Most people following me will already know that July is diastasis awareness month (#diastasisawarenessmonth). During this time, health and fitness professionals around the globe share information, education and public health promotion about diastasis.
The last time I did a blog about diastasis was in 2020….you can catch up on it here.
Since then our understanding of diastasis has continued to evolve. We have welcomed new research within an incredibly under researched area and we have challenged the status quo within clinical practice.
So what is new?
It isn’t exactly new for all of us, as my previous blog and the PPP-RR-LD Proforma already called and aligned for it. However, we now have peer reviewed research in print that solidifies that diastasis is more than just a physical issue. It impacts women across the biopsychosocial context meaning that it can impact:
i) physical wellbeing and function – abdominal wall function may be compromised such as sit up action/strength and rotational force. Somewhat important and everyday tasks for new mums….
ii) psychological wellbeing – this will become clearer a little further into this blog however it is well established that diastasis impacts how women feel about their body image, self-confidence and self-efficacy.
iii) social wellbeing – linking in with the points above, women with diastasis find social situations and circumstances more difficult to navigate due to anxiety about looks and comments about their abdominal appearance and often struggle to get clothes to fit as they would like. They can also feel extremely isolated in a world that can often seem to poorly understand or acknowledge diastasis.
I was delighted to be part of this paper led by a fabulous team of Spanish physiotherapists: Fuentes Aparicio F, Rejano-Campo M, Donnelly GM, Vincente-Campos V Self-Reported symptoms in women with diastasis rectus abdominis: A systematic review Journal of Gynecology Obstetrics and Human Reproduction 2021 50(7)
Check out this video of the inspirational Claire Black, who has publicly shared her journey with diastasis and recently exposed the mental health aspects of living with persistent diastasis that not many people talk about.
What else has moved on?
We no longer fear doming or strive for dome free physical activity. We don’t have any robust evidence that doming is bad. After all, it is likely to be a clever strategy that the body has adopted to manage increases in intrabdominal pressure. Instead, we have finally aligned with our sports/musculoskeletal medicine concepts and aim for individual load tolerance. This means that the starting level for each individual with diastasis may look different. Rehabilitation should reflect their strength and conditioning deficits, individual goals and work towards THEIR lifestyle.
As an easy to understand analogy that I use to advise health and fitness professionals is the balloon analogy. If we consider a partially blown up balloon, we can squeeze and deform it, the outward pressure is not excessive. Mild doming that can be deformed by touch is not excessive abdominal pressure against the midline abdominal wall and therefore should not be feared. Women should be reassured that strength and conditioning is important and that this mild doming is not causing harm.
If we now consider a fully blown up balloon and how it has no capacity to be deformed to touch we can begin to understand when doming may be considered a sign that the abdominal wall is being overloaded. To apply this to clinical practice, if a person with diastasis experiences doming that cannot be deformed by touch and they report that it feels like a lot of pressure and strain against the midline abdominal wall, it could be reasoned that it is sensible to regress the load of the activity.
Check out this video which helps make more sense of this analogy.
In fact, we recognise that fear of movement and doing harm is one of the most limiting factors women with diastasis experience. Health and fitness professionals are striving to move past such a reductionist and biopsychosocial-limiting approach and instead support and empower women to become strong and return to the activities they need to do and enjoy participating in.
Stay tuned for new research about diastasis. I am fortunate to get to work with some fantastic researchers and academics throughout the world and we are putting our brains and thoughts together to try and make the most of our opportunity to understand more about this topic. It will hopefully lend more support to all of the above advice but either way I will keep you posted.
Feel free to continue the diastasis conversation by leaving a comment, sharing this blog, or reaching out to me on socials.
Until next time…let’s continue with the #diastasisrevolution.
Don’t forget there is 20% off any diastasis related course or resource during July 2022 for #diastasisawarenessmonth using coupon “dramonth2022” at checkout. Here are some of what are on offer: