Breathe For Diastasis-Recti Abdominis

As I sat, attempting to interpret data sheets and statistics (not my forte), I noticed the growing tension in my chest, shoulders and neck. I eventually realized, after a couple hours of work, that I had been so focused and stressed that I had forgotten to breathe. I was essentially holding my breath the entire time I was interpreting my Osteopathic findings which amplified my current state of anxiety.  

As a yoga instructor, prenatal and postnatal movement specialist, I should know better. I mean, I teach women how to breathe. Every. Single. Day!

A few weeks ago, the lovely Sandra Ghaly reminded me, so eloquently of the benefits of diaphragmatic breathing. In her latest blog, she outlined some of the physiological changes that result with voluntary diaphragmatic breath. If you haven’t had a chance to read her blog, please do so before diving into this one. It is worth it, trust me. (https://bodycotoronto.com/breathe/).

Here are just a few of the benefits Sandra highlighted:

  •    Decreased cortisol levels in the brain, which reduces your perceived stress levels
  •    Lowered heart rate and blood pressure
  •    Boosted energy and immunity
  •    Sped up metabolism
  •    Reduced symptoms associated with anxiety, insomnia, post-traumatic stress disorder, depression and attention deficit     disorder
  •    Improved core stability

 

Let’s explore the last statement that diaphragmatic breathing improves your core stability. This last statement is especially important to consider for the pre-natal and post-natal population. For the past two years, or more, I have been researching tirelessly, the condition of Diastasis-Recti Abdominis (DRA). DRA occurs to varying degrees, in 100% of pregnancies and is characterized by the “overstretching”  and thinning of the linea alba. The linea alba is a tendon that runs between your six-pack muscles from your xiphoid process of your sternum to your pubic bone.

 

Core breathing is often prescribed for women in the early post-natal stages as a means to reconnect with the abdominal muscles. Core breathing, or diaphragmatic breathing, is super beneficial for the rehabilitation of DRA. If you are not breathing you are NOT using your core to its full ability, nor are you using all the deepest muscles that help you to “knit” the belly back to together. Here is why:

 

1)    Muscular Connections

 

The thoracic diaphragm is also known as the muscle of respiration or breath. This expansive muscle is positioned horizontally below your lungs and spans the area between your lower six ribs, their costal cartilages and the lumbar spine. It looks and acts like a parachute, broadening and descending during inhalation, while contracting and ascending during exhalation. The thoracic diaphragm has muscular attachments that blend with the rectus-abdominis muscle, that six-pack muscle that is often pulled apart with a DRA. The rectus abdominis blends with each of your abdominal muscles at the linea-alba. Each of your abdominal muscles has connective tissue expansions termed “aponeuroses” which cross-over to the opposite side of the body,  attaching to the linea alba and reinforcing the midline along their course. If you were to dissect the abdominal wall, it is virtually impossible to figure out which aponeuroses belongs to which muscle at the mid-line linea alba (2). This demonstrates the integrated nature of the abdominal muscles and explains why it is impossible to activate and isolate only one ab muscle on one side of your body. Rather they co-contract and function together to support you.

 

Ok…

 

Stay with me, that was a lot of anatomy.

 

What this all means is that your thoracic diaphragm attaches to your six-pack muscle directly and all the other abdominal muscles indirectly through their common place of insertion, the linea alba. So if you are not breathing diaphragmatically, you are not using all of those abs to their full potential of muscular contraction.

 

2) Deep Diaphragmatic Breaths = Stronger Core

 

Due to their anatomical connections, the abs and the thoracic diaphragm have to work together to stabilize you. If you have a restricted or tight diaphragm, you can have less activation through your core. In other words, a strong abdominal contraction relies on the diaphragmatic breath. An increase of the abdominal diameter from front-back with inhalation results in a stretch of the abdominal muscles. A greater stretch of the abdominal muscles enables a greater muscular contraction during exhalation. Think of a rubber band – the more it stretches the greater the force of its retraction or shortening.

 

3)The Pelvic Diaphragm

 

The term, “diaphragmatic breath” refers to both the thoracic and pelvic diaphragm. The pelvic diaphragm is composed of your pelvic floor muscles that span from the pubic bone to the tail bone. The pelvic diaphragm is also oriented horizontally and acts like a hammock across the bottom of the pelvis to contain the abdominopelvic organs. When you breath in, both of your diaphragms must lower and when you breathe out, they contract and lift.

 

You might be wondering: What does this have to do with my six-pack?

 

Well, to fully and maximally contract your abs, you need to use your pelvic floor muscles or have a functional pelvic diaphragm. A synergistic relationship between the abdominals and the pelvic floor musculature has been well observed. With undisturbed physiology, contraction of the muscles of the pelvic floor are co-activated with the internal oblique and transversus abdominis muscles of the abdomen (your deep core muscles!). Even in a population of women who have not been pregnant or given birth, it was nearly impossible to kegel, or lift the pelvic floor, without activating the abs (3). The maximal contraction of the pelvic floor muscles will trigger a maximal contraction of the core muscles. This is why it is so valuable to have your pelvic floor muscles assessed and treated before and after giving birth. You could be doing all the abdominal crunches (really NOT advised with DRA), but if your pelvic floor muscles are not responsive, you are not going to have a maximal contraction of the deep core muscles.

 

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Practicing the diaphragmatic breath is the best way to tune into the two diaphragms and the abdominal wall. Breathe in, nice and slowly, visualize the lowering of the thoracic diaphragm, the expansion of the belly, and the lowering of the pelvic floor. Let it go. Breathe out, visualize the pelvic floor shortening and lifting towards your head, the belly button drawing back towards your spine, and the ribcage coming together.

 

SO!

If you were not motivated to take more time out of your day to breathe deeply, for all of the cellular and physiological changes it can evoke, maybe you will be motivated to breathe your way to a Janet Jackson six-pack.

FLORENCE BOWEN

Florence was first introduced to alternative therapeutic modalities in her teens, as a dancer and competitive athlete. After high school, Florence furthered her dance training and obtained her Honors Bachelor of Science in Kinesiology from McMaster University. Teaming up with the artistic director of the McMaster University contemporary dance company, she developed introductory dance classes for children and teens across Hamilton. Inspired to further her teaching skill-set, she obtained her yoga teacher certification in Hatha yoga. Florence teaches across the city and combines her knowledge of human kinetics, dance, strength and conditioning, and yoga. Teaching movement to pre and postnatal women, and coaching as a birth doula, she gained a unique perspective into the supportive systems available to new and expecting mothers. Florence has an affinity for the holistic approach to women’s care. She is passionate about the assimilation of progressive knowledge to educate and empower women at any stage of life including: pre-conception, pregnancy and recovery after birth. Most recently, Florence completed her five years of study at the Canadian College of Osteopathy in Toronto. As a manual therapist, she believes in having her patients actively participate in their healing. She currently is working to complete her thesis which will examine how osteopathic treatment effects diastasis-recti abdominus in postnatal women.

 

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References:

 

(1)  da Mota, P. G. F., Pascoal, A. G. B. A., Carita, A. I. A. D., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual therapy, 20(1), 200-205.

(2)  Askar, O. M. (1977). Surgical anatomy of the aponeurotic expansions of the anterior abdominal wall. Annals of the Royal college of Surgeons of England, 59(4), 313.

(3)  Neumann, P., & Gill, V. (2002). Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. International Urogynecology Journal, 13(2), 125-132.

 

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