Episode 14 – Dr. Sarah Duvall – Pelvic Floor & Diastasis – Coming Back Stronger Than Ever Before!

In this Episode:

• Introduction: Dr. Sarah Duvall
• Common Fears Among Women Returning to Running Postpartum
• Common Considerations for Diastasis
• Pelvic Floor Connections
• Common Red Flags in Running Pictures
• Anterior/Posterior Tilt
• Stress
• Breathing Exercises to Destress
• Accessory Muscles for Breathing
• Conclusion

Show Notes:

0:42 –

Introduction: Dr. Sarah Duvall

• Today we will talk about diastasis to prolapse, breathwork, and more
• Postpartum Corrective Exercise course – Dr. Duvall
• Pelvic floor is important!
• Like, subscribe, give us a review, and please share!
• Pick up a copy of Strength Training for Triathlon Success
  • An entire chapter on breathing there
  • On TrainingPeaks University
• Dr. Duvall is a leader in postpartum corrective exercise
• More triathlon-based than cycling-based episode
• Core Exercise Solutions
  • Blogs posts and videos
• “My passion is to get women their bodies back – for whatever that looks like for them” – Dr. Duvall

7:31 –

Common Fears Among Women Returning to Running Postpartum

• Leaking
• Prolapse
  • “Most women can run with prolapse – if you do the work it takes to get there” – Dr. Duvall
  • “It’s not easy – you gotta put the work in” – Dr. Duvall
• Diastasis: when the mid-abdominal wall stretches to make room for the baby and the tissue thins out
  • “100% of women when they go into that delivery room have some form of diastasis… it’s a really cool, natural way for the body to make room” – Dr. Duvall
  • “It’s not just women who have diastasis – it can also be men” – Menachem

11:11 –

Common Considerations for Diastasis

• Usually your deep inner core is not coordinating as it should
  • Looking for how the deep abdominals are giving with the inhale
    • Nice TA expansion or just belly breath?
    • What kind of bracing are they using?
    • How is the pelvic floor co-contracting?
    • How is their posture?
  • “Everything is connected” – Dr. Duvall

13:12 –

Pelvic Floor Connections

• “The way we react to the ground is our foundation for movement” – Dr. Duvall
  • It affects how the rest of your body reacts
  • “What’s going on with your feet is a window into what’s going on with your hips… and then your hips are a window into your pelvic floor, and your pelvic floor is a window into your respiratory diaphragm” – Dr. Duvall

15:06 –

Common Red Flags in Running Pictures

• Posture and pelvis
  • Is your bottom tucked under and your head forward?
  • Are you hunched forward?
  • Is your pelvis anteriorly tilted?
    • Could be a compensation for hip impingement

17:26 –

Anterior/Posterior Tilt

• Both can contribute to diastasis and prevent a diastasis from healing
  • If you’re pelvis is tilted it’s not lined up with your diaphragm, which prevents the deep abdominals from working as they should
• “When you have the tilt either way it ends up stressing that midline by creating abnormal or excessive pressure in the abdomen” – Dr. Duvall
• Pelvic floor/prolapse (pressure issue of the pelvic floor) and diastasis (pressure issue of the front) are closely related just on opposite sides
  • Check in with external obliques, serratus
    • Serratus: “I like to think of it as your transition muscle between your abdominal wall and your shoulders” – Dr. Duvall
• Generally safe test:
  • Take a sideways selfie in the mirror with minimal clothing and analyze your pelvis
    • Is it tucked forward or backward?
    • Do you have an arch in your back? Where?
  • Can you come out of that posture or does it feel really restricted?
• “I am not a fan of stretching – I am a fan of moving through ranges of motion” – Dr. Duvall
• The psoas is the primary vertical stabilizer for the spine

25:38 –

Stress

• “I have seen so many injuries in people because they were stressed out” – Dr. Duvall
• Stress is a huge player in injury
• 4 pillars for athletics progression: hormonal, metabolic, neuromuscular, cardiorespiratory
  • “We all forget the hormonal” – Menachem
  • There’s a general trend for the neuromuscular
• “There are days to train hard and there are days to take a bubble bath” – Dr. Duvall
• How Dr. Duvall manages stress as a mom:
  • “I recognize there are seasons for things” – Dr. Duvall
    • Sometimes I’ll work a little less and train a little harder and vice versa
    • “I have to pick – I can’t do both at the same time” – Dr. Duvall
  • “Something has to give – you cannot have it all to the same level all the time” – Dr. Duvall
• Similar to running the last leg in a relay race that’s how Dr. Duvall does her job – she never wants to let anyone down and wants to be the best for her clients
  • “Then I realized I can’t run this race forever there’s no finish line” – Dr. Duvall
    • She had to create arbitrary finish lines so she wouldn’t burn out
• Don’t lose sight of your dreams!

37:19 –

Breathing Exercises to Destress

• It depends!
• Place your hands on your rib cage and take a nice deep breath
  • What did you feel when you inhaled?
    • “My thumbs went out and back and my fingers went up and out” – Menachem
      • This is what we want – nice even rib cage movement
  • It’s also easier to perform this exercise lying on your side because it decreases postural control
  • Standing is the hardest

41:54 –

Accessory Muscles for Breathing

• Learning to breathe properly with proper pelvic positioning can help heal a diastasis
• A lot of women complain about their bra straps falling off with accessory breathing, which tells you they’re using their accessory muscles
• Accessory muscles = helpers
• Typically you don’t want to use the accessory muscles the whole time on a leisure run
  • Can cause trigger points and “knots” from overuse

44:25 –

Conclusion

• Key advice:
  • “Our body is capable of more than we think – and that includes healing… you’ve gotta have the mental capacity to be able to let it heal” – Dr. Duvall
  • Check your attitude
  • “Our body is listening to us put it down” – Dr. Duvall
    • Be a bit more positive – fake it until you make it!
• Where can we find you?
  • Website: coreexercisesolutions.com
  • Google Sarah Duvall
  • Glutes, Core, and Pelvic Floor
    • Great overview