If you Google TVA/TA activation (transverse abdominis) you will find a number of variations for breathing with your TVA. Some recommend flattening your spine and some are adamant that you cannot activate your TVA if you flatten your spine. Here's the stitch. It can be different for each individual. For the general population flattening the spine is key when first learning to activate the TVA. Often it's important to cue that small pelvic tilt until she can appropriately activate the TA and the Pelvic Floor. If they don't add the small tilt, often they tend to compensate with the rectus abdominis or the hip flexors. On the flip side, if she tends to compensate with her glutes when doing a posterior pelvic tilt, then she should leave that small space between her spine and the floor when starting out.
We've covered the function of the pelvic floor, incorporating the pelvic floor into our foundational exercises and pelvic floor anatomy. We briefly covered some urinary incontinence training. But what about specialized pelvic floor training? Download this training from Diane Lee.
We cover postnatal running both in our Postnatal & Case Study sections. For a little more, please read Returning to Running Postnatal – guideline for medical, health and fitness professionals managing this population.
Assuming you are the initial professional checking for diastasic recti, you should instruct your client NOT to engage the transverse abodminis. Most clients are not aware of TA engagement, so the simple cue of raising their shoulders off the ground should suffice. This is the true self test - without TA engagement. If a health care professional has given them a diastasis recti diagnosis, then move forward with our diastasis recti modifications and exercises. If I engage my core, specifically the TA muscles, the gap closes when I raise my head off the ground. Is it still considered a diastasis if it closes with core activation? Megan Hoover, DPT Yes... It is still a diastasis. That fascia has separated. However, the GREAT news is that she is able to close the gap in that crunch position with activating TA. She is at a point where if she was my patient, I would be ok with her doing crunches (as long as she is engaging TA and watching to make sure she can keep it together). I do not have a client/patient engage TA when testing for DR for this very reason. They might think that they are ok, when in reality, they are just getting really good at activating the TA, which is awesome! Just not helpful for testing 🙂 Fascia might be back to it's tensile strength by 1 year postpartum, but that does not mean it is functioning normally. Especially with c-sections.... that scarring affects the fascia as it gets "stuck" to the fascia. For example, if you are wearing a cotton t-shirt and you pinch a section at the front and hold onto it. You are pinching in one area, but the mobility through the rest of the shirt is affected. So even though the fabric is just as strong as it was before, the ability of it to move and function normally is not. This is one reason I am such a proponent for getting that scar tissue and fascia moving the right way. When the fascia is restricted, our bodies always find a way to compensate and can cause other issues.