two exercises are performed seated with body weight centered over the pelvis and shoulders back. Place your hands over your belly to connect with your breathing. I sit criss cross applesauce (aka indian style) on a relatively firm pillow. My butt is on the pillow and my legs are in front of it.

2.) 30 Second Hold

Begin with a belly breath, then exhale and contract the abdominals by drawing the belly button all the way to the spine. Imagine you are touching the spine with your belly button. Hold it here and count out loud for 30 counts. Do 5 sets of this exercise per day.

3.) Repeating Transverse

This exercise starts in the same position as the 30 Second Hold, however it is a pulsed contraction. Begin with a belly breath, exhale and draw abs to your spine. This is the starting position. Hold this contraction for a count and then release the muscles halfway out. Repeat this back and forth motion. Count out loud for 50 repetitions. Do 2 sets per day.

So those are my exercises. Wash, rinse, repeat. And never miss a day. One thing I really did appreciate about this woman is that she told me it's okay to be angry about what happened to my body and mourn the loss of it. That my children and my love for them is completely separate from my feelings about my body and what the pregnancy did to me. I needed to hear that. So many people have suggested that my frustration with my PP body is PPD or an eating disorder. I needed to know that it's okay to be angry that this is the result of my pregnancy the same way I am elated that Reese and Ryan are the result of my pregnancy.

Anyway, I have NO idea when I would get an abdominoplasty or if I would get one. You can't pick up your kids for 6 weeks post surgery and then there's the recovery afterward. So I need to get past baby #3 and then get through the first year or two of his/her life before it's even an option for me. I didn't have a section, so I'm upset about having a scar on my body from the surgery and I'm terrified of having surgery altogether.

It's been very hard for me to recover as a woman - I don't feel sexy and I'm embarrassed about my body. And not only has that taken a toll on me emotionally, but it's impacted the physical parts of my marriage as well. I need to get over myself. I know I do. But it's hard.

You can read more about my experience with diastasis herehere and here

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