Sunday, April 20, 2014

The Splint is Temporary, Your Transverse is Forever!

At The Tummy Team we get so many questions about abdominal splinting.  We offer a lot of information on our website about the benefits of splinting, types of splints, why we splint and more.  Yet, there is still a lot of misinformation out there.  Even for clients within our programs, the concept of splinting is often incorrect.

In addition, just like every area of our practice, we are constantly learning more and more about how our body heals and what works and what does not.  Due to this, our view of splinting has changed over the past several yearsof doing Core Rehabilitation.  As we learn and integrate more comprehensive and functional use of the core muscles we have a much better understanding of when and how to use an abdominal splint. 

First, abdominal splinting is TEMPORARY! We including abdominal splinting as the initial portion of the core rehabilitation process.  An abdominal splint can support and fascilitate your transverse abdominis (the internal corset of your body essential to true core strength- see image below).  The proper use of the an abdominal splint can; increase blood flow, increase proprioceptive (feel of the body in space) awareness, protect weak and vulnerable connective tissue, and can supplement the muscle to allow you to be in the optimal postures and alignment for your body to heal. 

In our rehab process, we recommend 90% of our clients use an abdominal splint for at least the first 2 weeks of their rehab even when they do not have a diastasis.The initial awareness and increased support that the splint provides in those first few weeks can be very helpful. When we have ignored and neglected our internal corset muscle for years, the feedback that the splint can offer and the alignment correction that it promotes is eye opening and hopefully encouraging.  The temporary support the splint gives to the transverse reminds the body of how it was designed to function and give us a clear awareness of what we are starting to rebuild when we are doing core rehabilitation.

However, the splint is absolutely temporary.  The goal of the splint is to support the healing and rebuilding of the transverse abdominis.  The TRANVERSE ABDOMINIS is your actual God given splint.  Your splint is temporary but your transverse is forever.  Our goal is to systematically rebuild your muscles so the splint needs to support that goal.  The goal is not to replace your core with a splint.


The initial support and benefits of the splint can easily become an obstacle to your complete healing of the transverse if you use the splint for too long. Using the splint for too long, when you do not "need" it  or as a support to consistently help you do things your are not actually strong enough to do...will make it difficult for your transverse to relearn what it needs to do to hold your body up and together.

It is important that even in the initial days of splinting, that you are focusing on activating your transverse.  Letting the splint cue you and remind you of what that muscle is meant to be doing, even though it is not strong enough to do it all the time yet.  Resting into a splint or simply purchasing a splint to use so you can do activities that you core is likely not strong enough to do consistently will confuse your rehab journey.

Connection, awareness and listening to your body are crucial components to retraining and rebuilding your core and healing a diastasis.  We often look for a quick fix to just let us do what we want to do.  The Tummy Team focuses on the long term correction and lasting strength.  If you get a splint for only protection and comfort but not rehabilitation, you risk becoming weaker and more disconnected over time. If you believe if you simply splint you are safe to train for a 1/2 marathon or where your baby in a carrier all day, you may be deceiving yourself.  The splint can be an important piece in the rehab part but rehab is still needed and it is only a part of the process not the entire process.

There is a step by step process to rebuild your core that uses the splint as a small piece of that process.  Once we have reconnected and started building some initial strength and neutral alignment, we systematically wean you from your splint.  We used to make the decision of when to wean mostly based on the diastasis measurement, however we now realize there are several factors involved to determine when and how to start weaning from your splint.  This is obviously easiest to determine when you are working in person with one of our Core Rehab Specialists, but you can also make some of the decisions be taking an honest look at your own healing journey.

In general, we typically start weaning our clinic patients at around 3-4 weeks into the rehab process and our online clients at week 5-6 (only because it is more difficult for them to assess themselves).  After the first few weeks of Core Rehab, your transverse often is able to activate fairly easily in sitting with and without back support, you have begun using an elongated and active core more naturally and you have learned to exhale and engage to stabilize and support your body with effort.  Your awareness has improved and you then able to begin working on strength and endurance and multitasking.  This is when we start weaning from the splint.  The weaning process focuses on your waking "active" hours not necessarily your sleeping hours.  You wean from the splint by taking it off when your tranverse has the best opportunity to be your splint.  Typically this is in the morning, for the first few hours of the day when you are strongest and can be most focus on your core being active and aligned.  This often starts out at 25% off and 75% on.  You continue to use the splint as the day progresses and in that most exhausting (physcially and emotionally) time of the day 3pm-until you put the kids to bed.  Gradually you replace your core with the splint.  Listening to your body and resting and changing activities as needed.  (Keep in mind this a gross generalization of the complete process.)

The most common mistakes we see with using a splint often occur when people choose to splint without doing the full rehab program.  It is very easy to use the splint as a band aid or as a support to allow you to ignore what your body is telling you. This can be one use of the splint but it cannot be your total use of the splint.  For instance, we absolutely recommend that you use a splint any time you are wearing your baby in a carrier but we also ask that you listen to your body and limit wear time to 45min-1 hour at a time.  If you splint so you can wear your baby all day or while you are cleaning the house or letting the baby sleep on you for a few hours, the splint is supporting you but it is also allowing you to further ignore your bodies needs.  (This said, I am a mother and I understand sometimes we need to hold the baby for a long time with teething and illness etc. These times the splint can be a life saver.  What I am discouraging is letting the splint mislead you into thinking you can do more than you physically can without compensation and pain.) 

Another example, is to wear a splint so you can run or do physically challenging fitness.  If your core is not strong enough to run without a splint then you should dramatically limit your running until you can.  Splinting temporarily so you can learn how to use your core and stay in alignment to run well is great.  To splint for running for weeks, or months or more is actually training your body to rely on a splint to run.  Remember, splinting is temporary and is a step in the process not a replacement for the process.

We used to only sell splints to our rehab clients, since we did not want to encourage people to use the splints incorrectly.  Then we realized that there are many people who need splinting even when they are not ready to invest in full rehab.  We are selling more splints now than ever before but since not everyone that gets a splints go through The Tummy Team rehab process we start getting a lot of questions that are to be expected when only doing a part of the process. 

Possibly the most difficult thing to address is something like this..." I have been splinting for several months now and I am ready to be done with the splint but when I start taking it off and try to last all day my body hurts.  I cannot run like I can with the splint and after a long day of household chores I cannot hold myself up.  I think I reopened my diastasis when helping my son get out of the bathtub.  I guess I need to keep splinting..."  (This was not an actual email more like a combination of several emails we get.)  Splinting more cannot be the answer here.  Core Rehab with some initial splinting is the answer. 

Another difficult comment is... " my splint does not seem to hold me together, it is rolling and the velcro is failing and I keep trying to put it on snug but it just does not feel like enough support."  The splint is temporary and should facilitate but NOT replace your core. Too tight or too much focus on the splint doing its job can distract us from allowing it to help the transverse to do its job.  We need to focus on reconnection, rebuilding the muscles and then using them more and more throughout the day.  The splint helps that but will not do it for us. 

The good news is that your core can and will rebuild if you show it how and ask it to do its job.  There is immediate and long term results when doing Core Rehab.  As much as you want to get better fast, you REALLY want to be better long term.  Our goal is lasting core strength and healing of your core.  It is worth the investment.  Since your splint is temporary but your transverse is forever! 

If you are in the pacific northwest come see us at The Tummy Team.  If you do not we have very effective Comprehensive Core Rehab Programs ONLINE and you can follow that up with a Skype session to get the personal care your body needs to heal.  Let us know how we can help you fully heal.  360-952-CORE.




1 comment:

  1. This post was very helpful. I'm due to give birth to our 4th child in June and am planning on "wrapping" after the birth. Since I don't want to get used to a "corset", I was wondering just how long I would need to wear it to help retrain the muscles. I was thinking that the wrap shouldn't be too tight or worn for too long, or the body would become dependent on the wrap and the muscles would be weakened. Thank you for this information!

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