Healing a diastasis without a splint or binder
We are often asked if we recommend using a binder or splint for diastasis recti.
Solutions for dealing with diastasis recti must be grounded in the principle that the 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 the diaphragm (up inside your rib cage) through your waist, tummy, lower back and pelvic floor.
To restore stability, strength and aesthetics to a mother’s abdominal muscles (including narrowing a diastasis recti), correct engagement and function of the entire core and related structures have to be one of the key areas of focus.
Most programs will agree that crunches, planks, sit-ups and yoga moves such as Boat Pose are not recommended. These guidelines you will find common to any exercise routine that understands a new mother’s body… if your trainer has you doing crunches, get a new one!
MUTU System is not designed to deal only with diastasis recti
MUTU System is a holistic program, aiming to achieve correct alignment and functioning of the entire core, in fact, the entire body. Not just one muscle or just the gap, even with the use of a binder or splint.
New research from Lee. D and Hodges. PW presented to the Associated Charter of Physiotherapists in Women’s Health Conference in Bristol, England, September 2013 concludes that a whole-body approach, rather than using a splint or binding, is the more anatomically correct approach.
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 lumbopelvic 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. That is why we don’t recommend the use of a splint or binder.
Some important MUTU principles
- Diastasis recti is not the original problem. It’s what caused the diastasis recti that’s 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 wearing a splint 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 weakened 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.
MUTU System has 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 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).
Wrapping, binding, and wearing a splint
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.
Other manifestations of excessive intra-abdominal pressure or weakened core function may be hernia, prolapse, incontinence or back pain. You may suffer from one or more of these related conditions.
All these problems emanate from the same issue: a core that isn’t working properly. You can exercise until you drop, but unless your midsection is working correctly – none of the above abdominal and pelvic issues will improve (and they may get worse).
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.
The MUTU System Program
The program teaches, guides and demonstrates how to re-train your core to do its job. At first, this is a focussed, daily series of exercises and alignment adjustments which take around 10 minutes to complete. You move at your pace through 4 phases of exercises and techniques, re-assessing at each stage when you are ready to move onto the next. You also learn some very specific breathing techniques which make these exercises more effective and enable you to connect fully to the muscles again.
In our Program, which includes fitness and fat loss as well as core restoration, alongside this daily routine, you gradually build up a workout routine that shapes and tones your entire body whilst – and this is the vital part! – using your core correctly in every MUTU Intensive workout. You are not only learning how to exercise incredibly effectively in only 15 minutes a few times a week, but you are also doing it whilst working your core safely and correctly with every move.
Essentially you are learning how to make every exercise, an abdominal exercise!
When you reach Phase 4, or full core strength and stability, only then would you safely incorporate moves such as a plank, and you no longer need to continue with the separate daily core training exercises. On reaching full core strength and stability, you are now using your core correctly every time you move and workout.
Your body is now working – so you can continue with your MUTU Intensive workouts, keep going with the stretches you love, your new-found improved alignment and function, your MUTU Breathing techniques, and/or indeed any other chosen sport or activity… knowing you’re working your abs with every move!
The key defining points of MUTU System
- MUTU System deals with your whole body: whole body alignment posture and function, improving pelvic floor control, and training your core. In the Program it also covers flattening your stomach by eating right and how to shop and cook family-friendly food that keeps you all lean and healthy, dealing with stress… its a System built for moms which covers everything – in 10 minutes a day of Core training, alongside 15 minute intensive workouts 4-5 times a week. Note, high intensity does not have to mean high impact – there are no- and low- impact versions of all workouts clearly demonstrated for all levels!
- You do not have to do hundreds of repetitions of any exercise. MUTU focuses on physiological and emotional re-connection, the quality of the muscle action, not the quantity
- 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, 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.
- There are 4 Phases of exercises which you progress through as you train your core to work correctly. At Phases 3 + 4, the exercises move to strengthen your abdominal muscles – but first, you have to find them and train them.
I hope that helps to understand where the MUTU System is all about and to decide whether it is for you.
NO program is going to work if you don’t do it! Consistently and frequently. Restoring a compromised core takes time and commitment. I know its kinda stating the obvious… but if you don’t DO it, you won’t get the results.
I wrote this post because you ask me these questions about wearing a binder or splint, and I know you are searching for answers… not because I want to enter into a debate about who’s ‘more right’. Different approaches and philosophies work better for some than others.
I welcome your comments and questions. I am often asked about this subject, so wanted to open up my answers on the blog as well. I hope it helped. Please post any questions on binders, splints, of diastasis recti in the comment section below.
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 the link doesn’t take you directly 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
IMPORTANT: This article is not an analysis or critique of any other particular ‘method’, technique or product, nor does it question or assume to comment on the expertise or reputation of any other program or professional. It is simply an explanation of this one.