Restore Your Core: Diastasis Recti and Pelvic Floor Talks Lauren Ohayon

Yoga is an ancient practice that’s sought to unite a person’s body, soul, and mind for whole body health and wellness. Today, yoga has been refined and used as a routine that boasts many health benefits and restorative exercise planning for men and women around the world. Some studies have shown that yoga poses health benefits in potentially helping with anxiety, depression, stress, and helping reduce inflammation in the body. Thus, yoga can go far beyond aiding in balance and flexibility by taking part in exercise routines designed to restore function to your core, pelvic floor, legs, hips, and lumbar spine.


As someone who has experienced a severe back injury and benefitted from restorative yoga, I prioritize how I move in my programs. Instead of reducing exercise, I have developed techniques for continuing yoga and exercise that prioritizes movement safety dynamically. In this article, I will address yoga poses I use in my program that focus on:


Building strength, even during stretchingMaintaining good alignment and formWise and dynamic sequences that challenge you but do not break you

What are The 5 Basic Types of Yoga Stances?


In the practice of yoga, there are 5 basic stances or types of yoga. In order to find the right program for you and which yoga best suits your needs, it may be helpful to give an overview of the most commonly practiced types of yoga. Below is a list of the 5 basic types of yoga.


Standing Poses: Standing poses are often a warm-up practice to help prepare your body for movement. In slow flow yoga, standing poses are often practiced in longer sequences with stages of rest in between.Balancing Poses: Balance poses are great for beginner’s. This form of yoga can help build the necessary core strength for more advanced movements, postures, and stretches. Seated Poses: Seated stretches are great for loosening hips and hamstrings after a workout or at the end of your yoga class. Using a pillow or folded blanket for your bottom can help make these stretches a bit more comfortable.Supine Poses: Resting poses and positions are important to learn for break periods. These positions can continue to relieve and loosen your hips, hamstrings, and provide gentle twists and inversions.

What are 9 Yoga Poses?


My program is designed to teach men and women how to help their bodies become more responsive in their daily activities. This means training the body to engage and respond appropriately when engaging in lifting, walking, standing, and other daily light activities. Posture, breathing mechanics, and how you move your body are crucial to full body health and wellness.


Below I will address a few asanas positions and stretches that I encourage in my yoga practice.


At Restore Your Core, we practice what is known as restorative yoga. This practice incorporates blocks, straps, yoga mats, and blankets to help encourage proper body alignment as well as releasing any tension in your body. Most of these stretches and poses are designed to help release the tension in your body passively – so not always during a stretch.

Leaking of any form sucks. It is a common problem that many people face and is not just a little pesky nuisance that’ll go away if you ignore it. Ignoring urinary leakage may actually lead to more complicated issues in the future, making it harder to manage. Severity of urinary incontinence ranges between a small leak when you sneeze, jump, or cough to sudden uncontrollable urges to urinate that its difficult to make it to the bathroom in time.


Many fitness and health gurus will most likely recommend kegels or exercises that seek to contract or tighten the pelvic floor. However, it isn’t always an issue with your bladder muscles or pelvic floor muscles. Yes, they may be affected or may be presenting the more noticeable symptoms, but more often than not, urinary incontinence is a whole body issue.


What is Urinary Incontinence?


Urinary incontinence is a loss of bladder control that affects people in different ways. The most common types of urinary incontinence include stress incontinence and urge incontinence – an overactive bladder. Incontinence is likely to affect approximately twice as many women as men. This most often due to pregnancy, childbirth, and menopause. Pregnancy stresses and strains the muscles in the pelvic region which may often lead to stress incontinence. However, urinary leakage is not a normal or natural part of aging and is often a sign of an imbalance in the body.


Leaking Bladder


If you are suffering from urinary leakage the chances are that this issue is part of a whole body imbalance. No need to freak out! A whole body imbalance merely means that incontinence is not about your pelvic floor alone. It is about the container that your pelvic floor lives in. Your body. Treating the pelvic floor alone is symptom-targeted rather than root issue focused.


Isolating symptoms can be unhelpful is truly finding and fighting the source of the imbalance. Often, the symptoms we notice did not originate in the affected area. Just like a foot injury may eventually lead to leg, hip, butt, and back pain, urinary incontinence can be a symptom that did not originate in the pelvic floor.


What are the Types of Urinary Incontinence?


The common types of incontinence include:


Stress incontinence — More common in pregnant people or those who delivered vaginally. May be triggered by coughing, laughing, bending, lifting, jumping, or sneezing.Urge incontinence — More often an issue with aging and characterized by increased urinary frequency and urgency (overactive bladder)Overflow incontinence — Overflow incontinence is characterized by dribbling urine, increased frequency of urination, and inability or feeling of incompleteness after urinating.Mixed incontinence — It is possible to experience a combination of the symptoms and types mentioned above.

Symptoms of Urinary Incontinence


Some of the most common symptoms of bladder incontinence are:


Leaking urine during exercise, lifting, bending, or other daily activitiesSudden and strong oncoming urge to urinateUrinating without warning or feeling of urgencyUrinating in your sleepDifficulty holding urine or making it to the restroom in timeRecurrent urinary tract infections

Symphysis Pubis Dysfunction (SPD) happens when the ligaments that keep your pubic bone and pelvis stable become overstretched and no longer stabilize your pelvis. Essentially, a structure that is designed to move very little begins to move a lot, and it can be very painful and difficult to move with ease. SPD is a condition that sometimes arises during pregnancy, though it can also first occur during labor and birth or in the postpartum period. Pelvic girdle pain in general is quite common during pregnancy—between 48% and 71% of women report feeling significant pelvic discomfort. About 30% of women report that the area of the pubic symphysis is painful. While SPD does involve the pelvis and the integrity of the pelvic floor muscles, a general pelvic floor dysfunction treatment like kegels is often not the answer to symphysis pubis dysfunction.


Where is the Symphysis Pubis Located?


The pubic symphysis is a cartilage joint that resides in between the pubic bones: above the genitals and in front of the bladder. In most cases, the joint can rotate and move a few millimeters without causing any issues. 


What are the Symptoms of Symphysis Pubis?


The symptoms of SPD can vary for different people, both in terms of severity and presentation. The most commonly experienced symptoms are:


The symptoms will vary from person to person – both in severity and in presentation. However, if you’re concerned that you have pubic symphysis dysfunction, these symptoms may be present:


Pain in the pelvis in general, and specifically in the groin and inner thighs; pain moving around into the buttocksClicking sounds in the pelvisPain while sleepingActivities like getting out of bed, in and out of cars, stepping up and down from steep stairs, really, any position that widens the legs can be very painful

What Causes Symphysis Pubis Dysfunction


Symphysis pubis dysfunction is most often pregnancy related. However, the factors that predispose people to SPD are quite varied. The medical literature on symphysis pubis pain seems to agree that the hormone relaxin is not entirely to blame. Factors as different as hypermobility, bearing twins or other multiples, and a history of back pain can play a role in pubic symphysis pain during pregnancy. SPD usually resolves for most pregnant people after delivery, with most returning to normal function by 6-12 months postpartum. Rarely, some people find that SPD becomes a longer-term problem. Most people are able to have a vaginal birth even with symphysis pubis dysfunction—finding pain-free ranges of hip movement prior to labor can be helpful if such a delivery is in your birth plan.


What Causes Symphysis Pubis Pain?


Symphysis pubis dysfunction (SPD) and pelvic girdle pain occurs when the ligaments and joints that help support and align your pelvic bone become overly stretched or relaxed. This often leaves the pelvic joint unstable and can lead to various painful sensations, including pelvic pain. During pregnancy, it is common for these joints and ligaments to become stretched, especially as you are nearing the time for delivery. When the pubis symphysis becomes too loose too early in your pregnancy, you may begin to notice more pain in your pubic region.


Although the most common cause of symphysis pubis dysfunction is pregnancy, SPD is not entirely pregnancy related. In some cases, the cause of SPD is unknown.


It may be common to experience pain during pregnancy or postpartum in these areas:


hipsstomachpelvic floorpelvis

What Does Pubic Symphysis Pain Feel Like?


Discomfort and pelvic pain are usually the most common symptoms of symphysis pubis dysfunction. The pain is generally located in the front of the pelvis, above the genitals and pubic bone. In some cases, people report feeling a clicking or popping sensation as they walk or shift their weight. It is common for many men and women to experience the pain in their lower back, lower abdomen, hips, groin, and legs.

Sacroiliac (SI) joint dysfunction can sometimes lead to lumbar spine and leg pain. The SI joint is located between the sacrum and and ilium bones in the pelvis, connecting the spine to the hips. These bones help support and align the entire body. Although the medical field believes that the SI joint is responsible for those suffering from low back pain, it is often a difficult diagnostic to make.


In this article we hope to address SI joint dysfunction and how you may find recovery in our program.


What is SI Joint Pain?


Because the SI joints help support the weight of the entire body, sacroiliac joint pain is often more noticeable while you are walking or lifting heavy objects. The SI joint is supported by strong ligaments and muscles. This keeps the joint from having a flexible range of motion. As people begin to age, it is common for many people to experience stiffening of the ligaments. This can often lead to low back pain.


SI joint dysfunction often occurs when the cartilage wears down. This can lead to the bones rubbing together, which may irritate the sciatic nerve (located in the pelvis). If the joint is unable to move properly or degenerates, a common symptom is chronic pain in the lumbar spine.


In many cases, sacroiliac joint dysfunction can range between mild to severe pain. This can depend on the health of the joint or is caused by an injury. Acute sacroiliac joint dysfunction typically occurs suddenly and resolves over the course of a few days to weeks. Chronic sacroiliac joint dysfunction is characterized by persistent bouts of pain in the pelvis, low back, and legs that may last for more than 3 months. This pain may persist constantly or significantly worsen during certain activities.


Other terms for SI joint conditions include: SI joint dysfunction, SI joint syndrome, SI joint strain, and SI joint inflammation.


What Causes SI Joint Pain


Sacroiliac joint dysfunction is often caused by these four things:


Traumatic injury: sudden impact on the sciatic joint in cases of a motor accident, a fall, or sports injury can damage the sacroiliac jointsArthritis: degeneration of the cartilage (osteoarthritis) or an inflammation of the spine and lumbar joints can cause lower back painPregnancy: During pregnancy the sacroiliac joints become loose and may stretch to accommodate delivery. The added weight of your child and altered gait may stress these joints, which may lead to abnormal wear.

Infection: Though rare, in some cases the si joint may become infected causing low back pain.


What Does SI Joint Pain Feel Like?


Sacroiliac joint dysfunction most commonly affects the lower back and buttocks. However, pain may spread to the legs, groin, and feet. It is often described as a stabbing and pinching chronic pain. Sacroiliitis may be aggravated by:


Prolonged standingBearing more weight on one leg than the otherStair climbingRunningTaking large strides

How Do You Relieve SI Joint Pain?


Sacroiliac joint dysfunction treatment focuses on restoring joint motion and alleviating pain. Physical therapy and movement treatments are usually an effective and preferred method over surgical treatments.


Initial treatments for sacroiliac joint pain typically include:


Rest: Resting for 1 to 2 days is often advised. However, resting for a prolonged period of time may cause joint stiffness to worsen and may increase the pain. It is best to rest and move carefully.Ice or Heat: Ice is a great treatment for reducing inflammation and alleviating discomfort. Heat can be applied around the joint in order to relieve any tension of spasms in the surrounding muscles.Manual manipulation: A movement specialist, physical therapist, or other qualified health professional can help relieve the symptoms of hypomobility. This form of treatment seeks to reduce joint fixation and muscle tension while restoring your range of motion.

Core exercises and workouts help strengthen the muscles in your abdomen, back, and your pelvic floor. In many cases, working out core muscles may aid in your ability to do physical activities, restore damaged muscle groups, and aid in load and weight lifting. However, there are many fitness gurus and exercise routines that encourage unhelpful and potentially damaging core exercises.


One of the scenarios I run into many times with my clients is that they are encouraged to build core strength through navel to spine exercises. They are taught that in order to fully engage in fitness culture, they must try to achieve a flat belly or toned abs in order to be healthy. That cannot be any further from the truth.


This is the heart of what I teach in the Restore Your Core program: navel to spine does not work. Arbitrarily pulling our navel in, tightening the core to do exercise does not rewire, re-pattern, remind our bodies of what they need to do all day long. And if you are working out 1-2 hours a day and doing a lot of navel to spine but then the other 12 hours a day of waking time, your core is not reflexively doing its job – then those 2 hours on the mat are not useful.


In this article, we seek to address the proper way to pursue a strong core rather than doesn't sacrifice function for sexiness.


How Long Does it Take to Restore Your Core?


I wish I had an insta solution for addressing Diastasis Recti, but unfortunately, I do not. Getting a functional core is a process that involves many things including alignment, breathing mechanics and finally, the right way to train using exercise. The whole goal is to train your body to react and respond appropriately to your movements and activities. (Restore Your Core program is based on this approach.)


Effective Core Exercises & Training


Ensure you are not a belly breather. Belly breathing causes a lot of intra abdominal pressure and that can lead to a diastasis recti and pelvic floor dysfunction.Work on your posture and body alignment as both compromise your core.Stop sucking in your belly all day because that does not work.

Here is an alternate way to practice core engagement that doesn’t suck, suck, suck your belly in and it actually works. Try it:


Come to your hands and knees. Ensure that your spine has neutral curves: lower back has a slight arch and upper back is slightly rounded. Booty untucked gently. Look between your hands and imagine you have a cake between them with 100 candles. Inhale and exhale to slowly blow all 100 candles out. You should feel your belly lift away from the floor and tighten. That is your deep core.


Do the same thing sitting. Sit comfortably with a neutral spine. Imagine now you are blowing out a dandelion. Slowly exhale and feel how your core responds. Amazingly, these simple exercises are key to effective core training.


The next step is to get more and more complicated with the exercises so that each time your body needs support of your core – that exhale will direct the support mechanism to engage. The more you do that, again and again, and the harder and more progressive the exercises – the more reflexive your core will be. Your reflexive core will kick in for you for all of your activities because your deep internal support system will be back online.

Your pelvis is vital to supporting your spine and your entire body. At times, the pelvic floor may become overactive or hypertonic. When this happens, the muscles may be overly tight or tense when they should be relaxed. learning to relax and release the correct muscles in your pelvic floor (contracting the muscles as shortly as you would by bulging your bicep – or a long contraction as you would stretching out the bicep). If you have an overactive pelvic floor, you may experience symptoms such as: back pain, painful intercourse, a feeling of heaviness in your pelvic floor muscles, or incontinence.


What Causes a Weak Pelvic Floor?


The most common causes of a weakened pelvic floor usually include:


PregnancyChildbirthProstate cancer (in males)Constipation (strain and forceful pushing during bowel movements)

If your pelvic floor muscles are weakened, your body may begin experiencing a lack of support and alignment. Exercises can help strengthen your pelvic floor muscles and restore the proper support and alignment your body requires to function properly. They may also help alleviate pain and other symptoms you may be facing.


How to Strengthen Your Pelvic Floor Muscles


Find Your Pelvic Floor Muscles


Education is one of the primary benefits that we at RYC offer in our programs. Understanding where your pelvic floor muscles are located and how they affect your body can help benefit your recovery. In my program, I help men and women learn more about how their bodies work and how to properly engage and exercise their pelvic floor muscles.


Pelvic Floor Exercises


Exercise can be a great way to heal your pelvic floor. Unfortunately, in many work out programs for postpartum people and others seeking pelvic floor recovery, kegel exercises are the most commonly recommended exercise to use. However, kegel exercises can actually increase stiffness and make it harder to feel your pelvic floor muscles. Avoiding unnecessary contraction during pelvic floor exercises can be beneficial to recovering the strength and mobility of your pelvic floor muscles.


If we want things to shift in our pelvic floor, we need to also shift the habit mode of our muscles. In the case of our pelvic floors, there tends to be much confusion. Is my pelvic floor too tight? Not tight enough? How can I tell the resting tension? How can I fix it? Before we set out to resolve/fix our pelvic floor dysfunction we need to first “know” our pelvic floor. Know what engaging it feels like, what releasing it feels like, and how to control both contracting and releasing it. Only then we can discern what our tendencies are and create new movement patterns and choices.


Pelvic Floor Exercises: Stretching


Below are a few pelvic floor exercises I cover in my program at RYC. These exercises may help you begin to feel the way your muscles work and go way beyond kegel exercises.


Supine Pelvic Floor Stretch:


Lying on your back, keep your knees bent and bring them toward your chest. Slowly extend your knees to the side to stretch the inner groin. Relax your pelvic floor and butt. Hold this position for 5 to 10 breaths and relax.


Supported Slight Backbend Pelvic Stretch:


This is a fantastic pelvic stretcher. Using a pillow or bolster of some kind, gently lower your back to rest on top of the pillow. Once in position, slowly bring your feet together so the soles of your feet are touching. Keep your knees bent, but gently allow them to open sideways. If you feel any discomfort at all in your back or inner thighs, you can use pillows for further support or get rid of the bolster. Hold for 30 seconds or more (roughly 15 to 20 breaths) and relax.