Understanding diastasis recti – part 2

Mind the gap - understanding diastasis recti

In part 1 we looked at what a diastasis recti is and common things to look out for if you suspect you might have a diastasis. Here in part 2, we will discuss how physiotherapy can help, and common dos and don’ts if you do have a diastasis.

 

Physiotherapy

Unfortunately, there is not a one-size-fits-all set of exercises that can be prescribed to “fix” a diastasis. Treatment for this condition needs to be individually tailored depending on the extent of the issue, how many weeks post-partum you are, whether you’re experiencing concurrent lower back and pelvic pain, and what sports or activities you want to return to.

 

Initial physiotherapy treatment focuses on re-connecting to your core muscles, which include your diaphragm, transversus abdominus, and pelvic floor muscles. Once these muscles are working and co-ordinating together more effectively then you can start to progress exercises to integrate more superficial muscles. The eventual aim is to regain proper function and co-ordination so that you have a reflexive core that can cope with all the physical demands of being a mum, and also any higher impact and more strenuous exercise you might wish to do.

 

Women with a diastasis who return to higher-level abdominal exercises after pregnancy without first working to re-connect to their core muscles are potentially at higher risk of making their diastasis worse. We advise women against doing any sit-ups, crunches, planks, Russian twists, burpees, or similar higher level abdominal exercises until they have been checked by a physio or post-natal specialist personal trainer.

 

Dos and Don’ts

In general, any movement or sustained posture that increases the pressure in the abdomen or places unwanted tension through the linea alba (the connective tissue down the front of the abdomen) is best to avoid.

 

Things to consider:

 

  • Avoid slouching when sitting, standing or nursing your baby – try to use appropriate pillows to support your back and the baby

 

  • In standing you want to keep your hips and pelvis backed up over your ankles, and your ribcage stacked over the pelvis (see photos below). This helps to reduce unwanted sustained tension through the linea alba and helps get your core muscles into a position where they can work more efficiently

  • Avoid movements that create bulging or peaking of the linea alba. Common culprits are getting in and out of bed through a sit-up movement (try rolling onto your side and using your arms instead), and getting up from the sofa from a reclined position whilst holding your baby (again try to use your arms to help you)

 

  • Tightness through the chest, shoulder and hip flexors are also factors that can increase unwanted pressure through the linea alba, as well as constantly sucking your belly in, or straining whilst on the toilet

 

With diastasis recti it’s important to recognize that it is unlikely that one factor will cause harm on its own. It is the accumulation of day-to-day, repetitive, non-optimal loading through the abdomen that can contribute to diastasis recti. But similarly the opposite is true and women can see great improvements in their diastasis by being mindful of how they’re holding themselves, how they’re holding their babies and how they’re moving.

 

If you have any concerns that you may have a diastasis recti please make an appointment to see one of our specialist pre/post-natal specialist physios for a comprehensive assessment – we’re here to help.

 

Joseph March
Founder and Physiotherapist

After graduating from university in Australia, Joseph had solid exposure in a wide range of areas including professional sports, neurological, pediatrics, gerontology, and rehabilitation.

Joseph has over a decade of experience in Hong Kong, specializing in rehabilitation of musculoskeletal and sports injuries. He has treated issues related to pregnancy, desk jobs, as well as the unique injuries that come with a variety of athletic pursuits.

He has partnered with the Hong Kong Football Club as the performance squad physiotherapist, as well as the Hong Kong Ballet as the consulting physiotherapist.

Joseph’s hobby outside of work is the pursuit of a better functioning body. This has led him to delve deeply into many types of exercise and performance training. He has years of experience in Olympic weight lifting, movement training, powerlifting, yoga, pilates and strength, and conditioning. Through his own journey, Joseph has positioned himself well to understand other bodies and across a wide range of exercise and sport.

In the past Joseph competed at a high level in football and long distance running.

Cardeux Nel
Senior Physiotherapist

Cardeux represented South Africa and attained her first karate world championship medals at the age of 11. Cardeux’s other sport of interest is field hockey, which she has also played at a national level. From a young age, she attended physiotherapy to enhance performance and recovery. Understanding the importance of this stimulated her to pursue a career in helping others.

After graduating from The University of The Free State in South Africa, Cardeux spent a few years working in private practice as well as gaining experience in sports physiotherapy. She assisted with the Springboks in the lead up to the 2015 Rugby World Cup and worked at the Comrades Marathon for 4 consecutive years.

Cardeux’s treatment is focused on exercise, education and a holistic therapy approach. As a keen trail runner, she specializes in performing full running assessments, both clinical and video. She has also completed her post-graduate course in Dry Needling which she provides as part of her treatments.

Cardeux spends her time off continuing to pursue sports-related endeavors. She is captain of the Valley Premier women’s field hockey team, coaches running, and manages the Hong Kong Sports Clinic running team. She also extends her passion for the sport by giving back, as a member of WISE HK – Helping empower, educate and connect women and girls through sport in Hong Kong.

Elaine Leung
Principle Chiropractor

Elaine completed her chiropractic training at Macquarie University in Sydney, Australia with a Bachelor’s degree in Chiropractic Science and Master’s degree in Chiropractic. She then moved to Hong Kong to pursue her career and to promote the importance of health and the work-life balance.

Coming from a family of martial artist and traditional Chinese lion dancers, Elaine also developed an interest in Muay Thai, BJJ and weight training. This of course also comes with some injuries which have always been managed with chiropractic.

Her long interest and love for animals have then lead her to complete a Certificate in Animal Chiropractic in the USA to enable her to provide care for animals as she does for people. She is passionate about getting people (and animals) out of pain and living their lives to the fullest.

Emma Piachaud
Senior Physiotherapist

Emma returned ‘home’ to Hong Kong in 2011 after having spent her childhood here. She completed her Bachelor’s Degree (Hons) in Physiotherapy in the UK and has subsequently worked in the UK, France, and Hong Kong in a variety of settings, including the National Health Service, private hospitals and clinics, and a ski resort.

Emma is a keen sportswoman, which has led to a natural interest in sports injury rehabilitation and exercise-based therapy where she has completed many postgraduate courses specialising in manual therapy and core stability retraining. These have been in areas such as the lumbopelvic complex and thoracic rib cage and their combined effects on the musculoskeletal system. She has used this knowledge when treating clients, from elite athletes with chronic overuse injuries to postnatal women returning to sport.

Emma is available to assess and manage all musculoskeletal conditions including neck and back pain, sports injuries, thoracic and ribcage issues, and post-surgical rehabilitation. In addition, Emma has a specialist interest in treating specific problems related to ante and post-natal women, including pelvic girdle pain, rectus diastasis, mastitis, and assisting in return to sport and fitness.

Katia Kucher
Principle Nutritionist

Katia is a nutritionist with a Precision Nutrition certification and NASM Sports nutrition certification. Katia has also been a fitness, road, and trail running coach for many years. Her focus is on finding the ideal personalized diet plan to maintain a healthy lifestyle. Her other certifications include NASM Personal Trainer, PTA Global Personal Trainer. She also does corporate talks and presentations about nutrition and fitness.

As a nutritionist, her goal is to create a personalized nutrition plan and diet to help clients reach their health and fitness goals, or resolve any health issues. The key is to find a healthy, balanced, life sustainable diet that is adaptable to the client’s body type, metabolism, and lifestyle. For athletes, she creates nutrition programs to improve their performance, strength and endurance levels, and promote faster recovery.

Her background also includes helping clients dealing with injuries, by recommending a diet and specific foods that follow the healing phases to help with the healing quality and speed.

If you find it challenging to find a proper diet that will help you reach any of your goals, Katia can help you achieve your goals or help with any health issues, by recommending a diet you will enjoy and be able to maintain.

Taras Makarenko
Principle Osteopath

Taras is the Principal Osteopath with the Hong Kong Sports Clinic, where he specialises in mechanical pain associated with sports injuries, “desk-bound” related back pain, and nerve entrapment syndromes, like sciatica pain.

He has post-graduate training in both pre and postnatal as well as infant and newborn treatments. His experience includes over 6 years as an independent osteopath, working with multi-disciplinary fields alongside general practitioners, sports doctors, and physiotherapists to provide a higher level of effective recovery for his patients. He has engaged with high-level athletes in the field of tennis, soccer, rugby, field hockey, basketball, dance, ballet, trail-running, and triathletes.

To achieve long-lasting results, Taras strongly believes that structure and function have to be considered equally. His methodology includes an emphasis on educating patients about their pain, and to consider that effective recovery and treatment extends beyond the therapy room. Education is a key component to treatments when walking with patients for their road to recovery, with a mixture of in-clinic and home exercises (stretches and strength focused) as keys factors to improve symptoms.

A French national, he enjoys the fast-paced environment of Hong Kong, with his two kids and wife his loves alongside a keen interest in tennis and running.

Hamish Dickie
Senior Physiotherapist

Hamish originally undertook a Sports Science degree at Otago University and followed this up completing a physiotherapy degree at the Auckland University of Technology. A proud Kiwi, Hamish has worked with a number of high-performance teams and individuals and was part of the New Zealand Olympic team in 2018 where the team won 2 medals.

The first NZ Winter Olympics medals in 26 years. Hamish is still involved with the New Zealand Olympic program and physiotherapist for the Hong Kong Rugby men’s team. In 2018, Hamish’s wife Alex gave birth to the couple’s first child Charlie who has quickly become the apple of his father’s eye.

Prior to Hong Kong, Hamish and Alex spent a number of years in beautiful Queenstown, New Zealand where he developed the regions first high-performance youth sports academy to progress talented athletes. Hamish has worked in other high-performance programs including the New Zealand Baseball team and has worked at major tournaments such as the New Zealand Golf Open.

He has also worked in house at CrossFit boxes and is enjoying working with the CrossFit and weightlifting community in Hong Kong. Hamish was the physiotherapist for the Hong Kong Cricket Club rugby section in 2016/17 and is an active member of the cricket section where he captains the Optimists Sunday premier league team. An avid fitness enthusiast, Hamish loves all the running options that Hong Kong offers and is an avid runner on the wonderful trails.

Needless to say, Hamish understands sports and has a special interest in biomechanics and strength and conditioning components of rehabilitation. Hamish is also a qualified dry needling technician and uses a number of mobilizations, soft tissue and active release techniques to enhance the recovery process. Whether you’re a weekend warrior, youth athlete trying to reach the pinnacle of your sport or an international athlete Hamish is the right physio for you.

Charles Wang
Senior Physiotherapist

Charles completed his Physiotherapy degree at the University of Sydney, Australia. Charles has a particular interest in the link between biomechanics and injury, especially in the lumbopelvic area and lower limb. As such his treatment approach incorporates manual therapies and exercises prescription to optimise movement patterns and to recover from and prevent recurring injuries.

Joe Zhang
Physiotherapist

Joe graduated from the University of Sydney and has worked with a variety of athletes and programs, particularly at the Olympic and Professional level. He was a physiotherapist at the NSW Institute of Sport, working across all the programs in particular the Cycling, Hockey and Wheelchair Basketball programs.

Joe was also a team physiotherapist at the NSW Waratahs Super Rugby team and Sydney FC’s W-League team. He worked also as a state program physiotherapist in gymnastics and netball.

Joe’s treatment approach incorporates soft tissue release, dry needling, mobilisations and exercise prescription to speed up recovery, optimise movement patterns, and prevent injuries from recurring.

Joe has played representative basketball, and was also involved in weightlifting.