This is a recent note I received from a woman with a disappointing result from a popular program that recommends braces for Diastasis Recti, a common separation of the abdominals during pregnancy that lingers for some women. If you have been around my blog or heard my social media voice, prescriptive bracing ain’t my thing. Some folks do have a positive result, I acknowledge that, but that wasn’t true here, please read on…

Good morning Ms. Wiebe,

I stumbled upon your site when I was googling about the “XXX program” not working.  You had commented on your site that you did not think the system works because of the pressure it puts on your abdomen.

I am having a hard time finding anyone on the internet who is not a success story with the “XXX program”.  I thought I was one too, after 4 straight months of doing her exercises 3x a day as recommended and wearing the splint 24/7, even in the pool.  I started the program with my natural waist being 31″, and after 17 weeks of exercises, my waist was measuring 26″ when I took the splint off.

I got really tired of that splint, and took it off for a few days, and took a break from the exercises.  Within a DAY after stopping, my waist was back up to 28″.  I got so frustrated, because I worked for so long, and the results are not permanent.  It is a couple of weeks later, and my waist is settling at 29″ (which is 2 inches smaller than when I started.)

I am writing you to see if you have any recommendations for an exercise program to help me heal this diastasis.  (I am one of the typical women with skinny arms and legs and a pot belly!)

Thanks for your time,

K

Hi there!

Please call me Julie! Your note simultaneously broke my heart and burned my hide. I really do not like prescriptive bracing for Diastasis Recti (in other words saying everyone should wear one after they have a baby or if they have a diastasis). By wearing it everyday for an extended period, even with periodic breaks for exercises, you have not retrained and restored your abdominal wall for function. So the minute the brace was gone the abdomen didn’t know what to do. Your abs and your brain had learned to rely on the brace. Many bracing advocates say as long as you take it off and do exercise you will be OK, it won’t untrain the abs. I don’t agree, the body is a whiz at following the path of least resistance, which the brace affords the abs. I am so sorry.

I want to send you to a colleague of mine in your area. She and I have similar approaches and she can help you determine better what is happening with your abdominal wall, fascia and the rest of your central stability system (pelvic floor, diaphragm, trunk, glutes, etc). You need some eyes on that abdomen! This will help you get some understanding of how to coordinate the abs with the other muscles that help it do its job and manage the pressure in the abdomen.

Take heart, there are other ways to heal a diastasis than the “XXX program”. As you noted , I had some concerns about “pressure” in the prescribed program. My primary concern is the added pressure that bracing and a focus on abdominal engagement, has overtime on the pelvic floor  and the diaphragm. This does not resonate with my understanding of creating a coordinated, balanced action of all the muscles that support our center, not just the abs. Check out my blog, Dear Coach, and this quick video where I addressed the over focus on abs and the impact of excessive pressure in the middle on the diaphragm above, and pelvic floor below. This video has some other suggestions as well to encourage closure by taking a look at the position you hold your abdomen in all day.

You aren’t alone I promise. Please check in with my colleague for some new ideas.

Take care- Julie

PS For more voices on the brace vs no-brace debate, please see this thread on a Linked In Forum where PTs and trainers weighed in.

** For an opportunity to learn how I retrain the interrelationship between the diaphragm, abdominals and pelvic floor for central stability, follow this link. **