If you haven’t read my previous blog, Diastasis Recti: PART I – Conception to Diagnosis, it would be worth going back to read that first. This follow-on instalment isn’t necessarily eventful and my intention is certainly not to imply that our experience was harder than others, rather to provide a snap-shot as to how my life was affected by diastasis recti post-partum. I will pick up from where I left off.
The first few days after the twins were born are a bit of a blur, largely due to the sleep deprivation! Aside from them both having a tongue-tie and reflux, our babies were healthy, so we were blessed beyond belief. Sadly though, I was not in good health. Just a few days after delivery my abdomen had swollen to a point where I looked heavily pregnant again. I wouldn’t consider myself vain, but this was not how I envisaged things to be; I anticipated being one of those Mum's that would just 'bounce back'. Whilst I undeniably felt embarrassed by my appearance, it was my limited mobility and constant pain that became the focus of our concerns.
Some of my memories from those early weeks are a little fuzzy, whilst other memories remain extremely vivid. I remember feeling bizarre sensations in my abdomen; the lack of muscular wall had left my unconstrained bowels vulnerable, behind a layer of loose paper-thin skin. I previously described how this looked and felt like an octopus’s tentacles moving over themselves – something I will never forget! Eating resulted in substantial bloating, and my bathroom habits changed significantly!
Although it was my abdomen and pelvis that sustained the most damage, it was my back where I felt the most pain. My lack of anterior abdominal support resulted in a strained lumbar region, alongside frequent and prolonged spasms. Leaning over the side of the bath to wash the boys caused searing pains throughout my back and shoulders. Standing up required me to haul myself up on furniture with my arms or anchor my hands on my waist to support my upper body. This was necessary for almost every activity, every day. The simple act of getting out of bed required me to roll on to all four limbs and reverse off the bed; I was 29 years old!
Approximately two months after the birth, I attended my first physiotherapy appointment. Up until that stage, I had opted to wear an elastic tubular bandage in an attempt to create some degree of support. I was feeling hopeful that the Physiotherapist would firstly, be able to recommend a more appropriate support, but more importantly, she would be able to fix me up and send me on my way.
I followed her into a treatment room and sat down (I was always seeking out a place to sit or lean in order to ease the pain), she looked at me and said, "Oh goodness dear, you are walking like a 90-year-old lady! Whatever are we going to do with you?". She was a sweet lady, full of concern, brimming with experience, and candid to the core. "I have to be honest dear, you have the most severe case of diastasis recti that I have ever seen. I will do what I can for you, but my initial impression is that you will only have one route to recovery and sadly, it's unlikely to be with me." She was so kind and genuinely saddened by my case, I was certain that she was doing the best she could by me, and sometimes that is all you can hope for.
So, there I was, driving home from the appointment with my babies sleeping behind me (probably screaming, but those rose-tinted glasses come in handy sometimes!), with all hope of an easy solution dashed. Although I tried to remain positive, I was so disheartened by my newly-acquired limitations: my inelegant manoeuvres to get out of bed or up from a chair, the constant pain in my pelvis and hips, the groin strains every time I moved slightly awkwardly, the pain induced by coughing and hiccups, and the increasing struggle I faced to pick up the babies as they rapidly grew. Another scary thought that resonated with me was a concern raised by the surgeon who delivered my babies - if I had a car crash, whilst my seatbelt might save my life, it would potentially cause internal damage because of the extent of my diastasis recti.
When the boys were 4 months old, we moved to Australia. Upon arrival, I transferred my care and rehabilitation to a delightful and experienced Physiotherapist. Early on in our sessions she asked me, "I know this is a personal question, but do you plan on having any more children?" I was quick to reply “yes, assuming we can”. She explained that considering my response, we should work on making my body as strong as possible in order to carry a second pregnancy. Whilst my diastasis recti may close slightly, I should focus more broadly, from my pelvic floor up to my ribs, and ‘knit things together’ as much as possible prior to falling pregnant again. She had a fabulous way of describing this 'knitting' concept, and it's something that I often refer to in my own sports classes now.
She described the process as though I was pulling on a super-tight pair of jeans and working hard to zip them up and fasten a belt. In essence, I would concentrate on isolating, then tensing the individual muscle sets in order, from my pelvic girdle through my belly button and beyond. This process would allow my muscles to engage and ‘knit’ together. During this period, I could only practice these exercises whilst laid on my back. I would focus on contracting the muscles deep in my pelvic floor, and all the way up through my rectus abdominis as though I was ‘zipping up the jeans’. Then I would focus on engaging my transverse abdominis muscles whilst I ‘buttoned up the jeans’, before finally engaging my obliques as I ‘tightened up the belt’. It sounds so simple however, given that my separation was still approximately 9 inches across, I was only able to do a very limited version of this. At that stage, the focus was to remind the muscles how they should work and re-learn how to activate them.
I think this sequence is incredibly powerful. The logic and process behind the exercise make perfect sense, and I’m hopeful that someone with a less severe case of diastasis recti could notice significant improvements.
Over the next 6 months she implemented a structured exercise regime to aid my diastasis recti rehabilitation. In parallel, (based on her recommendation) I saw a Personal Trainer who worked with me on controlled cardiovascular exercise and strength & conditioning training, designed to increase my heart rate, burn fat and start working on muscular endurance. I found that tabata-style workouts were better for me due to their high intensity, without fatiguing my muscles too badly or causing significant back pain. I emphasise ‘controlled’ because this plan was extremely light compared to any training I had undertaken prior to the pregnancy.
Here's the thing though, every single minute of every single day (and night) I wore an elasticated support around my entire torso. From the moment I woke up, until going to bed, I also wore an abdominal splint over the top. This corset-like flexible brace worked by pulling my abdominal muscles into the midline, in theory allowing my muscles to relax and encouraging them to close the gap (although I believe it had minimal success on me), it did however, reduce back pain. Furthermore, I wore a padded belt that sat around my hips in order to hold my pelvis in place and minimise pelvic pain and groin injuries. I wore them every single day out of pure necessity! On days when I exercised (2-3 mile walk/jog with the double stroller), in conjunction with the other items, I would also squeeze into some Victorian-style lycra bloomers that ran from my knee to my bra-line. These (non-)sexy smalls had reinforced and compression panelling around the abdominal region.
I felt like a raggedy old doll, held together by patches and tatty thread. In order to hide all of my supportive garments I wore baggy clothes. With hindsight, it's a miracle my husband came close to me and I fell pregnant again! ;) I did not photo-document this period - I really have no photographic evidence at all. I feel somewhat sad now that I was so ashamed of my own body, despite the little miracles that it had created.
Engaging in exercise definitely lifted my spirits. I started to feel healthier, more positive, and noticed that I was able to walk or stand for longer periods of time. I can't speak highly enough of the Physiotherapist and Personal Trainer who supported my journey, but ultimately it was still a smoke-screen, trying to prepare my body for the next pregnancy, not focussing on any form of permanent solution.
Roughly 18 months after the boys were born, I fell pregnant again; considering the state of my body I was grateful that it was only one baby this time!
And so, to the next pregnancy…
(Conversations, even those in quotation marks, are based from memory.)
Comments