Exercise with diastasis rectii and hernia

[MeadowHay]

Wasn't sure where to put this.

My general health and fitness is pretty poor for someone of my age (mid twenties). I have a two year old, a weak pelvic floor (although not usually symptomatic) and chronic back pain due a weak core. I was trying to improve my fitness, especially my core strength, prior to another pregnancy and to improve my back pain. I was doing various exercises at home using body weight and some dumbbell exercises and it was going well, I could see small improvements and my back pain has been sooo much better. I saw a physio briefly almost a year ago who told me that I needed to improve my core strength. I was concerned about injury or worsening my diastasis rectii. She said I had a very small separation which was the same as hers and inevitable after having a child, nothing clinically significant, and that I was free to do whatever core exercise I wanted and it wouldn't get worse unless I had another child.

Unfortunately it seems that I have given myself a hernia which the GP says is related to my diastasis which she agreed is only small. FFS.

What now? It seems like I will never be able to build core strength? But I need to, to stop my back pain. I'm terrified of a second pregnancy making all of it so so much worse too but we really want another.

I asked the GP about exercise and she said to Google and not do any exercises that it says not to do with a diastasis but otherwise I'm fine to continue. She even said I could do planks but Google tells me I can't. She did say a second pregnancy would make the diastasis and the hernia worse but that it shouldn't create additional symptoms.

I can't really afford to see a private physio or anything like that.

My hospital has a drop in with physios for diastasis, although probably not running at the mo due to COVID - could be worth checking yours out. Also, this website has a leaflet on exercises to do:
pogp.csp.org.uk/publications/fit-future

Pilates has been my savior pre, during and now post pregnancy. Although make sure you see one who is properly trained, with post natal qualifications so they can give you appropriate modifications, and ideally one recommended by a women’s health physio. There are some great ones out there doing postnatal classes and location isn’t an issue an issue at the moment as it’s all over zoom (although in person is obviously better after lockdown). Don’t just use a generic one at the gym though because their training can be hit and miss and might end up doing more harm than good.

Can the GP not refer you for physio? I saw a private physio after my first and she was brilliant.
What about a postnatal exercise class? My physio does group classes which might be more affordable, or failing that even a DVD specifically designed for postnatal women.
Do you do your pelvic floor exercises? There's a free NHS app called Squeezy which is really helpful for that.
One thing I really learnt from my physio was that you don't need to do core exercises such as sit ups and planks to strengthen your core and with diastis recti they can be damaging. I did an awful lot of breathing exercises focusing on feeling my breath in my back, ribs, chest and abdomen, stretching exercises called Greyhound and a lot of mobility stuff such as gentle punching with both arms. Squats and lunges also featured a lot but with a heavy focus on technique. You need to be aware if your core is actually stacked correctly so you aren't slumped or with your back arched.

No the GP said my hernia and diastasis are both too small to warrant referral for any kind of treatment. She has referred me for an ultrasound scan to confirm the diagnosis just because she said it would be so rare for someone like me to get a hernia (healthy weight, not super weak core, not pregnant, and with only a small diastasis plus not doing anything mad like moving heavy furniture around or huge weightlifting etc). I feel so unlucky and like my body is just rubbish. And I feel the physio I saw last time maybe didn't give me the correct advice?!

I went to a physio (NHS) who helped me strengthen my core with some very simple exercises. After 2 months I went back and had made good progress (by doing them twice a day) and now exercise "properly". Would it be worth going to a private physio even once to get exercises suitable for you? I also see a private physio sometimes (for something else) and it is £28 for half an hour.

The only ones I can find round here who specialise in women's health (diastasis and pelvic floor etc) charge about £100 for an assessment.

I've bit the bullet and signed on to an online exercise class called holistic core restore which is specifically for women with core/diastasis/pelvic floor weakness/back pain which is all me! Costs like £120 for 6 weeks of classes but you do get some equipment with it and then another six weeks of online platform use or something where you can still have contact with the instructor. Doesn't start for a few weeks but fingers crossed it helps.

Good luck with that! It does sound ideal so i hope it does the trick.