Tuesday, September 15, 2015

Discovering my diastasis recti, and how I am healing it, Part 2

A couple of weeks late, but I am finally back for my 6 week update on my diastasis recti and how I am using the Tupler Technique to heal it.  If you read Part 1 of my journey you might be curious about my experience over the last 6 weeks.  If you haven't read it, please do, as it explains WHAT diastasis recti is, why it is important to check for it, how I discovered I had it, why I chose the Tupler Technique to attempt to heal myself, etc. 

Doing the Exercises
As I mentioned in Part 1, the Tupler Technique is no small commitment.  That became more and more true the further I went with the program.  You are expected to complete the specified exercises 3 times a day.  The number of "reps" and sets of exercises gradually increase (as your transverse muscles get stronger and can handle more challenge) and therefore take a little bit more time to complete as time goes on.  I would say that at first it took me 5-7 minutes to do the exercises (3 times a day).  By week 6 I would say it usually took me more like 15-18 minutes to do them.  That is no small thing when you're home with 4 small kids, homeschooling, and barely have enough time to take a bathroom break during the day as it is!  Making time for the exercises required planning ahead and prioritizing them over other things some days.  I found that I just HAD to do the morning ones before my kids got up and we started our day.  Otherwise I would never pause long enough to do them.  I tried to do the mid-day exercises as soon as I put the kids down for afternoon naps.  Defintely NOT what I wanted to do as soon as I finally had a few quiet minutes to myself, but I did it anyway.  Healing the diastasis was just that important to me.  I knew that I was committing to the program, wanted to do it the right way, all the way, and have no excuses to not see results. I did the evening exercises after the kids went to bed while I watched part of a show or something (little reward for myself, if I had to sit there and do them, I might as well be pleasantly distracted ;-).  Of course there were days here and there where I didn't fit all of the exercises in!!  That usually happened with the middle of the day sets if we were out and about or just too busy.  But I very rarely (as in, almost never) just let myself be lazy if I was at home and just didn't "feel like" doing them.  That's where my competitive nature comes in handy for once, ha!  I wouldn't let myself just not do them without a good reason.

The splint is annoying.  It just is.  However, it definitely loosens up after the first week or two and you just get a lot more used to it!  At first I couldn't imagine how I would wear the thing for months on end, but it really wasn't that bad after the first week or two.  I started in summertime in Colorado.  It's hot here, man!  I had envisioned trying to wear a thin, tight-fitting tank top, then the splint, then another loose-fitting tank top or t-shirt over to "hide" the splint.  But after the first day I realized that I actually didn't care at all what it looked like.  I probably only covered it up with another layer a couple of times in 6 weeks!  I bought the tan color and the black color (not necessary to buy 2, but I wanted to be able to wear both colors and work out in them so I needed to be able to wash them easily without worrying about not having one be dry, etc).  I bought a few tight-fitting tank tops from Target.  Just basic, black, wife-beater style (what an aweful description!) and one with prettier lacy straps.  I wanted them to be fitted so that I could wrap the splint over them and not make them bunch up and look weird.  A lot of the time people didn't even notice I was wearing the splint when I wore the black one over a fitted black tank top!  And if someone asked, it was just a good opportunity to share about an issue that people need to be more aware of anyway.  I don't worry about covering it up or hiding it.  I just don't care that much what it looks like....and it's hot in Colorado!  I really did wear the splint around the clock (except for showering) for the whole 6 weeks.  Like I've said, if I was going to go to all this effort, I wanted to do it right!  Do the exercises diligently, and wear the splint as directed.  Here is a picture of how I wore it just around the house every day.  If I went out I usually wore the black one with a black tank, but I never took a picture wearing that one, apparently.

The Ups and Downs
The ups...  As the weeks went on I definitely felt my TA (transverse abdominals) getting increasingly stronger.  I got into more of a habit of engaging my core constantly during all of my daily activities.  My bellybutton went back in after being "out" post babies.  My low back stopped bothering me.  And honestly I was finally more than just "hopeful" about having a fairly flat stomach after 4 kids.  My abs looked BETTER in the mirror, even though I had completely stopped exercising for the time being.  (It's always nice to exercise less and look better...ha!  If only that worked all the time...)  I could definitely tell it was working and as I checked myself (at the bellybutton, and about 3 inches above and 3 inches below) I saw the finger width begin to close.
The downs...  As the reps/sets increased each week it was harder to make time for them.  Still doable!  But challenging.  I also found that it is extremely important to keep your neck and shoulders relaxed while doing the exercises.  It is easy to tense up and hunch your shoulders as you're concentrating on counting and thinking about which core muscles you're using, etc.  I make a very conscious effort every time I do them to keep my shoulders down and relaxed.  Otherwise you run the risk of building up too much tension in your upper back and neck which can cause problems.  I was aware of this all along so tried to prevent that from happening.  I could tell that I was still getting really tight in my neck about weeks 4/5 and I was about due for a trip to my chiropractor.  It depends on how you feel about "alternative" treatments, but I think chiropractic and massage are important, or at the very list beneficial, while doing this program. The human head is heavy!  When you add in a lot of "head lifts" 3 times a day it's bound to put stress on the neck and shoulders from dead lifting that weight (even if you're using correct form).  Having your spouse do a few minutes of deep massage on your neck and shoulders helps a ton!  And if you're feeling that it's still tightening despite that, a chiropractic adjustment and some of their pressure point work to release tension is key!  I learned my lesson the hard way.  I felt my neck and shoulders getting more and more stressed and I kept putting off a visit to my chiropractor because we were busy starting the school year and I put myself on the back burner.  Then during week 6 I tilted my head back in the shower to rinse my shampoo and totally tweaked my neck!  It was under a lot of strain already and I hadn't been good about loosening it up with massage.  That little movement in the shower was just the last straw and I heard a few little pops and knew what I had done (been down that road before).  Couldn't turn my head without pain!  Anyway, went to my chiro that afternoon and took and few days off of doing the head lifts (kept up the seated contracting exercises) to let things settle down in my upper spine.  Just something to be aware of!  The exercises work, but they do put consistent stress on your neck and shoulders 3 times a day!

My 6-week check in
When I started the Tupler Technique I asked Brooke (the licensed Tupler Technique gal I saw in Denver - check www.diastasisrehab.com for someone local to you!) if it usually takes the whole 18 weeks to heal it, or if it really varies between clients.  She thought I could potentially heal mine closer to 6-10 weeks with the program.  That is because I already had some core strength built up (not great transverse, but not starting from zero, either), I have been a life-long athlete, familiar with how to isolate and use particular muscles, wanted to be disciplined following the program, etc.  I also exercised throughout a couple of pregnancies, and in between pregnancies when I had time (not too long because my kids are all fewer than 2 year apart!).  I had also been working out hard for 6 months or so prior to discovering that I had diastasis recti, so I wasn't concerned about losing weight or changing my diet.  I really just needed to heal the diastasis and that was the only issue. Brooke does a great thing with her practice in that she does free "belly checks" for anyone who wants to come by.  Fabulous way to know for sure if you have diastasis, how bad it is, and what your personal plan could look like to fix it (group class, DVD's on your own, 1 or 2 private sessions with her, etc).  I paid for a 1-hour consultation with her to begin the program, but then went back to see her at 6 weeks for a free "belly check" so she could check my diastasis progress, write down my updated measurements, and take a second set of pictures.  I was nervous to go because it was kind of my "moment of truth" for someone to officially tell me if my work was paying off, and how much further I needed to go for complete healing. 

Well, let me tell you, that was a shocking appointment!  First she looked at my guide book where you log all of your check marks each day for the exercises.  She said I had been extremely consistent (I missed some here and there, but I guess she could tell that I was very intentionally about sticking to the program).  She checked my abs (as you are supposed to do while lying down on the floor) and hesitantly, but excitedly, pronounced me "healed" from the diastasis!!!!  After only 6 weeks!  I was stunned!  If you remember from Part 1, I started with a 4 finger gap at all 3 spots (bellybutton and 3 inches above and below) and my connective tissue between the gap was considered "deep" (as in you can press deep in between your abdominals when you're checking for diastasis) on bottom and middle and "medium/deep" at the top (out of shallow, medium, and deep options).  After 6 weeks my measurements (top to bottom) were now 2 fingers wide and "shallow" depth, 2.5 fingers and medium/shallow, and 2 fingers and shallow.  If you've been pregnant then anything approximately 2 fingers wide or less is considered normal.  Some separation occurs naturally during pregnancy and no one ever has zero gap between their abdominals.  That's why the connective tissue functions to keep them together and strong.  So even though there is still a slight gap, it is considered healed and normal.  The connective tissue is a major factor so going from deep to shallow is a big improvement!  The middle place you measure, right at your bellybutton, is always going to be a little different than above and below it because the bellybutton is there and is always going to make the connective tissue  slightly weaker there, so a shallow/medium depth in the very middle is "normal" for me after 4 pregnancies!

The proof is in the pictures...
Well, I kept debating whether or not I really felt like posting a picture of my stomach online for who knows how many people to see.  Not exactly something I was looking forward to.  However, when I began researching diastasis recti I had a really hard time finding any articles or blogs that showed before and after pictures of people who stuck with the program.  A number of them posted pictures and measurements when they started out, but usually they dropped off and didn't continue with the splint and exercises.  So, in the spirit of hopefully helping someone else on a similar journey, here are the pictures for you.  The first two are the day I started.  Herniated bellybutton and it's pretty obvious that I have diastasis recti!  These pictures show what I looked like being back down to my pre-pregnancy weight, working out hard for 6 months, and my stomach looking WORSE the more crunches I did.  This is as bad as it's ever looked after losing baby weight.  That's how I knew something was wrong: exercise was only exacerbating the problem.

Day 1 of the Tupler Technique
 The second set of pictures were taken at my 6 week check in with Brooke.  Same camera, same lighting, same room as the first set of pictures.  And these were after NOT working out at all for 6 weeks.  Obviously all those crunches I was doing were making the situation a lot worse!!! (If only I had known about this before and saved myself a lot of time and head ache!).  These pictures are after 6 weeks of doing the Tupler Technique exercises, but no exercise beyond that.  In fact, I think I even gained a pound since I stopped working out during the program.  My bellybutton went back in after only a couple of weeks.  (SIDE NOTE: in the second set of pictures I still think my bellybutton looks a little jacked up at the top even though it's back "in."  That's because during college I made the very wise decision to pierce my bellybutton.  Not that uncommon, right?  But when you're a college soccer player...not so smart.  Even with it all taped up it got ripped out during one of my soccer games, which left a nice little scar, which then stretched during 4 pregnancies.  Live and learn....Dad, be proud that I'm finally admitting it was stupid - and thanks for not disowning me at the time).
Week 6 of the Tupler Technique
 Here is a side-by-side of just the front shots so you can see the difference.  Of course it doesn't always look exactly like this and may look different depending on the time of day, if I've been doing the exercises, etc.  It is normal for your muscles to stretch out as the day goes on and your stomach to bloat a little bit by later in the day.  So even though it won't always look exactly like this, I am looking forward to learning more core exercises that are not crunching, in order to continue to improve my core strength and keep definition consistently.  There are plenty of ways to work your core with stabilizing exercises, planks/push ups, standing and side lying exercises, etc.  I am just now on a mission to learn as many of those as I can to replace traditional ab workouts!
Day 1 vs. Week 6
Where I'm at now...
Honestly?  I'm totally paranoid that the diastasis is going to open back up again now that I'm not splinting.  Brooke assured me that all I need to know is that I have a great measurement for what to do and what not to do in order to make sure it doesn't separate again: as long as you can keep your transverse at 5th floor when exercising, that exercise is fine!  If you can't keep it at 5th, then don't do it.  Those terms make sense once you start the program ;-)  I am doing the TT exercises 2-3 times a day, and also starting to add in total body workouts again (slowly!).  I have never had to exercise with modifications in mind or really having to think that hard about what I'm doing.  It's a whole new world now!  My brain hurts just thinking about holding my TA correctly during each repetition of every exercise, making sure I'm doing "belly breaths" (so as not to add extra strain on the connective tissue), etc.  But it's inevitable that I need to learn to work out with these muscles in mind, so I might as well get used to it.  I am attempting to return to the Bikini Body Guide (aka My Favorite Workout).  However, it does incorporate quite a bit of core work on the floor (crunches, jackknifes, leg lifts, etc) which I will need to swap out for "diastasis friendly" core work.  If I go along and decide it's just too much work to change so many things in the routine, then I will try a different work out program which uses primarily standing/stabilizing/side-lying core exercises.

Now you know one of my biggest fears: that the DR will return and go back to the way it looked before.  I guess actually writing that out is a form of accountability for me.  I will post pictures in 2 or 3 months once I've settled into a consistent workout routine, without splinting (except for during exercise, at first), and see how things are looking.  I'm curious, myself!  And a bit nervous.

Important Thought: 
You CANNOT heal the diastasis, then quit the program and not incorporate exercise into your daily life, if you expect it to stay healed.  Think about it.  You'll spend weeks and weeks building that transverse muscle and doing exercises 3 times a day.  If you just quit everything all together and return to life as you lived it before, of course the diastasis will re-open!  Any muscles that you build will not keep their strength without continued exercise.  Now I begin the journey of learning to modify every exercise I do.  Bicep curl include a TA squeeze from 5th to 6th (as they say with the TT).  A push-up includes a core tightening squeeze at the right point.  Everything from now on should incorporate a transverse muscle work out.  It's a bit overwhelming, but I am determined to keep the diastasis closed AND be in good shape!

Thanks for sharing in my journey.  I really hope that my story and the pictures are helpful for someone out there, since I myself had a hard time finding the type of step by step blog post that I was looking for.  Please feel free to share on Facebook, or leave a comment if you're in the same boat!  It always nice to know we're not alone in something new, and potentially discouraging at first :)  Blessings!