Diastasis recti in wheelchair users

We know diastasis recti is not just something we find in post-natal women. Of course when you look at the numbers of those with DR, post-partum women are by far the largest group.
But, as I’ve touched on before, we also find it in men and women who have never given birth but who have another direct cause of diastasis recti. If you have 30 minutes or so, here’s a little episode I did on this on the HPNB podcast.
One of those groups is wheelchair users and that’s what this little blog is about.

A little caveat at the start; Obviously “wheelchair bound” encapsulates a lot of people and a wide variety of levels of muscle and limb control. This kind of makes this a tricky blog to write as some wheelchair users might have minimal leg-function, some have none at all, some have legs and others don’t. Some have full upperbody functionality and others might have very little. As a friend of mine likes to point out; “There’s a reason the Paralympics have soo many different classifications”. I have tried to be as inclusive as possible when writing this blog and designing the program but there is only soo much I can do. I strongly recommend any wheelchair users with diastasis see a physio that can help with that, ask your GP for a referral.

The REAL cause of diastasis recti isn’t pregnancy

As I’ve mentioned before in blogs, and the podcast; Diastasis recti is caused by too much internal pressure on the core.
Let me quickly clarify; By “too much pressure” I mean “too much pressure for YOUR core”. What is fine for one person isn’t necessarily fine for someone else. Obviously not everybody has the same level of core-strength and that’s pretty much what makes the difference.

Sometimes the internal pressure would be too much for any core to handle, which is what we find in pregnancy, but in other cases the diastasis is more preventable.

Diastasis in wheelchair users

Wheelchair users get hit with a double-whammy when it comes to diastasis recti.

On the one hand; We know that being sedentary for large chunks of the day weakens the core.
Sitting in a wheelchair all day and, and I know this sounds stupid, not being able to stand up and go for a walk means that the core doesn’t even get to do it’s very basic daily engagement which even most ridiculously sedentary people get. So the core of a wheelchair user tends to be much weaker than the core of someone who isn’t wheelchair bound, assuming all other conditions are the same.

And on the other hand; wheelchair users quite often have to hoist/push themselves in and out of the chair and this requires quite a bit of effort. What most people do when they have to shift a big weight is hold their breath and brace themselves. Doing this several times a day puts a tremendous strain on a core which is already weakened by being inactive for most of the day.

You can almost feel the strain just looking at her.

How to recover from diastais recti when in a wheelchair

I’m not gonna lie, when you have DR and you’re wheelchair bound it’s a bit trickier and takes a bit more work to heal. BUT(!!!!) fundamentally diastasis is just a muscle injury. And this means it can be resolved through exercise.
The tricky thing then is figuring out which exercises you should do. Obviously the internet/Youtube is great for that sort of thing when you are able-bodied but you’re kind of screwed if you’re not. So, often, you’re left to figuring stuff out for yourself.

Well, no more! Just go to the bottom of this blog and download some help for free.

How can you prevent diastasis recti when you’re in a wheel chair

We all know that prevention is much better than curing when it comes to these things so let’s, briefly, discuss how you can prevent diastasis becoming a problem for you.

Exercise your core muscles. You can still exercise the core muscles very well even if you’re wheelchair bound. Things like anti-rotational exercises (Woodchoppers or Palov/Core presses, holds etc.) can be done “from the comfort of your own wheelchair”. It’s all about how you set the wheelchair up.

Breathe properly when exerting yourself. In other words, exhale through the motion when you’re pushing yourself out of the chair. Try to get your muscles contracting in the way I describe below. S

The corebreath can be practised lying down or seated and breathing this way when exerting yourself will ensure there isn’t too much internal pressure on the core caused by bracing. It also teaches your muscles to activate in the correct order and that is a massive help.

How HPNB can help

As I mentioned on a previous episode of the podcast where I discuss this; HPNB is also very much focussed on the “standard” able-bodied person with diastasis recti. To be honest, it never occured to me that there might be a problem for people in wheelchairs until someone pointed it out to me. I’m guessing the same goes for most fitness professionals, if not most people in the world. But that’s no excuse. I created HPNB and I give everyone 3 months free access. This is because 3 months is long enough for most post-partum women to resolve normal levels of diastasis. Then the program goes into a bit more depth and people can work on one or two other things that they might be looking to work on, or indeed continue to strengthen up their core. I can’t do this for wheelchair users simply because I don’t have the resources to do so at the moment, but we do what we can!

So I’ve put together a little routine for you to try and do. I have had to make some assumptions with regards to muscle activation and someones capabilities for independent movement but I’ve broken it down as best I could. It is based on the standard HPNB system so we know it works. It’s just a case of applying it. If there’s one thing I’ve learned it’s that a lot of people in wheelchairs are shit-hot at rehab so you’ll be very likely familiar with the “It’s only 10 minutes a day” attitude. The sessions are not supposed to last too long, they are a very simple but effective group of exercises that will activate the right muscles and then help strengthen them up and create some muscular endurance. You don’t need anything fancy, just a long resistance band will do the job. This is the basis from which you can move on and take everything to the next level, should you choose to do so with a physio/outside personal trainer or whatever.

Below you can download, for free and no email address required, a 2 month program that should work for most people. You don’t need to sign-up, just click the little links and download the files.
The Youtube clips below each exercise are still the original HPNB clips and are shot with able-bodied women. However, I can’t think of a reason as to why these exercises won’t translate to a wheelchair based user. Some other exercises are on the floor and I reckon that most of these should work wth a bit of adjusting, so I’ve put some comments below the exercises.

If you want to let me know how you’re getting on; What does work, what doesn’t etc. just for some feedback that would be much appreciated.

Home workout week 1-4 wheelchair users

Home workout week 5-8 wheelchair users

All the best,

Peter