The Gap Isn’t The Problem – The Lack Of Function Is. Why Closing a Diastasis Recti May Not Be The Answer
The MUTU System program is endorsed by Women’s Health Physical Therapists and Physiotherapists worldwide. It is 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 confirms this hypothesis – that merely to aspire to ‘close the gap’ is neither helpful nor 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 that supports this approach
Highly respected Physiotherapist Diane Lee, with Paul Hodges, have presented new clinical findings on treating diastasis recti. Lee’s clinical findings and teaching have long been widely regarded as a leading authority on diastasis recti, as well as pelvic girdle pain, incontinence, and pelvic organ prolapse.
The 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 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 on Diane Lee’s site 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 unconscious, non-optimal recruitment of the abdominals.
What does this mean?
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.
What does this suggest?
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.
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.
When is surgery necessary?
Lee goes on to ask ‘When is surgery necessary?’ and suggests that rather than a defined ‘how wide is too wide’ distance, it is when the fascial system remains unable to generate tension, despite optimal deep muscle activation, then this may be the case. Where the trunk cannot provide stability in joint movement or loading (for example when standing on one leg, or carrying out functional tasks such as lifting or squatting) – then a qualified physical therapist will be able to determine where surgery may be beneficial to restore midline tension. It’s important to note though, that surgery won’t teach the muscles to work right – total core training along with alignment work will very much be necessary post-surgery to achieve true core stability and strength.
Lee concludes that individual, professional assessment to locate the ‘primary driver’, or the original site of instability or non-optimal function in the body, is necessary for truly personalised diagnosis and the most effective treatment and prescription.
Diastasis recti is not the reason for a mummy tummy
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 right… because 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.
When is diastasis recti a problem?
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, uncontainable 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.