The MamasteFit Podcast Episode 108 – Understanding & Healing Diastasis, with Hayley Kava, Pelvic Floor PT

Gina: Welcome to the MamasteFit podcast. In this episode, we have pelvic floor physical therapist, Hayley Kava here, who is gonna be talking all about diastasis. We’ll discuss diastasis during pregnancy and in the postpartum, and how you can approach healing out of the box. So Hayley, could you introduce yourself to our listeners who may or may not be familiar with you?

Hayley: Yeah. My name’s Hayley Kava. I’m a pelvic floor physical therapist who specializes and is certified in postural restoration. And I, yeah, I like to approach pelvic floor problems, pregnancy and postpartum problems, with that outside of the box approach.

Gina: So let’s start with defining what is diastasis? This is, some folks call it like, abdominal separation, DR, DRA, di-ah-stasis, di-uh-stasis. So can we just define what that is?

Hayley: Yeah, so diastasis, like, the word “diastasis” just basically means that, something is separating. So you could have diastasis in other parts of your body, but a diastasis rectus abdominis, or DRA, is the separation of abdominal muscles, through something that’s called our linea alba. So the fascia that connects the left and right side of our abdominal wall, in the middle.

Gina: Okay, so during pregnancy, I understand that diastasis is a normal adaptation. Like our, as our baby grows and our belly stretches, diastasis needs to happen in order to accommodate for our baby’s growth. And so we’ll have folks that’ll message us like, “Hey, how do I prevent it?” Or, “I notice some coning, like I’m so upset that I got diastasis,” and I just wanna reiterate that it’s a normal part of pregnancy, it needs to happen. But there are things that we could do during pregnancy to help minimize the severity of it.

Do you have any insight on what someone could do during pregnancy to one, acknowledge that you’re gonna probably have some sort of esis, but what could they do during pregnancy to try to minimize it for healing in the postpartum?

Hayley: Yeah, so I think it’s important to remember that the abdominal wall is more than just our six pack muscles. And I think aesthetically we think about our six pack muscles and what they look like or what our belly, what our abdomen looks like, from like a purely, I don’t know…

Gina: Aesthetic?

Hayley: Aesthetic standpoint! But there’s a lot of layers there.

We have the rectus abdominis, which is the middle, like our six pack, and then we have our external obliques, our internal obliques, and our transversus abdominis. And so all of these muscles are coming to that midline. And yeah, if you make it to full term, like or third trimester even, 95 to a 100 percent of people who are pregnant will have some thinning or stretching at that linea alba. It just has to happen in order to accommodate the uterus growing. So yeah, you could do all the right things, you could do all the core work you want you could do all of that, and it is sometimes just gonna happen.

The amount that tissue thins and the integrity of that in the postpartum healing period we can influence is, that we wanna consider where- all of those muscles, right, so we’ve got this complicated wall of muscle- we wanna consider where those muscles start and where those muscles finish, and then what their actions are. So just like our hamstring starts in one spot and ends in the other, and we wanna train that muscle through its full range of motion, same thing with our abdominal wall. Those abdominal muscles attach from the rib cage up here, all the way down and attach on the pelvis. So we can’t think about it just in the middle. We have to think about it as an entire sort of wall of muscle.

So the things that we want to do to address in pregnancy, despite normal changes that are happening in our rib cage at the top and in our pelvis at the bottom is addressing that positioning, right? So if, as belly’s growing, as baby’s coming out of the pelvis and ribcage is maybe expanding, or, like flaring forward, we wanna do things to try to reign that in a little bit so that then that ab wall is not getting just contentioned continuously throughout that pregnancy. And then positioning our pelvis at the bottom, as well. So we don’t want, we don’t want that pelvis unchecked continuing to go more and more forward despite that belly and that uterus growing more and more forward. So the things that we do, the warmups that we do, or how we’re strength training and our awareness of that, is really important, as well as recognizing that those changes don’t always all happen totally symmetrically. So the left and right side of our body’s a little different. Often our babies don’t hang out right in the middle, they may prefer one side or the other, it might be flip flopping from side to side, and that causes sometimes like asymmetrical changes of the rib cage as well. So we wanna be conscious of not only symmetrical, typical changes in pregnancy, but sometimes maybe our own individual bias towards asymmetry.

So clinically what we see is a lot of more like left rib flaring, and a little bit more overactivity of the right abdominal wall. And sometimes that makes typical diastasis rehab or prevention in pregnancy tricky because if you’re addressing this abdominal wall symmetrically all the time, you aren’t going to impacts the change that you want to have.

Gina: Absolutely. Even during my own pregnancy, I always noticed like a little bit more like right kind of discomfort from just always being compressed to this side, so it just felt like it was very like stuffy over on the right side of my body. And so when I would find these big right side body openers, it would bring so much more relief. And even now in the postpartum, when I do symmetrical exercises where I’m rowing to my right side and I row to my left, it always feels so much harder to really get my left obliques to turn on with a motion that I’m doing on both sides.

And so during my own pregnancy, I was incorporating exercises that were more like one sided where I would do something different on the right versus the left based on my overall understanding of asymmetry. So can we just break down the asymmetry a little bit more for folks? ‘Cause there are common patterns that a lot of us tend to have, and obviously not every person that’s listening will have all of the exact same things, but there is a pattern for most of us.

Hayley: Yeah, so the pattern as described by postural restoration and anatomically, really, what we see is that our right lung, like just anatomically, our right lung is bigger than our left lung. Our liver, which is like a big dense organ, is on the right side, and that liver comes underneath our diaphragm on that right side and offers quite a bit of structural support to that diaphragm. On the left side, our heart sits on top of the diaphragm on the left, and our stomach and spleen is underneath the diaphragm on the left side. So we have good support, structurally, on the right, and a little bit of downward pressure pushing onto the front of that diaphragm on the left side. And so what that looks like a lot of times is that we, yeah, we kinda lean over toward the right and the right abs. So our right internal obliques and our right transverses abdominus, our right rectus abdominis tend to be a little bit more compressed, and then the left side tends to be a little bit more elongated. And so it’s harder, it’s trickier for us to shift our pelvis back over to that left side, and load over that left side because we don’t have that same like organ support there.

Gina: Absolutely. So I think understanding the asymmetry can be one of the key things, especially in the postpartum to help with healing of diastasis.

Other things that I noticed during pregnancy beyond like positioning, and I know positioning plays a big role in pressure management as well- so how well can we move the diaphragm to change the pressure within the intraabdominal cavity? So for us, when we’re guiding our clients through their fitness workouts and for online fitness programs, we talk about positioning during our prenatal lifts and how that can really impact the pressure management. And when we have too much pressure being directed straight into the front of the belly, it’s gonna cause some abdominal coning where the center of the abdomen pushes out a little bit more than the rest of the abdominal wall.

And now if someone is just sitting and just chilling, or they’re doing an inversion or a more passive position, sometimes the belly relaxes in a more cone like position- it could just be like baby’s positioning or it’s just how their abs are relaxing and usually not an issue at that point ’cause there’s no pressure pushing into it. But if we’re seeing that coning under exertion, so I’m lifting a weight overhead, I’m pulling a weight towards myself, those are like the two really common ones that we see it, or I’m doing a very core intensive activity and I’m seeing that coning, that means that there’s pressure pushing that tissue out. And even though it’s already thinning during pregnancy, if we’re constantly pushing and pushing into that tissue with additional pressure, we’re gonna thin and damage it potentially a little bit more. So I usually compare it to an elastic band where you put it in your hair like for a week, and by the end of the week it’s just this like floppy band, like similar to our abdominal wall, like we’re pushing and stretching it. It could be because of our positioning, like maybe we’re in that more arched, rib flared position with pelvis tilting forward so the belly is already in a more stretched position and then we add additional pressure so it’s easier to manipulate.

So during pregnancy, my biggest tips to help protect the core is to, one, focus on positioning. Sometimes it’s hard to stabilize ourselves in a standing position, and so if we’re noticing a lot of coning or we’re having a hard time finding a more neutral position with our lifts, maybe we come to a seated position, or we find a more supportive position, or we regress the movement to something that’s easier for us to stabilize in. And then also thinking about pressure management. How am I breathing with this movement to help stabilize my core and to also maintain my core integrity? So exhaling with exertion or exhaling before the exertion. So if I’m pressing a weight overhead, I exhale, pull belly in, and then press overhead to help me stabilize and maintain the integrity of my core. And so those two things I think play a really big role in how diastasis is potentially gonna present in the postpartum.

But there’s other factors as well. Like your genetics plays a big role in it, what type of exercising you were or weren’t doing maybe plays a role in it, so there are some things, like how many babies you have, how big your baby is. So even with, just like Roxanne and I- we’re both sisters, we come from a fairly similar genetic background- I have no diastasis now, like I didn’t really deal with it a lot during my pregnancy and postpartum, healed pretty quickly. While for her, she still has some, it doesn’t necessarily mean it’s a functional issue for her, but we’re from the same family and we each have our own journey with it as well.

Hayley: Yeah, totally. And I think we wanna think about approaching- just like we wanna approach pregnancy in general is- when we’re working out, we wanna be conscious that we’re reinforcing these good movement patterns, we’re reinforcing our exhalation, we’re watching for some of that, I’ve heard it called like “hard coning” versus “soft coning.” So if you’re coning and you touch it and it is squishy, it’s usually less of an issue, versus I’m touching that coning and it’s like rigid, being more like traction on that tissue intensity.

But I’m also of the mindset that, yeah, it’s like time under tension. So we can go in and do our workout, we could be even like super extended in that workout, we could be seeing a lot of coning in that workout, but that’s one hour of 24.

Gina: Yeah.

Hayley: Right? If we do things in our cool down, or we do things throughout the day that help optimize our position, it’s probably not gonna be as damaging as we might think it’s gonna be.

But if we are hanging out all day long, or we work out in these really extended positions that have a lot of that outward pressure, then we go and walk around and we’re hanging out in that position, then we sleep and we’re sleeping in a really archy position and, you know, the other 23 hours of the day we’re also not optimizing our position, I think it’s that buildup over time that also is a big contributing…

Gina: Oh, absolutely.

Hayley: Factor. Yeah, so some of those lifestyle things could be helpful too.

Gina: Yeah, we have folks that’ll like, we’ll post a video on coning, and they’ll message or email us and panic, “Oh my God, I was coning in my workout. Have I completely destroyed my abs?” And I’m like, “It’s okay. It’s not a big deal. That happens every once in a while.” If you sit up in bed and you see coning, you didn’t destroy your core. I think what you’re saying is if it’s all day, every movement that you do, you’re like in a super arched position, you’re coning with everything you do, it’s probably gonna be more damaging, as opposed to five reps in your workout you notice some coning, like probably not gonna destroy your core.

Hayley: And that the benefit of like strength training in pregnancy, whether it’s your abs or the rest of your body, probably far outweighs the potential risks and in the postpartum.

And from like a research standpoint, from like postpartum diastasis recovery, the research shows we really don’t have a lot of good research! That we need more evidence! But, of what we do have, is like loading those muscles, so challenging our core muscles, whether we have a little bit of coning or not, is actually better for healing than avoiding loading of those tissues and focusing exclusively on like just transverse abdominis connection.

Gina: Yeah. So let’s talk about postpartum. So during pregnancy, thinking about your positioning, thinking about your breathing pattern, if you cone every once in a while, it’s not gonna destroy your core, but just being overall mindful of your body positioning throughout the day could be really beneficial, but we’re not trying to live in neutral either. We want to improve mobility, be able to change position throughout the day.

Now, when it comes to the postpartum, I think a lot of the approaches are similar. Like we’re still thinking about positioning in our breathing pattern. And then like you’re saying, loading tissue, also considering asymmetry, ’cause that also can impact how like we’re presenting as well. Whether or not somebody had a Cesarean birth could potentially impact like how sleepy they are, like how much rest, what is their nutrition looking like, I think are all like really big factors.

So let’s talk about approaching healing diastasis in the postpartum ’cause we’ll get folks that’ll message us like, “Hey, I have a diastasis. Am I allowed to exercise?” And I’m like, “Yes, please do!” Like you don’t have to wait until everything is, you have no functional issues before beginning a workout program. ‘Cause really the exercises that you do in programs are probably gonna be what helps you feel good in your body again.

Hayley: Correct. I feel like a big thing to address in postpartum core rehab is the changes in the ribcage and the adaptive changes that we make in the postpartum, to just live. The ribcage gets wider, our diaphragm tends to like descend postpartum because now we don’t have a uterus to help hold that diaphragm up. So our core actually tends to work better in pregnancy because it has something rigid to push against. So now postpartum we don’t have that same like rigid feedback. Diaphragm wants to push down, and that rib cage is now stuck in a slightly like wider position like it was at the end of pregnancy. So if we can address how well that rib cage moves, the diastasis, the ab wall function, will happen.

I’m of the mindset that we don’t necessarily need to do a ton, like isolation wise, to our core. Like, yes, but we want those activities to be integrative of what’s happening also at our pelvis and our rib cage, and then the ab wall can just function, right? Like our ab muscles, our pelvic floor muscles, these are automatic postural muscles. Just like we don’t need to be doing a gillion Kegels, we also don’t need to be doing a gillion TVA connection activities without addressing, yeah, the position of ribs and the position of pelvis. Because if you’re struggling to connect to or feel your feel your abs, it’s probably not because those abs don’t work, it’s because they’re really probably not in a great position to work.

Gina: Yeah, absolutely.

Hayley: And so that’s big, and I think what is really different than a lot of typical approaches.

Gina: Yeah.

Hayley: So like when we’re using things like child’s pose and really trying to get the back of the rib cage to expand. Or some of the side sitting position, we’re trying to get that side rib cage to really open up, the point of those is to help us reestablish better pressure in the thorax so that the intraabdominal pressure can be a little bit more regulated.

So the compensation in the early postpartum period that a lot of people develop is we’re using our backs for everything. We’re kind of clenching our butt cheeks, we’re clenching and keeping our backs really tight, in order to help hold us up because now our abdominal wall is not able to do what it was able to do in pregnancy and its healing. And so I think a big part of the recovery process is just breaking some of those ingrained habits, or like breaking that patterning down, that compensation that naturally comes out of, “Okay, I’m holding my back tight and that’s keeping me stuck in that position. And that’s why it’s tricky for me to connect with my abs or feel like my abs are working when I’m doing my workout or when I’m just living my life.”

Gina: Yeah.

Hayley: And so the techniques, whether, again, whether they’re integrated into warmups, or cool downs, or things that you mix in throughout the day, help us break those habits and then allow us to really see that healing happen.

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We incorporate a lot of like back expansion exercises just to bring us into the opposite position to release that tension in the backside of the body.

One of the common, I think, misconceptions in the postpartum and even during pregnancy, is that we are tucking our butt underneath and finding more of this posterior tilt, and I think that’s where like all the “mom butt” type stuff, like, notions come from. But you did a reel one time where you’re like, “Maybe we’re not tucking under, but we are still in this arch position ’cause we have more compression to the backside and then the hips move forward.”

Hayley: Yes.

Gina: And so it’s almost like a masked anterior pelvic tilt that looks like a posterior pelvic tilt. And so when folks are like, “I’m trying to arch more and arch more, and it’s just making things worse,” it’s because you’re already in this arched position. We may need to actually find more rounding in the back and in the pelvis to help release some of the tension so we can position ourselves better. And so similar to pregnancy, it wasn’t necessarily like the exercises that you’re doing or not doing, and same in the postpartum. It’s how are we positioned, and how is that impacting how we can manage the pressure within the abdominal cavity? And like you were saying, how well can the muscles work based on the position that they’re in? And I think that’s a key thing when it comes to, can I feel my core? How well do I breathe and move with things?

So the general like layout of our workouts to help folks recover in the postpartum from these common issues that they may be experiencing is our warmups all start with core exercises that are trying to integrate: how are my arms and legs moving in relation to the positioning of my pelvis and my rib cage? Like, how well can I maintain my core position as my arm reaches overhead, or my leg extends down? And we move folks through a variety of positions, and that’s how we’re starting our workouts. Can I feel all of this stuff, that’s supposed to be automatic, working? And then over time that will become automatic by starting by being a little bit more like mentally aware of things. And then we integrate those concepts into the actual workout. Okay, I’m lifting, but as I lift, I’m gonna find a more supported position at first so that I can think about how can I keep my core in its position as I move some weight. And then we incorporate rotational exercises, we incorporate back expansion exercises, things to try to help us come out of these positions that we get commonly stuck in. And it’s harder with like general programming, our fitness program is obviously very specific to a timeframe, but it’s not specific to the individual.

And so because it’s not specific to the individual, it becomes hard for us to say, “Hey, only on the left side do you do this.”

Hayley: Right.

Gina: “On the right side, you favor this.” And it gets confusing for folks ’cause we’re so used to doing everything the same on both sides, even though our bodies are not the same on both sides, and so our programming is, “do them on both sides.” And I think this is where working with a physical therapist can be really beneficial, especially one that has an out of box approach to PT, ’cause there’s nothing worse to me than somebody coming to me and saying, “Hey, I’ve been seeing a PT for six months and I still have diastasis, I’m still peeing myself, I still have symptomatic prolapse,” and I’m like, “Okay, have you gotten off the table? Are you still doing clamshells and glute bridges and Kegels?” And they’re like, “I’m still on the table. They just do manual therapy on me,” and I’m like, “That’s the problem.” If we’re not getting off the table and taking the isometric and the isolated exercises and then expanding it to like, “How can I make the whole system work better?” we’re not gonna see progress. And similarly, like we were talking about, if we don’t load the tissue our diastasis is not gonna heal in the postpartum.

Hayley: Right. So if our abs and back are in like a tug of war- so like back muscles like to take over, ab muscles like to shut off ’cause they work as a team- in general, we’re not gonna see our back muscles be at their maximum activation.

So if we think of like a sit up, right? So as you curl up in the front, your ab muscles have to contract, your back muscles have to relax in order to like fully do that sit up, or curl up, or whatever you wanna call it. And so, if those back muscles are holding on tight, they’re maybe fighting us, they’re resisting our ability to properly do that curl up. But you lay down and you have your back muscles massaged, is just massaging those back muscles going to change your neuromuscular control, like the control of your ability to do that thing? And functionally, is that going to change how you use your muscles day to day and during your workouts? No, probably not. So that’s where, yeah, like doing pelvic floor muscle release or doing visceral abdominal work, like all of those things can be awesome. But yeah, at the end of the day we have to teach our bodies how to move and control themselves. And having that one-on-one is amazing, but I think we can learn these things even from global programming. And even when things, I’ll tell clients all the time, it’s okay if we wanna be able to do things on both sides.

Gina: Yeah.

Hayley: It’s not that it’s like breaking any rules, even if you’re asymmetrical, to do things on both sides, but it’s sometimes a learning moment of, “Oh, this feels really hard over here.”

Gina: Yeah.

Hayley: “Oh, this feels super easy over here.” And I’ll usually tell people, I’m like, “How about you just start and finish on the side that feel

Gina: Yeah.

Hayley: So you’re going to do just like an extra round on that side.

Gina: I think that’s a good approach.

So, we talk a lot about asymmetry when we talk about like pelvic pain. And this week, on our Instagram, we’ve been talking a lot about pubic symphysis, and SI joint pain, and how I was personally approaching it during my pregnancies, and how Roxanne approaches it in her postpartum to help address some of that asymmetry that is causing some of the discomfort for us. And we get a lot of questions from folks who are like, “How do I know what I have?”

Hayley: Mmhmm.

Gina: Like, “Which side do I need to focus on? Because I also have pain and I would like to not be in pain.” And I think social media is a really great resource for folks to resolve their pain with without having to, I don’t wanna say like they should never see a professional or work one on one with somebody, but it makes information really accessible so that folks can find relief now. Like they don’t have to schedule an appointment and wait eight weeks to see somebody.

Hayley: Right. And I think, you know, and not as a knock to my own profession, but even when you do go for individualized care, you’re maybe not getting someone who’s looking at those things anyway.

Gina: Yeah. So what are some ways for folks to tell, “Okay, how do I know what is going on in my body?” And I think there are some tests that they can do in themselves.

Hayley: Yeah. Oh yeah.

Gina: Like ones for me, that I would say, if you’re doing this exercise and you feel like it’s easier on this side versus that side, this is probably the position that you’re in. Or, if you do like a 90/90 or a shin box flow, which side feels easier for your legs to be in? Is it with the left leg externally rotated, or the right leg, externally rotated. So those are some things that like come to the top of my head that I know feel different for me on each side, Are there things that folks can use to figure out asymmetry for themselves?

Hayley: Yeah. So diastasis is always like tricky, tricky to talk about, for me, because how people understand it and evaluate it, traditionally, is with the head curl up test. So you lay on your back, curl up your head, and you feel at that midline and you’re feeling the distance between those two rectus bellies. And you’re feeling the distance between those two rectus bellies, and that’s not considering where someone’s rib cage is at, it’s not considering where the pelvis is at, it’s just looking at what’s going on at that midline. And so when I evaluate someone’s abdominal wall for diastasis recti, that is one small piece of the evaluation.

But you can start to get a better assessment of your entire abdominal wall by just, you can lay down on your back, you take note of what you’re feeling in contact with the floor. So if you lay on your back and all you feel is your tailbone and your shoulders, we know that we’ve got some tension in the back of that body. If you can feel some of your rib cage, or some of your lower back, or your entire back on the ground, cool, okay, we’re like settling down into the ground. Then, usually a lot of people like put their hands on their lower ribs, and then you can kind of compare side to side, and you can compare the angle that those lower ribs take. So infrasternal angle is the angle of the rib cage, and that angle can be greater or less than 90 degrees, and you can feel that on yourself. Sometimes I’ll have people take your thumbs and hook your thumbs in there, and that can give us a little picture of, okay, if I’m really wide on one side and really narrow on the other, or I’m very wide on both sides, or very narrow on both sides, then that gives us some info. Then, taking your fingers and patting down that abdominal wall. And you can get a sense for the thickness, the integrity, of the muscles of that entire abdominal wall.

So if you lay down on and you feel like your ribcage down to your hip bones feels like more muscular on one side versus the other, that can give us a window into some of that asymmetry. And then I’ll often have people even try going, span their fingers out…

Gina: Like this?

Hayley: Span them out, like across, like this, like from the rib down to their hip bones. And people will sometimes find that it’s smaller on one side versus the other. So if your index finger is hooked under the rib and your pinky finger can touch the hip bone and there’s a difference between one side versus the other, it starts to give us this little picture of, ooh, maybe we’ve got more compression on that right side, and a little bit more expansion on the left. Or you might find something a little bit different in yourself. And so that sometimes helps give us a little window into that.

And so then when we go back and come back to our curl up, right? And we go, “Oh, I really notice that I’m quite wide on the left side and quite narrow on the right. What happens if I exhale, feel my body shift over to the left side, get that left side coming together a little bit more, then curl up? How does that maybe change what’s going on at that midline?” And often we see that now those measurements are different, right? We can manipulate in a moment, from moment to moment, we can manipulate our measurement of that midline.

And the research on our reliability of those measurements is poor, right? We’re, from person to person, comparing someone’s diasis, we’re not good at that. We know this from research that’s been done. And so, I like to take a little bit more of a look at that entire abdominal wall. Is someone really holding on tight to those upper… Is someone holding on tight? Are you gripping those upper abdominals and maybe overpowering those lower abdominals. Or, are we just keeping that entire abdominal wall clenched and stiff? There’s ways that you can get a picture into that. And I like to show clients, like again, we can change that diastasis measurement in a moment, meaning, okay, we can optimize how you’re creating tension through that midline. Now you can do whatever you want.

Gina: Yeah.

Hayley: Like you can do whatever you want. Do we need to be maybe conscious of what you’re doing a little bit more? Will that help us? And so that’s really cool.

And, so sometimes I like to joke with my patients. I go, “I don’t care about your diastasis,” I do, and they do, but I care about everything above and everything below that and how we can then get it to work.

Gina: Yeah. It seems like just body awareness is a key thing when it comes to healing and feeling good in our bodies again. Because even when, I think you were talking about, like, you had Casey do a pelvic floor exam on you.

Hayley: Oh yeah.

Gina: And your Kegel was like zero out of five. And then once you shifted, it was so much better.

Hayley: Yeah.

Gina: And it was all about like positioning. And so it’s not necessarily… ’cause we’ll get folks that are like, “My doctor checked my diastasis and they said I’m gonna need surgery,” or, “My PT checked it and they said I had it,” and I was like, “…and then what?” So it is crazy that just shifting your position can make a huge change in like the integrity of your core and the tension that you can generate.

Because that applies to so many different movements as well. If someone’s experiencing tons of coning or pain or discomfort in this movement and we make a slight tweak, all of a sudden it’s gone. I had somebody in the gym today that was having more impingement when she was stepping up onto a box. And I was like, “Let’s try a shift like this,” and it was gone.

Hayley: Yeah.

Gina: Just from a position change it. She didn’t magically get so much stronger…

Hayley: No.

Gina: …like in the 10 seconds that we did the shift. And it was all about positioning, which plays a huge role in how our bodies can operate.

Hayley: Yeah. And I think that’s huge. It’s huge for potential healing, ’cause I think sometimes we hear, “Oh, I’ve been diagnosed with diastasis recti, I have this,” and now it becomes part of our identity, and now we’re nervous about doing things because we’ve got this label. And it’s like, “Whoa. Hold on. Let’s just pause for a second. Let’s work on this for a little bit and see what’s shaken out.”

Gina: Absolutely. Another thing, and talking about what we were discussing before with loading the tissue, one of the things that I’ll sometimes see where someone is like struggling and struggling with healing their diastasis is that they haven’t challenged themselves enough. Instead of it being like, “You’re doing too much, let’s regress,” sometimes it’s like, “The heel slides are not gonna cut it. Like we need to get off the floor.”

Hayley: Right? Heck yeah.

Gina: And like come into an upright position. Like all of our core exercises cannot be dead bugs and bird dogs and heel slides and Kegels and whatever. Like we need to take what we’re learning in these supine floor positions and move into a position that we operate in. Like we operate in a standing position, this is how we move our human bodies. And so coming off the floor to then integrate our exercises is gonna be beneficial. And then loading that tissue with weights.

And I think there’s, there is still, there’s less than it was before, but there’s still some stigma with weightlifting as a woman. We’re less familiar with it, we’re not maybe as comfortable with going to a gym and like learning how to lift weights. It’s a little bit scarier. But I’m really thankful for things like CrossFit and like women’s focused fitness facilities to make lifting weights more accessible ’cause it’s so beneficial. Not only for this timeframe in the postpartum to help our tissues get denser and stronger, it’s also really beneficial for our bone strength and density, which helps us long term as well, like even beyond this small time within our lives.

And so if someone is noticing plateauing with their diastasis, “Hey, I’ve been doing all my exercises and I’m not noticing a change,” I’m like, “Have you been lifting weights? Do you feel challenged in the movements? Like we can’t just do HIIT workouts, like we need to lift.”

Hayley: Load, yeah. And I think lifting and then looking at our, again, what is the function of these abdominal muscles? And the function of these abdominal muscles is not just to work in this front to back plane, but side bending and rotation, making sure that the things that we’re doing for our whole body incorporate flexion, extension, side bending, and rotation, to work those muscles in all the different planes that they function in for more complete sort of rehab of those muscles.

Gina: Absolutely. So if you could give someone some advice during their pregnancy and/or postpartum when it comes to the labeling of diastasis, where, “shrink your waist,” like “mommy pooch,” all this like harmful marketing that is targeting like women in this very vulnerable timeframe, our bodies are very different than they were in other points in our life. What advice would you give to somebody who is starting to navigate this and feeling nervous about diastasis and those trigger words?

Hayley: It is normal for your abdomen to not be perfectly flat after you have a baby. It’s perfectly normal for your abdomen to not be flat before you have children. And so that is not an indicator of function. Like, you could have, I’ve had clients with very large gaps whose cores function just fine. I’ve had people with zero diastasis whose ab muscles don’t really worked that well and they have a lot of dysfunction, so back pain, or whatever. And so a DR diagnosis is not your fault, and, it is also not a red light for exercise. And flatness and aesthetics can certainly be a goal, but knowing that you didn’t do anything right or wrong, if that’s not what you have.

Gina: Yeah, absolutely.

Hayley: I think, I think a lot of programs that sell a lot of units, use a front person who genetically is really fortunate that they have low body fat and they naturally have a flatter belly. So they’re performing exercises in their own postpartum journeys, and we see that, and we want that, and so we then we buy that thing. We’re in a vulnerable place to be marketed to in that way. And then when you actually dig into that programming, it’s, yeah, it’s heel slides.

So that’s what I would say to that. It’s not… it’s a process. Like healing our bodies and our core postpartum is a process. And again, you get to decide what your goals are with that, whether aesthetically, functionally and just because your belly’s not flat does not mean

Gina: Something’s wrong with you.

Hayley: Something’s wrong.

Gina: Yeah, absolutely. Yeah. I definitely find that there are certain marketing practices that are very effective. They’re a little unethical in my opinion, but they’re very effective, and it’s to prey on someone’s vulnerabilities. And so if you market to someone that they need to be smaller and they need to fit this aesthetic to be happy and healthy in the postpartum, it’s really easy to get people to buy stuff from you. Like with the before and after pictures, the photos that’s just the abs and they’re like super flexed, the lighting’s really nice. Those irritate the absolute living shit out of me, and it’s something that we’ll never do at MamasteFit. Like we’ll never do a before and after photo, ’cause just because someone’s smaller doesn’t equate better function, feeling better in their body, a better quality of life, which is what we really care about. Like I don’t care if your goal is to lose weight, to fit a certain aesthetic, like I support you in whatever someone’s goals are, but that’s not like the main focus we want. We’re focusing on function over aesthetics. We want you to feel good in your body.

It’s a big reason why like I don’t normally post a lot of pictures of, “Look at my abs like nine months in, nine months out,” kind of pictures, ’cause it’s not important. Like it’s not important what I look like. Sure if I really marketed using my own body, I would probably sell more programs ’cause it would be appealing. Like it is a cheap marketing tactic, and we’re not into that.

Hayley: Yeah. I’ve had lots of clients who have purchased programs and are coming to me post trying a diastasis program, right? “Oh, I bought this program that’s specifically for Mommy Tummy and I followed it to a T and I’m not seeing the changes I wanna see,” or, whatever. And, it’s like, well we can’t like spot lose weight either. Like you can’t just do all this isolated core work and expect that you’re gonna just get shredded in your core,

Gina: Yeah.

Hayley: if you’re not addressing the rest of your whole body, right? You’re not gonna have like toothpick legs you know, it’s just not how physiology works. Yeah, being able to zoom out a little bit, approach the system as a whole, and when our whole system is working well, then we can focus in on whatever it is that your goal is.

Gina: Absolutely. Thank you so much, Hayley, for coming on the podcast and sharing all your insight on diastasis. Thanks for bringing your little dude, too! So if you heard any little noises while listening, Hayley was not farting. It was her baby.

Hayley: Oh my gosh.

Gina: Her baby having a blowout.

Hayley: Oh my gosh!

Gina: You guys can follow Hayley on Instagram @HayleyKavaPT, we’ll link her info down below. She offers a pay-what-you-want Pelvic Balance Series, online, which you can pay a dollar, you can pay 50 bucks. You can pay whatever you want to learn from her in a group setting. Highly recommend the course, especially if you wanna learn more about how your body is moving and get support from a PT in more of a group setting.

So check out her online offering. She offers one-on-one virtual consults. If you’re local to us, you can come work with her in person. Thanks so much, Hayley, for coming on the podcast.

Hayley: Yeah, thanks for having me.

Gina: Thanks so much for listening to this podcast episode. If you want to learn more from us, check out our prenatal fitness programs and our postpartum fitness programs so that you can have the exercises to help you feel good within your body, to help you feel strong during your pregnancy and your postpartum. And we also integrate a lot of those rotational movements, those one-sided movements to help address the asymmetry that you may be experiencing as well.

You can check out all of our fitness programs on our website at mamastefit.com, and you can use code STORY10 to get 10% off any of our online offerings. And you can even bundle them with some of our other courses to save an additional 15% off.

This podcast is sponsored by, Needed a perinatal nutrition company that specializes in optimizing nourishment for the perinatal timeframe. If you wanna check ’em out, you can check ’em out at thisisneeded.com and use code MAMASTEPOD to get 20% off your order.