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4 things to know before you consider surgery for Pelvic Organ Prolapse or Diastasis Recti

Diastasis and Pelvic organ prolapse are among the most common complications from pregnancy. The way our health system works, women miss out on key information and help in avoiding these conditions or keep it from getting worse

Let’s understand these conditions a little better. Why they happen and what you can do about it.

#1. Rib Flaring or Ribcage Width

During pregnancy, the body accommodates and creates space for the baby by expanding the ribcage. This change, if not addressed in postpartum, can cause lingering issues like diastasis recti.

Read that again… the ribcage could be the cause or separation in your abdominal muscles. Surprised? Don’t be!

The external and internal oblique muscles (in the abdominal wall) attach to ribs 4 and 5.

Now, if there is a lack of balance between the external and internal oblique, women experience pressure problems like Diastasis or prolapse.

Clinically, internal oblique dominance is a common finding with a diastasis and external oblique dominance is a common finding with prolapse.

Those who recruit (use) more of their internal obliques tend to have a wider ribcage, and those who recruit more external obliques tend to have a narrower ribcage. Getting the external obliques to kick-in and working on closing the ribs will help heal a Diastasis Recti.

Of course, there will be somebody who will throw me a curve ball, and would not fit in this criterion, but most commonly this is the case.

#2. Diaphragm Excursion with Rib Flaring

The diaphragm plays a crucial role in Core activation and Pelvic floor activation. If the ribcage (lower ribs) is too wide, the diaphragm is in a more flattened position and its excursion (ability to expand) is limited.

Without that, we’re much more likely to use an upper-chest breathing pattern and need to engage our abs to get a good exhale. The abs get engaged instead of simply getting a good passive movement from the diaphragm.

So, in this condition, abs compensate for the limited excursion of the diaphragm. This overworking of abs for breathing leaves the abdominals tight, and “tight” not in a good way! Tight in a way that creates excessive stress on your midline and worsens your diastasis.

#3. Rib cage tipping

Tipped-up or Tipped-under ribcage can put the diaphragm in a position that poorly influences its interaction with pelvic floor. Think about your rib cage as a bell and imagine it’s in a rung-up position.

This position affects the expansion of the back of your diaphragm and creates a poor balance in your system.

Another thing that comes with this tipped-up ribcage is a recurring feeling of lack-of-stability. Women tend to – subconsciously – overwork their abs to keep themselves balanced, and to compensate for this lack of stability.

So, this alignment hampers the ability for your overworked abs to heal. The question then becomes: How tight are your psoas (hip flexors) and quadratus lumborum (back muscles)? They can stop your diaphragm from expanding at the back as it should.

#4. Pelvic Floor Tightness

Pelvic floor tightness can decrease the ability of our diaphragm to go down. Remember the CORE FOUR and remember how important diaphragm movement is for healing? Abs also get affected because they are a part of this system, so a tight pelvic floor can prevent diastasis or prolapse to heal.

We must find out why pelvic floor is tight… is it compensation for your hips, feet or jaw? Tightness in pelvic floor improves by taking the compensations away and with Motor Imagery. It’s a phenomenal approach and I will share more on that with you soon!

So, before you book (or even consider) a surgery for Diastasis or Prolapse, think about the above 4 factors and get them assessed.

With the right professional support, you can easily learn cues and activation patterns that can get your muscles to work in a balanced way and totally avoid a surgery in most cases

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