Under Pressure (Part 1)

If you’re interested in reading more on ideas presented in the article below, I suggest reading Diastasis Recti: The Whole-Body Solution to Abdominal Weakness and separation. If you’d like movement instruction via video, start with Alignment Snacks Complete Set.

I’m having a hard time writing a post on diastasis recti (DR). Why? Because it is a musculoskeletal issue that has various components. The average woman seeking treatment in physical or non-supervised treatment programs spend hours learning about form and exercise. And you want it in 1,000 words.

I think it would be easier for me to explain how a diastasis recti happens in the first place. If you are reading this and don’t have this condition — DON’T HANG UP! The info in this article is about how your body should be all of the time so that you don’t develop this, or other pressure-based conditions like pelvic organ prolapse, varicose veins, constipation, hemorrhoids, hernias, and high blood pressure to name a few.

I know you want me to tell you how to fix it. And I will. But my answer is not going to be: Do these four exercises for five minutes three times a day for ten weeks and then call me in the morning. One of the reasons people have a difficult time correcting their own ailments without surgery is because they are not changing what they did that caused it in the first place – and I don’t mean what they were doing the moment before the ailment happened. Fixing DR is the same as anything else. It is not a situation caused by pregnancy, or a giant baby. It is caused by carrying high pressure in the abdomen. Trying to do exercises to fix a pressure-induced issue while continuing to hold your body in a way that continues to create high pressure will never work.

If a pressure-based ailment has developed in your body, then your entire body needs to be aligned so the pressure goes back to the correct homeostatic values. We have become a spot-treatment kind of culture. An “I’ll give my health at least 60 minutes-a-day” kind of population. An “I’ll spend more money on my clothes than I on what’s under them” kind of population. But if you are really interested in fixing your DR for good, you need to learn what caused it and what you are doing, right now, that is keeping the split in place.

So, are you ready?

Diastasis recti: A musculoskeletal injury, where the rectus abdominus tears at the connective tissue, separating it from the linea alba – a collagen cord that runs from the bottom of your sternum to the front of your pelvis.

Ok, science class! There are three main cavities in the body and probably more than that if you loved Now&Laters as a kid.

The cavities include the thoracic cavity, which houses your heart and lungs; your abdominal cavity, housing your guts and possibly a baby-to-be if you’re lucky,; and finally, your pelvic cavity. If you grew up in a more natural way, walking long distances per year, squatting to bathroom and birth, barefoot, and were well rested, the position of these cavities would be aligned like this:

(P.S. Don’t make fun of my pictures. Even if the feet are tiny and the femurs excessively long.)

Alignment is different than posture. Posture is about how something looks. Alignment is about how something works. So, to work on your alignment is to pick a position that improves performance, not necessarily aesthetics. The above-pictured alignment of the cavities is very important because the pressures within the cavities are affected by various positions.

So let’s talk about pressure.

The best way I can explain pressure is like this. If you have 20 small children and put them in a small room, the pressure will be very high. If you wanted to increase the pressure you could either add more kids or make the room smaller. You could also give all the kids candy.

The only way to decrease the pressure would be to 1) remove some of the children or *stuff* from the space or 2) get a bigger room. Preferably at someone else’s house.

Now back to body alignment, or more importantly, how alignment affects inter-cavity pressure.

After decades and decades of sitting, shoe-wearing, sucking in the stomach, and various postures that we have selected for aesthetics or cultural reasons, this has become the common stance for most Western populations:

The most important thing about this picture, at least for our discussion today, is what is happening to the abdominal cavity. When the ribs lift in front, they drop in the back. Pinching the back of this “abdominal balloon” places the contents under greater pressure. And like things under great pressure, they try to escape. Because the spine bone makes a strong boundary in the back, your guts (or your baby, if there’s one there) have to go…somewhere. The choices are up, down, or forward. Or any combination of the three. In diastasis recti, the forward pressure on the uterus causes the uterus to push forward into the muscle. And it’s not just babies. High pressure abdomens cause all sorts of ruckus.

Here is a fun pic showing how things escape the abdominal cavity:

A hiatal hernia is when the organs move up through the diaphragm and party with the heart and lungs. Hint: It’s no party. And, FYI, neither are the other two.

The pic might be a little silly, but these hernias (especially the hiatal) can be life threatening situations. And if you happen to have one of the more minor ones then take it as a red flag. Pressures are not as they should be in your abdominal cavity (and neither is the alignment).

If you are ready to say buh-bye to your DR, or your “fill in the pressure ailment” the solution starts with whole-body posture. Before you do a stomach exercise, a pilates roll-up, or try any other type of solution, you need to change your pressure gradients. And before you can do that, you need to see how to recognize the body positions that make IAP (intra-abdominal pressure) worse. So, students, what do you see here (don’t cheat — see what you see first!):

And once you’ve checked out my super-duper postures and bedhead (yes, I took these about 10 minutes after rolling out of bed after sleeping for about two hours less than I needed…please don’t zoom in), let me know if you saw this:

You probably noticed that the title of today’s post has the ominous words “Part 1” in the title. So this is where we end today’s presentation.

Your homework, my dear students, is to study these pictures – and  understand the differences between them. Focus particularly on the rib shearing and pelvis thrusting, and not so much on the bed head, which technically isn’t an alignment issue.

The second part is to start to look for and recognize these postures as you are out and about. Once you learn how to see these alignment snafus, you’ll start noticing them everywhere and then eventually in yourself.

As for Part 2,  tune in again to learn other high-pressure makers, some exercises, and what body parts play a significant role in the chronic knee-bending, hip flexing, rib shearing posture that so many of us are so fond of (hint: it’s the psoas, so read *this* too).

Till then, ta-ta. I’m going to go brush my hair now.

Are you still interested in learning more on this?

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42 thoughts on “Under Pressure (Part 1)

  1. OMG… You heard me all the way from the Right Coast. This morning, at 6 am Eastern, I was lying in bed and realizing how my chronic bearing down on my pelvic floor has got to end. I spent an hour lying there just focusing on letting go and feeling the vulnerability, and returning my attention there as much as I could throughout the day. Yes, I really need this info NOW! Thank you, thank you, thank you.

    -Abby

      1. It’s me… Practicing standing in alignment as much as I currently know how. 😉 Oh, yeah, and I made a standing desk a couple of months ago, too, thanks to you. You’re my hero(ine).

      2. Oh, and BTW, I’ve been thinking that your $40 psoas course is my next step. I appreciate how cool you are with not being “salesy” on your blog. It’s okay for you to say, “yes, Abby, I think that’s a great idea.”

        1. The psoas course is amazing. If you want to know all about it, then I recommend the course! Out of all the courses, it is my favorite. And, if you ever do the whole-body course, you can take off the cost of the psoas course, so it’s kind of like a whole-body payment plan 😉 Thanks for your lovely comments too 🙂 I want to know more about your supersimplefoods.com too — I’m going to go read your site 😉

          1. I agree, the Psoas class is amazing. Once you are hooked though you will want to see them all. I did the No more kegals first not because I was having pf trouble but just because it was longer. 🙂 I found that one to be a great intro to a lot of the alignment and exercises. You really can’t go wrong either way.

          2. My website is just a baby right now. I’m allowing it to grow “organically” 😉 so I can stay in balance as best as I’m able. I’ve been a successful “raw-foodist” for 12 years now and have helped lots of people improve their diet and their health. I’ve had so much demand for my expertise that I’m developing a more visible presence and expanding my reach. Like you with bio-mechanics, I’ve seen lots of people on the eating side of things offering questionable health solutions, often with the best of intentions.

            So, yeah, psoas, that’s next on my list. Thank you. I’ve been focused on body mechanics as part of the picture for a long time and still have some nagging issues. Your perspective is really a breath of fresh air (with some timely flatulence…). And yeah, I may very well take the whole body course when I can.

          3. Sounds good. I really love raw foods too 🙂 They make up the bulk of my diet! It will be fun to watch your site evolve…

  2. Brilliant post and pictures Katy. On top of being a ingrained rib thruster and pelvis tucker (working hard on this) I have also been squeezed into a plastic corset for almost a year to correct scoliosis in the lower back. There wasn’t space for anything much in the abdominal cavity e.g. such as food and I assume tummy being pushed in from front meant internals had to push up or down. Maybe my hiatus hernia is not caused by stress after all … 🙂

    1. Geez. Yah, if you surround the body with plastic it doesn’t have the ability to subtly adapt to pressure with muscle activity. I can’t believe they are still trying to get bones back by applying inert pressures. Did any of these people even take a muscle physiology class in college.
      Ok. Rant over.
      And take care of that hernia ASAP. No bueno.

  3. I understand that the correct posture is to lift your chest up, but your chest is more lifted in the first and third pictures and I am wondering why?

    1. Hi Bella,

      Do a search for rib thrust in Katy Says. Those blog posts will probably help answer your question 🙂

    2. Bella – Correct posture is *NOT* lifting the chest. Lifting the chest is incorrect alignment, which is why it is shown in the first and third picture…

    1. Yes! To know more about alignment and HBP, do a search on the blog page for the term blood or blood pressure. There are many posts dedicated just to high blood pressure!

  4. I understand and appreciate your great presentation of accurate science; I just despair of my ability to (literally) “see straight” in order to help myself/others. : (

    1. I think you see more than you know. Once you realize you can *trust* what you see (years of undermined authority, perhaps?) then you will be an even bigger asset than you are now. And you’re pretty awesome now 🙂

  5. I’m excited I got the perfect middle Katy immediately, although I cycle through all three alignments many times a day.

    I like it better as a demo than the shafted Katy on KatySays homepage because the kyphotic curve is so well represented.

    Thanks! You’re magnificent.

    1. Sounds like YOU are magnificent! Nice work — sounds like SOMEONE has been taking the whole-body alignment course 🙂

  6. I am confused about the pressure gradients. Wouldn’t the amount of pressure in each cavity stay the same, but just be changing shape?

    1. The volume of a cavity depends on its shape. When you change the shape, you change the pressure. Imagine a balloon. If you push on the sides to change the shape, it causes the balloon to bulge because of the increased pressure. Or, If you had a measuring cup that was dented inward, the volume of that container would be less than if it wasn’t dinged. Your confusion may be arising from the fact that I didn’t draw a smaller shape when I organized them in the “poor alignment” post. When you thrust your ribs, it pinches the back of the abdomen making it smaller. I’m going to do a post that explains the “why” a little more in depth. Stay tuned!

  7. oh my goodness my husband is laughing at me now as I’m practicing my rib thrusting/non rib thrusting etc all the time:) My problem is that once I get one thing in a good spot another part starts to hurt…still working on it. Then I have those magical moments when it all comes together for, oh, about two seconds:) Thanks for the work you do:)

  8. Thanks Katy! I catch myself doing that first picture while holding and rocking my newborn. I see it in the mirror and remember your baby holding post and try to correct it. I was wondering if you have ever seen varicose veins clear up or go away by correcting the high pressure situation? Or are they irreversible and all we can do is prevent them from getting worse?

    1. I have seen varicose veins clear up but there are some serious steps to take. This is the tip of the iceberg. There are some other alignment exercises and points you need to master (depending on there the veins are!)

  9. Oh, I feel like I’m guilty of all of these bad postures at the same time. I know I have the habit of sucking in/tensing my stomach (even at 38 weeks pregnant) so this is really helpful as a reminder to STOP DOING THAT. I have varicose veins and wonder if this might be a contributing factor. Good to see you say they can clear up. Would you consider a post on that topic…?

    Also, sorry if this is really gauche, but didn’t you *just* have a baby? And those are your abs? Please share your secret. I’m having a baby sometime in the next 3 weeks and am already dreading the ab situation 🙂

    1. At 38 weeks, now is a perfect time to practice letting it go. It will help you in labor, as many women have no idea they continue to “suck in” while pushing down at the same time — this isn’t the fun you’d imagine it to be! Yes, varicose veins are on the list-to-do — I’ll bump it up a bit 🙂
      Congrats on your impending baby! It is amazing. You may be in labor RIGHT NOW! Isn’t that cool!

      Yes, these are my abs. My baby just turned 5 months. Here is my “secret”:
      I breastfeed.
      I walk everywhere and carry my baby in my arms.
      I eat about 2500-3000 calories a day, about 70% of them from high quality fat.
      I don’t eat anything out of a box (usually) or mutter the words “I really shouldn’t be eating this”. I only eat that which I am totally on board eating. If I want a scoop of ice cream, I am super excited to eat it and don’t create any negative emotions or punishments. I’m aligned with my diet, so to speak.
      My core is strong, NOT because I work it hard. I don’t work it at all. I keep my bones in the position that allows my muscles to function, constantly, without me needing to thing about it. Dropping the ribs and keeping a neutral pelvis do wonders for abs.
      I don’t do any high-intensity or stressful activities. I try to meditate for at least 10 minutes a day.
      I belly laugh about 8 times a day. And, I just read one of your posts so i can check one belly laugh off my list.
      I don’t have any living room furniture, so I sit on the ground and roll around a lot. The getting up and down off of the floor and stretching while I am there replaces any yoga class that I would make it to before I had a new baby.

      Hmmm. I think that’s it…
      Thanks for your comment! Welcome!

      1. That all sounds do-able! Thank you for the details. It’s always encouraging to hear that sometimes just being sensible will get you a long way. Must practice proper alignment – so many of your posts just ring such a bell, including the piriformis post yesterday (never knew I had a piriformis until I got pregnant) that it would be silly not to!

  10. Is it too late for me – I’ve already got a hiatus hernia. Though I don’t think it was my fault I got one. I had a major stomach op about 20 years ago and there’s a lot of scar tissue just below my ribs. I’m short waisted and, apparently, the pressure of the scar tissue pushing up, coupled with my anatomy, caused the hiatus hernia. So, am I lost cause, as I’m rather worried that I have a life threatening condition!? Is there anything I can do to improve my lot?

    I really enjoy reading your posts, and I’m learning a lot of stuff,

    Emma

    1. It’s never too late to stop these habits and fix your alignment. It would be especially important, in your scar-tissue induced high-pressure situation, to mind your pressure from here on in. You can improve your situation by doing all of the things listed here, and throughout the site! Especially the abdominal relaxation 🙂
      Cheers! Thanks for your comment!!!
      Katy

  11. I know that this is a late posting, but just saw a friend today who has DR and it was great to come back to this posting, re-read and get even more clarification by reading it the second time. I forwarded this posting on to her, so hopefully she will find it helpful. Thanks Katy!

  12. That was an excellent presentation on Hernia’s. I will have to read it and study it some more. Very interesting. New Email address.

  13. Hi Katy,

    I am curious if an umbilical hernia repair would have a negative effect on the muscles and their function. I imagine it would have to, to some degree or another, but…enough that I should think twice about it? I’m torn over everything I read, whether or not to repair mine before or after a pregnancy, or, if there is no strangulation of intestines, to never repair at all.

    Also, if my body is properly ‘stacked’ would this reduce the likelihood of a umbilical hernia becoming more of a problem? Even during pregnancy?

    I’d really appreciate your thoughts.

    Emma

    1. I’m also very interested in the answer to this question. Would proper alignment and strong core muscles help stop a hernia from becoming a curse during pregnancy?

  14. Guh, why do you have to be such a buzz-kill? Here I thought I could just fix my DR with 10 minutes of TvA exercises each day. (Okay, I know those have helped, though! But… alignment, alignment, alignment.)

    Thanks for another great post!

  15. YAY!!!!! I just found this post last night while reading your book and it was definitely the missing piece for me. I read “RUA Rib Thruster” and “Mother Thruster” and knew I was a HUGE rib thruster, but I couldn’t figure out how in the world to get my ribs back until I saw your little drawing and started imagining them sort of closing in the front and lifting in the back. Magic!! I feel like a new (ridiculous looking 80 year old hunch backed woman) person!! Now to work on the shoulders…

    Quick question first: in order to both untuck my tail bone AND keep my ribs down, I feel like my core is really engaged and working. Is this correct and what you would expect me to feel, or am I just gripping too hard to force the alignment and actually just sucking in (which would be bad)?

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