Diastasis recti NEEDS to occur during pregnancy to make space for your growing baby. Everyone gets DR who carries to or near term. Not everyone will maintain a DR postpartum, and many of us will spontaneously heal.
What possible contributes towards this spontaneous healing?
One possible way is to minimize the amount of coning that occurs during pregnancy and while healing in the postpartum period. When we cone, we are putting extra strain and stress on an already weakened tissue. Coning could aggravate or further damage the tissue, and thus make it more challenging to heal postpartum. Think if you sprained your ankle, but kept running hard on it, it would have a hard time healing. Let’s talk more about what coning is.
What is coning?
Coning is when the Linea alba pushes out further than the rest of the abdominal wall. This could look like a tent or triangle shape of the abdomen. Coning occurs when the internal pressure within the abdominal cavity exceeds the functional capability of the abdominal wall and pushes out at the point of least resistance (the stretched and thinned Linea alba).
What increases pressure??
Certain breathing or pressure management strategies may increase pressure too much, or the external load or demand of task may be too high for your current functional capacity. If you find that you are coning, focusing on your breathing technique or adjusting the movement may help more optimally support your core.
Things that increase pressure
Breath holding or the Valsalva maneuver
Exhale to bear down (exhaling down and out, as opposed to up and in)
Sneezing, coughing, or spontaneous laughing
Increased range of motion (picking up from the floor compared to a counter top)
Increased loading (lifting 100lbs vs 10lbs)
When does coning happen??
Coning tends to occur when the pressure within the abdominal cavity exceeds your management of it. Certain exercises, postural tendencies, or even breathing patterns may cause coning. If we adjust any of those variables, we may find that coning is almost entirely eliminated. The following list is by no means a “no go” list, but rather where we tend to see coning and when you may need to be more focused on your strategy.
Our prenatal strength program incorporates modifications to minimize coning throughout your pregnancy. Learn about diastasis and how to minimize coning throughout pregnancy in our prenatal fitness education course that comes with our programming.
We offer individualized feedback on movements in our private Facebook group and via email for our athletes!
Common movements that may cause coning:
Core flexion (sit ups, crunches)
Core isometric movements (planks)
Overhead movements with rib thrust
Pull Ups or hanging from bar movements
Rowing
But!! All of these movements COULD be done without ANY coning, as well!! It’s all about your strategy.
How can you prevent or minimize coning??
You sure can! We can prevent or minimize coning with a few strategies.
Postural Set Up: how we are setting up for lifts or movements can support or increase demand on our core. If we can maintain a more neutral spine position (ribs stacked over pelvis) during loaded movement, we may find that we can better manage pressure and prevent coning. A common movement that causes coning is overhead movements, such as a strict press, where our client thrusts their ribs upwards and moves out of neutral. This tends to cause coning at the top of their abdomen. Focus on setting up in a neutral position when moving with external load.
Breathing Strategy: focusing on a diaphragmatic breathing pattern, where we inhale down and out, and exhale up and in, can help support how we manage pressure during movement. We want to avoid breath holding during pregnancy and while healing in the postpartum, as it can increase pressure within the abdominal cavity. Focus on syncing movement with the prime movers activation pattern: when your prime mover is eccentric, we inhale (think lengthen to lengthen), and when they are concentric, we exhale (think shorten to shorten). Example: lower in a squat = inhale; rise out of a squat = exhale.
Engagement Cues: turning the transverse abdominals (TA) or corset abs on can help to manage the tension in the linea alba. If you place your fingers in the lower abdominals and cough, you can feel the TA turn on or harden. We want this muscle to be turning on to help support managing that pressure. Cues that could help turn on the TA could include squeezing a ball between the hands; pushing inward; think hip bones coming together; and then focus on activating the pelvic floor (see next number).
External Props: we can use external props to help activate the TA and PF. We like to use a pilates ball in our gym to help cue the pelvic floor. Place the ball between the thighs, and on exhale, squeeze the ball between the thighs to activate the adductors (inner thighs). This helps to activate the pelvis floor… that then trickle effect turns on the TA too. You can also squeeze the ball between the hands.
Increase Support or Decrease Demand: If you try all of the above, and you are still experiencing coning, the movement may be outside of your current capability. This does not mean you will NEVER do planks or pull ups again, but right now we may need to find something else to do instead to better serve your journey. We can decrease range of motion (how far you move); decrease loading or weights; decrease reps or overall volume. These are all methods to make the movement a little easier, or find a new move to do.
Take a look at this set up! Her belly pushes out a bit more forward, causing an anterior pelvic tilt with a slight rib thrust. This position is shortening the backside but increasing the length of the front abdominal wall.
This increase thins the abdominal wall even more than usual, making it less set up to withstand pressure changes. This means that this postural set up could cause coning as she presses overhead with exertion.
Is all coning the same?
No!! Not all coning is the same! The type of coning that we are trying to avoid is a HARD cone, where if you pressed into the cone, it would be rigid and hard to touch. This means there is a lot of pressure pushing into that connective tissue, aka a lot of strain. If it is a SOFT cone, where if you pressured into the cone, it would easily move or “smoosh,” this is probably fine.
A common situation you would find a soft cone is during an inversion or in an all fours position where the core is not engaged, but rather relaxed. We usually get concerned messages about coning in an inversion, but there is nothing to worry about because there is not added strain on the connective tissue with pressure!
Hope this helps you better understand what coning is and how to approach fitness during your pregnancy and postpartum! You can learn more in our fitness education courses or use our fitness programs to support your pre/postnatal fitness journey!
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