Pelvic Health Series: Our journey to regaining strength, alignment, & function Jamie - part 3

It has been two months since my first appointment at Bounce Back Physical Therapy with Jillian Palmer.  I have had some ups and downs with my recovery but overall I have been loving the experience.  I have loved learning more about how my body functions and being able to apply what I'm learning from a women's health expert to my classes. Over the course of this two month span I have had appointments every two weeks to try to find a solution for the symptoms I was experiencing.  If you want to know more about the beginning part of my journey, my symptoms and diagnoses, or Kellie’s journey, please click here and read the first four posts in our series. I’m going to take you back to where I left off after my last post and share with you my experience of trying to find better function in my pelvic floor and close the abdominal separation I have. 

I feel like Jillian, or any physio therapist for that matter, is like Sherlock Holmes, trying to solve the mystery of what is causing the symptoms or problems your body is experiencing.  She has this brain full of tools that could potentially fix your problem, but the trick is finding the right tool for your body. 

I was lucky with my pelvic floor.  She sent me home after the first appointment with a little foam ball to sit on and breathe and relax and imagine my pelvic floor wrapping around the ball with each breath.  Within two weeks I noticed a difference and after just one month of allowing my pelvic floor a chance to relax, I was already noticing a huge difference in function.  I could do up to 30 jumping jacks without feeling any heaviness in my rectum!

Your pelvic floor is an amazing muscle that is responsible for so many important functions in your body.  By not allowing my pelvic floor to fully relax, it wasn’t able to do its job.  Think about it like this, if you walked around squeezing your hand into a fist all day, your hand would be tired too and wouldn’t be able to function properly.  Or if you constantly clenched your bicep, when you needed it to engage to lift something, it would have a hard time doing what you were asking of it.  Your pelvic floor is the same.  It needs to engage and relax just like every other muscle in your body.  Thankfully, when you give your body the chance to behave the way it is built to, it responds magically.

Finding the right tool to unlock the mystery behind why I am experiencing a significant diastasis has been much harder to find.  Your rectus abdominus (or your six-pack muscles) want to be close together.  They don’t function well with a large gap between them, so if you can find the right tool to unlock the reason they are stuck open, they should willingly go back to where they are supposed to be.  I continued to see Jillian every two weeks, and every two weeks she would send me home with new exercises or stretches to try to get my separation to close. One tool Jillian talked about that really hit home with me was thinking about tension to task.  I needed to start to think about engaging my core relative to the task I was trying to complete.  There was no need to engage my core to a level 10 when I was picking up a pen or washing dishes, when a one or two would suffice. 

No Diastasis Recti          Diastasis during pregnancy      Diastasis postpartum
Image used from ProgressiveMotion.com

During one of my appointments, Jillian watched my abdominals closely as I was doing my core breaths and with every exhale and engagement I would get a small bulge in between by abs. There wasn’t any significant coning or doming or tenting like when I was pregnant.  It was just a small space where my abs were separated that would slightly raise above my abdominals.  This small bulge meant that with every exhale and engagement of my pelvic floor and transverse abdominus, I was generating pressure within my core capsule.  This pressure needed to go somewhere and it was going straight to my weakened linea alba, or the space between my abs that I couldn’t generate enough tension in to contain the pressure.  My insides, my organs, were literally being pushed out and trying to escape from my body. 

Once we realized this was happening, we needed to test my core's abilities. She lead me through very basic movements to see exactly what kind of pressure my core was capable of handling and I was shocked to learn how little I was actually able to control.  When someone tells you that your insides are trying to come out of your body and can show you exactly when, if that isn’t a rude awakening, I don’t know what is.  The reality was that if I continued to push my core and body the way I was, I was at risk of a hernia.  So, over some Ben and Jerry’s cookie dough icecream, (a necessity for me when I have some soul searching to do or let's be honest, anytime really) I did some thinking.   Is doing a full push-up or burpie really worth a hernia?  Physically, I had always prided myself on pushing my body’s limits but at this point was the risk really worth the “reward”? 

On top of significantly modifying all core and prone exercises, I needed to learn to relax my core.  We noticed that I was pre-engaging my obliques with every core breath I did, further separating my rectus abdominus.  Even though we discussed tension to task, and I understood what it meant, I wasn’t actually applying it except when physically lifting things.  For every core breath I did, I was fully engaging every muscle in my midsection, which wasn't necessary. I needed to learn to relax my obliques and just let my pelvic floor, transverse abdominus and multifidus do the work.  Put your hands on your obliques next time you do a belly breath or a kegel and see if they harden or engage.  You might be surprised.  I sure was and it took a lot of mental focus to let them relax while only engaging my pelvic floor, transverse abdonminus and multifidus. 

Outside of relaxing my obliques during core breathing, I needed to let my stomach go.  As hard as physically modifying everything is, mentally for me, this one was 100 times harder.  Not only has this been a challenge almost every minute of the day for me, it has been completely eye opening.  When I started to be really mindful about my core and started to think about tension to task for every aspect of my life, it shocked me to realize how much of my day was spent with my core engaged.  Why would my core need to be engaged fully when I was sitting in the car or watching tv, or walking around the grocery store?  I then started to wonder how long I had been doing this for.  Definitely the whole time I was pregnant, but maybe even before.  Maybe even as long ago as my teenage years.  That’s an awful long time to ask your core to engage and not expect to see some negative side effects. It is highly likely that I was experiencing symptoms before but pregnancy and recovering from pregnancy brought them to the forefront.  “Sucking in” my core was a bad habit I developed a long time ago and it was going to take a lot to unlearn it and retrain my body and mind.  My journey quickly switched from solely a physical one to a mental one as well. 

Habits are important. 

Up to 90 percent of our everyday behaviour is based on habit. 

Nearly all of what we do each day, every day,

 is simply habit.

 – Jack D. Hodge

So for the time being, I am working on unlearning, retraining, relaxing fully, engaging properly when I need to and learning new habits.  I am still smiling and remembering each day to celebrate the small victories and am proud of myself for working within my current bodies capabilities.  

Photo Credit Roughley Originals

After 2 months of visits we still haven’t unlocked the mystery that is causing my abdominal separation but I am happy to report that the depth of my separation has decreased, I am able to generate a lot more tension in my Linea Alba and at my last appointment we found a tool that worked some magic and I can’t wait to see what it does for my body.  Stay tuned for my next post to find out all about this magical trick.