The water is getting pretty murky out there, and I am seeing and hearing a lot of confusion regarding this question: alignment (defined as a specific alignment, usually “neutral”, the use of an optimized position) or variability (adopting a variety of postures) for pelvic health or diastasis concerns. Unfortunately, these two ideas have been communicated and/or absorbed by the listener/reader as polar opposites. Black and white: you have to adhere to one philosophy or the other. This has caused some to even question their own experience and path to recovery and return to fitness. The previously encouraged or now discouraged, and have returned to a state of not sure how to adopt and adapt their training to new information. So I thought I would offer some thoughts to help, I hope, clear the water up a bit.

First, these two ideas that there is 1. an optimal position for each person and 2. positional variability… can and do co-exist. If you have followed me long enough you know that the answer for how you would determine which to focus on in your own recovery, daily demands, return to fitness, actual fitness, function, etc. is… IT DEPENDS!

So what does it depend on?  Here are a few things to consider when you yourself are working out what is your current priority. Or if you are training, coaching or rehabilitating someone and trying to sort out the same question.

Where are they in the recovery process?

The use of an optimized position for re-establishing their connection with and the relationships between components of the system that is impacted by pregnancy (central stability system/postural control system/”core”), is important in the early phases of post-partum recovery or when a woman at a distance from her deliveries needs to restore her connections. We do have research to support that midrange alignment of any muscle (not just the pelvic floor or abs) is the optimal position for its capacity to generate tension and promotes its mechanical advantage. This makes midrange an ideal access point to reconnect with that muscle group. I like to think that optimized position creates availability of the muscle. Check out this video for a helpful demo you can participate in to flesh out this thought process for yourself. Everyone’s optimized, midrange position is a bit different. I like to call it their “sweet spot”, and it falls within a range somewhere in the middle of the extremes of their postural capacity. That “sweet spot” will be the position that they find the best connections with components of the system they are trying to recover. A midrange position is a great place to do that. And, head’s-up, if the position you choose to start someone in, does not elicit the response you are looking for you…change it. Simply put, you have to start somewhere. 

Once you have re-established that foundation, then you begin to build in variability- load, movement into different planes, speed, position changes. All the while monitoring for symptoms, compensations, movement efficiency, etc.. Bottom line: Don’t confuse the start with the middle and/or end of a process, and honor where you are in YOUR timeline. Don’t be afraid to try new positions. You won’t know what you can tolerate until you try.  Just monitor and modify. Alignment and access are linked, and access is about building brain strategies. I want to restore the brains connection and access to the system post-partum. That way it is available to my mamas and athletes always, no matter what position or circumstance they are in.

Does moving into and out of midrange positions (a little or a lot) or while loaded recreate your symptoms?

As noted above, as you move from your sweet spot into challenges away from your midrange, potentially under load, or with new activities you need to monitor your symptoms. If your primary symptoms are irritated by said position, load, challenge, etc then do not continue just because someone on the internet said you are supposted to be able to assume all of those positions. And don’t feel bad about it either. You just may not be quite ready for that particular position or activity or you need modifications to make it symptom free (for example- change your position, change your load, or change HOW you are doing it-i.e. strategy-don’t hold your breath for example).  Don’t assume that if you are at the start of your journey that you won’t be able to take on challenge out of an optimized position. You will need to try new things to build the resilience of your system, structure, and strategies. Don’t be afraid. Monitor and modify as you go.

Are you under a load? What is your max load tolerance?

Under a load, you should assume good form. And good form is another way of saying good alignment. Not only is this for safety, but for maximized muscle recruitment (access/availability) and for the recruitment of the muscles you are trying to challenge. For example….if you are squatting under a weight and you bum is tucked under this reduces the availability of your glutes and they won’t participate as well in or be trained through that activity. Instead, you will likely feel more quad work during the squat. Not a bad thing if you need more quad work, but that is not necessarily what you are going for in a squat.

So good form under load is important.  But, and here is the big BUT….what about body weight as resistance or as your load? If that is your max load and repetition is your training device or speed of a body weight exercise is your challenge, then I would argue that form would be a consideration here too. Particularly if you are symptomatic or if you must compensate to achieve those final reps or to maintain speed. OR what if your max load is actually your growing baby and stroller? And then you need to carry that baby around while you move and work and walk and shop. For a CrossFitter that trained through their pregnancy an 8-pound bundle of joy is like a feather. And yes, moving and carrying that little bub around is not a demand that would require her to have great form as they squat down to pick up a toy or stray pacifier. But for some women that is their max load, and yes, I would argue they should try to have good form for that pacifier-from-the-floor lift.  Again, particularly if they are symptomatic. Are you tracking with me here? We have to understand the needs of the person in front of us, the demands that are on their body, their strategy and capacity to meet those demands.

Ultimately, we need to build automaticity and resilience in all positions. However, for many they must start at the beginning and build from there. An optimized positional ‘sweet spot’ has its place, as does positional variability…they are intertwined components of our movement system. Please remember that the optimized position that works best for you to access the system is your sweet spot, it’s your home base. But the goal is that it is the foundation you get to leap from!

Hope that helps. Julie

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