Most of your guts are in a membranous sack and that sack anchors into the front of your back. Read that again. It anchors in diagonal lines that are approximately two to three inches above and below your belly button and go from the left ribs towards the right hip.

The membranous sack is double layered and is technically called the peritoneum and it is fascia. If there’s a fascial pull in the root, it can tug on the peritoneum.

mesenteric root and peritoneum.png

The outer most layer of the peritoneum is attached to the deepest layers of the abdominals, which attach at the linea alba (the line down the middle of your six pack.)

When there’s a fascial pull on the mesenteric root, there’s a separation of the abdominals called a diastasis recti. If you’re super unfortunate, your guts poke through that little (or large hole) and you’ve got yourself a fancy little umbilical hernia.

“Well Casey, how the heck do you fix that?” to which I say “carefully.” As a manual therapist trained in visceral manipulation, I use my hands to introduce load into the root so the tension eases. It’s mildly uncomfortable but always tolerable. Then I do a little bit of Neurokinetic Therapy voodoo to flick on your obliques or release the pelvic or respiratory diaphragms, then it’s up to you to not screw it up again.

I don’t do it unless my clients promise me they’ll try their best not to screw it up.

How does one avoid screwing it up?

  • avoid loaded spinal flexion - no sit ups (at all), hinging at the hips instead of the back, rolling out of bed

  • minimizing intrabdominal pressure for a couple of weeks - no breath holding while lifting or exercising, no straining to poop

  • do resisted rotational movements like paloff press, active revolved abdominal pose or baby dead bugs that challenge you, but not to the point of breath holding or belly peaking

  • practice uddiyana bandha/diaphragm vacuum/abdominal vacuum/hypopressives daily

  • roll on a Coregous ball from your lower right rib cage down to your left hip and back up again, avoid placing it right in the center of your abdomen

  • release you pelvic floor with a Roll Model Method ball (pluses seem to be a good size, avoid the tail bone)

  • minimize your gut inflammation by making good food choices and moving your body


If you’ve got a diastasis recti or umbilical hernia, do yourself a solid and pop in for an appointment or two so your guts don’t pop out.

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