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

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