Wearing a diastasis recti splint or binder, belly-binding, wearing a corset when exercising (even one specifically designed to be worn for exercise and to ‘reduce a diastasis’) may ‘hold you in and together’ and support your lower back whilst you’re wearing it, BUT what it can never do, is actually strengthen or tighten the muscles just by being worn.

Diastasis recti or abdominal separation can be improved with alignment and exercise along with healing nutrition – by reconnecting and restoring your core muscles, and by improving the integrity of the connective collagen at the front of your tummy to reduce the size of your waist, and to increase stability and strength.

To reduce a diastasis gap you need to learn to engage and work your entire core: transverse, pelvic floor and oblique abdominal muscles in an optimal, functional way. Your whole body alignment must be addressed as a foundation in order to reduce intra abdominal pressure . This is not just about the gap…

There needs to be a physiological and even emotional (brain talking to muscle) connection to repair and restore  the core. If you are sucking in your stomach, this is not ‘activating your core muscles’, but rather simply displacing mass upwards and downwards – squeezing it away in either direction from the tightly bound centre. Imagine a tube of toothpaste squeezed in the middle – what was inside has to go somewhere. In the case of your midsection, it goes upwards placing pressure on the diaphragm and downwards onto the pelvic floor. This creates further excessive intra abdominal pressure, worsening a weakened pelvic floor – even putting you at risk of pelvic organ prolapse – and achieving little in terms of real transverse abdominis engagement.

There is more to core repair than splinting, sucking in and closing the gap… restoring our core after childbirth is an integrated process that requires an integrated ‘whole body’ approach.

For your own confidence and comfort as you recover and work on restoring your core muscles after childbirth, by all means wear some ‘magic pants’ to hold it all in.

But if you want it to stay in… you need to re-align and re-connect. MUTU System shows you how.

MUTU System programs, endorsed by specialist physical therapists and physios worldwide, are grounded in a whole-body approach to alignment and foundation core connection for natural activation. MUTU System has never advocated the use of a splint or binder to ‘pull’ a compromised core or diastasis recti back into place. New research from Diane Lee confirms this hypothesis – that merely to aspire to ‘close the gap’ is neither helpful not anatomically correct.

MUTU System has a philosophy of empowering and achieving deep connection, both physiological and psychological, along with whole body, natural movement rather than excessive or isolated ‘core work’, and I passionately encourage you to educate yourself with this new knowledge.

NEW DIASTASIS RESEARCH FROM DIANE LEE PT

Highly respected Physiotherapist Diane Lee PT with Paul Hodges has presented new clinical findings on treating diastasis recti. Lee’s clinical findings and teaching have long been widely regarded as an authority on diastasis recti, as well as pelvic girdle pain, incontinence and pelvic organ prolapse.

Discussion had previously centred around solutions to ‘closing the gap’ as well as seeking a protocol or ‘maximum gap’ at which surgery would be deemed necessary (or when a diastasis was unable to be narrowed with exercise).

More recently Diane Lee began a clinical study to investigate diastasis recti in detail with funding from the University of Queensland. Some of the findings were presented to the Associated Charter of Physiotherapists in Women’s Health Conference in Bristol, England, September 2013.  The lecture “New Perspectives from The Integrated Systems Model for Treating Women with Pelvic Girdle Pain, Urinary Incontinence, Pelvic Organ Prolapse, and Diastasis Rectus Abdominis” is now public and can be viewed in full here.

As part of their research Lee and Hodges studied not only the distance between the 2 sides of the abdominals or ‘inter-recti distance’, both at rest and during exercise, but importantly, the quality of the deep transverse abdominis muscle activation during that exercise. Some women could narrow the gap by engaging their abdominals, but they achieved this by an unconscious,  non optimal recruitment of the abdominals.

This means that they could make the gap come together by contracting their obliques for example, but the deep core transverse muscle, the one necessary for true trunk stability, was not being recruited at all. The result = a temporarily narrower gap, but still no tension (stability) restored in the midline.

Some other women were able to effectively recruit their transverse muscle for complete stability and tension in the linea alba… but in doing so the gap itself either stayed the same or even widened.

This suggests, that without core stability from recruitment of the deep core muscles – transverse abdominis and co-activation of the pelvic floor – the woman is no more able to control joint movement or load bearing than before – regardless of the gap.

The ability to connect with, restore + recruit (use) the deep muscles of your core correctly… is vital to gaining function + strength. Merely pulling the gap closed… isn’t. MUTU System’s whole-body approach to restoring core function, is the anatomically correct approach.

There is of course much more to the study than my brief comments here and despite its ‘for medical peers’ technical content, I encourage you to watch the full lectures if you can.

These findings cast still further doubt on the protocol of those diastasis programs in which the manual or forced drawing together of the 2 sides of muscle (‘closing the gap’) by binding or splinting, is proposed as the solution for restoring core function.

Contrary to popular belief, diastasis recti is not the reason for a ‘mummy tummy’. We need to think bigger than one muscle.

Putting tummies back where you want them is what MUTU System DOES. MUTU System shows you how to re-train your core and pelvic floor do their job, and how to get your tummy strong and toned.

And I will never tire of telling you… that it’s NOT ALL ABOUT THE GAP. Diastasis has become this kind of scapegoat, the Stooge, the fall-guy for all ‘mummy tummy’ woes. “Fix that gap, your tummy will be flat”, we’re told. “Nothing works right or looks rightbecause you have diastasis recti“. No.

It’s important, as it contributes to instability and weakness of the core, which is why MUTU System tackles it. But it’s not IT. And if you tackle diastasis in isolation, you’ll never get the tummy you want.

You can narrow the gap and strengthen and flatten your abs with the right exercise. You can adjust your whole body alignment and stretch and work your muscles to get a strong functioning core and pelvic floor. You can lose fat. MUTU System‘s quite good for all of that incidentally. But you might not *fuse* the 2 parts of the rectus abdominis muscle tightly back together again. Which is actually, perfectly OK.

Diastasis recti is a problem when: it causes a pooch tummy, and when it contributes to a weak, unstable core, when your back hurts, your tummy sticks out and your pelvic floor doesn’t quite work. 66% of women with diastasis recti have some level of pelvic floor dysfunction (Spitznagle et al 2007). Diastasis recti and pelvic floor problems tend to go together.

It is a problem when: the connective tissue is stretched and the muscles of your core can no longer support your pelvic and abdominal region; when the gap is wide or the mid-line weak.

A problematic Diastasis Recti  is a result of excessive intra-abdominal pressure. Pressure within the cavity that the muscles of your abdomen and pelvis can’t withstand – so they all push away and out and down 🙁 …And nobody wants a tummy or a pelvic floor pushing that way.

It’s the same excessive, uncontain-able pressure that causes hernia or prolapse. You have excessive intra abdominal pressure because your core (that’s your abdominal muscles, along with your pelvic floor and the muscles of your lower back) are not working optimally. Your pelvis is not aligned quite right, your core is not doing its job quite right – of containing that natural pressure. Address your alignment as a priority and your body can start to fix itself.

Lose the fat covering up your strong, toned tummy. (That part’s important BTW. A few pounds of flesh sitting on top of your muscles, parted or not, are going to make your tummy hang out. Just sayin’)

Nourish your  body so it can heal and the collagen will rebuild so the midline of your abdomen can regenerate and gain strength.

Will a small gap remain? Possibly. Does it matter? Not really. And Measuring It All the Time is definitely not helping.

I developed the MUTU System program because I believe that to tell women that if they just ‘close the gap’ (with surgery, or by holding it together with a splint or binder of some sort) then their tummy will lie flat, is doing women a disservice.

If you want a flatter tummy after having a baby – you need to start with the big picture. The whole SYSTEM of muscles that work, support and shape the midsection of your body.

GetStartedNowYour body doesn’t ‘work or not work right’, or ‘look or not look right’ because of one muscle. So lets start fixing the WHOLE WOMAN and stop obsessing over the gap?

Solutions for dealing with diastasis recti must be grounded in the principle that correct function of the Transverse Abdominis muscle and the entire core is crucial for maintaining optimal function of the entire lumbo-pelvic region. Ie, your mid-section, from diaphragm (up inside your rib cage) through your waist, tummy, lower back and pelvic floor.

MUTU System is based on the principle of dynamic movement and optimal functioning of your entire midsection including your pelvic floor in CORRECT ALIGNMENT… to achieve the flat stomach, toned pelvic floor (that’s toned, not tight – there’s a difference) as well as the stability, comfort and freedom from pain you want.

This is important: MUTU System was not created to deal only with diastasis recti.

Correcting diastasis recti is not the sole focus of MUTU System programs, rather it is one of the results you can expect! Diastasis is not, in my view, an isolated issue or the ‘Holy Grail’ of healing women’s bodies after childbirth. ‘Fixing’ diastasis in isolation won’t fix your body.

Correcting a diastasis  it is one piece of the jigsaw in regaining stability and strength, a jigsaw which encompasses a whole system of muscles and functions of the lumbo-pelvic region.

My own study + over a decade’s experience of working with pregnant and postpartum women has taught me that to suggest that simply ‘closing the gap’ would result in a flat tummy after having babies, would be doing moms a disservice. Because there’s rather more to it than that.

SOME IMPORTANT MUTU PRINCIPLES

  • Diastasis Recti is not the original problem. It’s what caused the diastasis recti thats the problem, and that is: excessive and un-contained intra abdominal pressure. This is corrected through correct alignment, first and foremost. Alignment, rather than binding or multiple repetitions of any exercise, is key.
  • The ABILITY TO CREATE TENSION in the mid-line is more important than the width of the gap . It is the ability to restore tension and stability of the fascia, or Raphe (the collagen connective tissue between the 2 sides of the abdominal muscles made of the Linea Alba and Linea Semiluniaris ) which is the key factor, not just the existence of a gap
  • Don’t ignore other factors: poor nutrition, stress, fatigue, excessive calorie consumption, inadequate essential fats or hydration, digestive issues and lack of the correct, safe and most efficient and effective exercise… will all contribute to your body’s ability to heal, as well as how much your stomach sticks out or overhangs! If you want to *see* the results of core training and strengthening, you have to lose the fat that sits on top. As above, it’s not all about the gap
  • No exercise routine can ‘treat’ or ‘fix’ every situation . In some situations of a severely compromised, stretched and weakend linea alba (the connective tissue between the 2 parts of muscle), surgery may be required for correct function + stability is to be restored*. A biomechanical and ultrasound examination will be necessary to determine this. BUT… 1.  this is often not the case and 2. Surgery is extremely expensive, has a long and uncomfortable recovery and will do nothing for your strength, tone, weight or overall fitness. A focused postpartum core restoration program will benefit your entire lumbopelvic region greatly especially in recovery, even where surgery is deemed necessary.

GetStartedNowMUTU System training and programmes have a holistic philosophy, which deals with posture, functional exercise (IE metabolic resistance exercise techniques that make you truly strong, lean and ‘fit for purpose’), optimal nutrition for health, hormone balance and energy, specific yoga techniques to help re-settle the pelvic organs,  tone and heal the deep muscles as well as relieve stress and promote optimal respiration… AND at the foundation of it all, a complete 4-Phase program to train (find) and then strengthen the muscles of your core. Narrowing a diastasis recti is one of many beneficial effects.

Remember that you are not trying to close the gap for its own sake, or for purely aesthetic reasons (although improving the look of your stomach is clearly a motivating factor).

A diastasis is a manifestation of a lumbopelvis, or core, that has experienced excessive intra-abdominal pressure (ie pressure that pushes or causes bulging out – in the case of your stomach – or down – in the case of your pelvic floor-) and sustained abdominal loading (functioning) with incorrect technique.

It is a sign that you have excessive pressure pushing outwards from within your pelvis and abdomen – the Diastasis is a SYMPTOM, it is not the cause….To address only the symptom by binding or sucking in your stomach will NOT solve the whole problem.

There is a difference between training (finding and correctly engaging) the core, and strengthening it. You can’t do the latter without the former. As respected Physiotherapist Diane Lee* says: ‘You can’t strengthen a muscle your brain isn’t talking to’. For many of us, the after-effects of childbirth mean that our brain is not talking to the right muscles. We have to re-learn how to use them.

MUTU System does not suggest you constantly splint or bind your stomach. In cases of a very severe gap or compromised sensitivity immediately following abdominal surgery, some form of temporary binding may be advised by your medical caregiver and may be helpful for comfort and to help you focus. But the splint doesn’t do the work, your muscles have to. Splinting or binding is not an element of MUTU System programs, as we do not consider that the anatomy of the linea alba and rectus abdominis is consistent with simply approximating (manually bringing together) the 2 sides) as a solution to regain function.

RESOURCES and REFERENCES
*For further excellent information on Diastasis and Postpartum Core Health: See Diane Lee and Associates articles here

** From the 2012 3rd International Fascia Research Congress: Diane Lee: Split down the middle? Clinical Findings Suggest Closure of a Diastasis Rectus Abdominis is Not Always Necessary for Restoring Function (if link doesn’t take you direct to the abstract, scroll down to No.8 ‘New Hypotheses’, 3rd paper)

For excellent information on alignment and diastasis, see Katy Bowman’s work at Aligned and Well