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Saturday, April 14, 2018

Diastasis Recti: Every Mother Runners Worst Enemy

My brain is exploding with new, amazing discoveries about rehabilitation of the core and coming back after baby. There is so much I want to share here that it is spilling out of my brain faster than I can type it!!

I have recently begun to really take charge of my recovery post-baby...a full 7-1/2 months after the fact. But, better late than never, no? I did an initial round of physical therapy as soon as I was cleared for full activity, at 8 weeks postpartum. I was able to get back abdominal strength that was completely eliminated in the aftermath of my emergency c-section experience. And by completely I mean *completely*. Sitting up straight was an enormously difficult task. Standing at the sink to clean all the bottles and pump parts required multiple rest breaks because I didn't have the core strength to hold myself up without back pain creeping in, so this meant I had to rest on my forearms. A LOT. It was really bad. And those two months of PT did wonders for restoring my 'general use' strength so I could function normally, start running again, and get rid of the back pain I was experiencing daily.

Now, I need to finish the work I started and close the diastasis recti (DR - an unnatural separation of the abdominal wall, more or less) that has remained despite all the core strengthening I have been doing. Or, perhaps, the DR has remained *as a result of* all the core "strengthening" I have been doing?

Boom. I just said it. Postpartum truth bomb to myself. I was doing it all wrong. I'm in the freaking business and I *still* was doing it wrong.

Guess what? The six-pack abs I worked so diligently to create and maintain over the last decade were worthless. They looked awesome, they served me well in the short term, and I could wear cute, fitted shirts. Then, throw in two pregnancies, an emergency c-section, and only then did I discover how much all my hard work has been in vain (and for vanity). The body is exceptionally good at faking it, until you break it. Pregnancy doesn't give you a DR, lifestyle gives you a DR and pregnancy just brings it to the forefront and holds a mirror up to all your unknown mistakes. (An aside: you would be amazed to know how many *men* have a separation of the abdominal wall.) DR isn't a pregnancy,  "I-had-big-babies" problem (for reference, my kids were 4.5 and 6.5 lbs). DR is a pressure system problem.

My biggest mistake? Breathing. No, seriously. I have been a belly breather for as long as I can remember, and a belly sucker-inner. I won't go into all the details of why this is bad because it would be a silly-long post, but go HERE to find all the goods and to join me in the rabbit hole :)

I am seeing an amazing PT, Susan McLaughlin. I attended her prenatal workshop when I was pregnant with my daughter and was very impressed with the content and used most of what I learned as I prepped for birth/delivery. I'm excited to be working with her and after what I have learned in our first two visits, and the breath work that I have been doing for three weeks has already improved my situation enormously. After a few days, I was hooked and discovered an unopened can of worms I never knew existed.

I mean, I've been breathing my whole life, right? So I've basically been prepping my body for this challenge all along. My pressure system is off and getting it to a good place is actually seriously hard work. But not physically hard. It is mentally hard. Relearning how to breath is a weird thing. I started at a three-finger width DR three weeks ago and when I rechecked it after 10 days of focused work on my home 'exercise' program Susan gave me, it was down to just barely more than one finger-width. AND ALL I HAVE DONE IS WORK ON BREATHING WITH MY ENTIRE RIBCAGE (aka "360 breathing"). No planks, no crunches, no bridges, no sidelying hip abduction, no quadruped bird dogs. Breathing. That's it. I think about it all day long, and even have found myself thinking about it as I fall asleep at night, before I lift my toddler, while I'm holding my 7 month old, driving, eating, all the time! My running is even better now because I can breath. I didn't even know that I was having trouble with it before all of this. Hills? They are my new friend. I seek out hills to run now because I can practice good alignment and ribcage breathing all at once. Who knew?!

The things I am learning are not just great for my own situation. I have been able to cross it over into my work and help others. I was working with a gentleman patient earlier this week with an interesting ribcage (and seeing us for something "unrelated" to this...but, c'mon, it's all connected). I checked and found a 3 finger width DR (IN A MAN), watched his breathing while he did some of his exercises (belly breather), and then showed him (manually and with verbal cues) how to manipulate his breath and use his full ribcage. I was curious. He could get awesome closure of his DR (down to 1 finger width) and good tension of the connective tissue. He said his back felt a lot better just in those few minutes. It was so cool, and he was really encouraged!

Anywho, like I said, rabbit hole :)

In all of this, my ultimate goal is to be able to get back to the kind of running I did before kids (long distance) and for the long term. I don't want to pay later for short cuts used for short term benefit (and long term negative consequences). It takes patience and time, but the payoff is significant. I see enough of the negative consequences walk into the clinic every day to know that it's not how I want to be in 20-30 years. Susan remarked at my most recent appointment that I'm lucky, I get to take advantage of all this stuff I'm learning so early on and for the long term (I'm in my mid-30s). That was a good reminder...because sometimes I feel like I'm learning it *late* in life, ha.

In other news, I've found a new pair of shoes in my quest to discover what else is out there other than my beloved Brooks Ghosts, which I have worn exclusively (for road running) for the last eight years. The Altra Intuition 4.5...I'm digging these so far. I'm also (coincidentally) reading Katy Bowman's book "Whole Body Barefoot". Not my intention to be a barefoot runner, but it is my intention to learn as much as I can about all of the things :) And feet are really, really cool things...they are our foundation, the place where so much of our experience of our world starts!

(Katy Bowman and her Nutritious Movement website/blog/podcast/books is incredible stuff. Check it out if you also want to fall down another rabbit hole with me.)

Okay, I need to stop myself here. I can feel full on nerd-mode starting and I want to redirect that energy towards other awesome things right now, such as super-snuggles from my kids :)

Paige, out.

(P.S. Now take a deep breath and try to fill your entire ribcage...let it expand from every nook and cranny, like a balloon expands in all directions, not just front or back, up or down. ALL directions. And, then smile :))

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