Diastasis recti: identification and treatment

A Fit Mess
afitmess
June 21, 2016

Pregnancy is a time when you learn a lot of things about your body. It’s also a time when you realize that carrying a baby does so much more than just make your belly bigger. Often we aren’t made aware of these changes until they happen to us. One unfortunate result of carrying and delivering a baby is known as diastasis recti and it affects many women today.

 

What is diastasis recti?

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle (the muscles that lie on the front of your belly). In simple terms, it’s when a gap forms between your abs, creating a “pooch” near your belly button. Although children and men can develop this condition, it’s most common in women who are pregnant or postpartum mothers. Women who have had more than one baby and those pregnant with multiples are more likely to have this happen. In fact, diastasis recti occurs in about 30% of pregnancies (according to BeFit-Mom).

Diastasis recti occurs because of internal abdominal pressure. Pregnancy is obviously a time when your mid section will experience added stress. As your uterus grows it puts more pressure on your abdominal wall. This pressure causes a strain on your stomach muscles. On top of this, pregnancy hormones cause your muscles and tissue to thin out and relax (to prepare for birth). This can cause your midline to widen and a gap to form between your stomach muscles.

DiastasisRectusAbd-SM
American Physical Therapy Association

 

Why does it matter?

Your abdominal muscles play a major role in your health and well being. They support your spine and control the tilt of your pelvis, reducing or preventing lower back pain. They help you maintain proper posture and body alignment, taking unnecessary stress off your joints and ligaments. And finally, they support you during common activities like bending, lifting, and carrying heavy objects – movements you find yourself doing when you have infants and children. Simply put: separated muscles are weak muscles and increase your odds of injury and lower body pain. They can also worsen over time.

My diastasis recti occurred after the girls were born, but it can develop at any time during pregnancy and following birth. A small separation of the abdomens is fairly normal, however, diastasis recti is distinguished by a gap that is more than two fingers wide (a rough estimate).

 

How to tell if you have diastasis recti

I like the simple test from BeFit-Mom:

  1. Lie on your back with your knees bent, and the soles of your feet on the floor.
  2. Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.
  3. With your abdominal wall relaxed, gently press your fingertips into your abdomen.
  4. Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
  5. Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominis muscle. Test for separation at, above, and below your belly button.

 

If you need further instruction, there are plenty of YouTube videos out there that can be used as a visual reference. It’s rather easy to check this on your own.

Contrary to what you might think, diastasis recti often goes undetected. In fact, I wasn’t aware I had it until four or five months after the girls were born. I went to see a specialist about some postpartum pain I was having and upon examination she told me that I had DR three fingers wide! I was still recovering from my c-section and in quite a bit of pain, but I wasn’t sure what was “normal” healing pain and what was cause for concern. I was also trying to take care of two infants and keep up with a hectic nursing and sleep schedule.

Luckily, my doctor gave me some exercises to do on my own which improved my condition significantly. I also learned proper body movements so as not to cause further damage. And Matthew provided great insight and instruction on what to do, and what NOT to do in terms of postpartum exercises. I had no idea that certain exercises could actually worsen my condition.

Specialty exercises and proper movement can usually improve DR (it certainly did for me), but sometimes surgery may be necessary to repair a significant gap. I still have a small space between my abs (one finger deep) and I’m not sure that will ever change, but I still try to keep proper form during my movements and reduce the unecessary strain I place on my abdomen.

Since this condition is something that deserves more recognition, I thought I’d share some of the things I did to improve my abdominal gap.

 

How I fixed my distasis recti:

  • Postural training
  • Physical therapy and targeted movements
  • Proper postpartum exercises 

 

Postural training: The physical therapist I saw during my pregnancy was an incredible resource (I wish all women would see a PT during pregnancy!). She gave me tips on how to perform daily activities using correct form and proper alignment. Movements like getting in and out of the car, getting out of bed, and carrying a child are everyday activities we rarely pay attention to, yet they are important to address when you have DR. For example, you should avoid any movements that put added pressure or strain on your abdomen. When getting up and out of bed you should always roll to your side and then use your arms to prop yourself up (rather than sitting up from lying on your back). And remember to bend your knees when picking up your children (or any heavy object!).

 

Physical therapy and targeted movements: The doctor I saw postpartum specialized in women’s health and pelvic pain. Having her examine me made me realize that my pain wasn’t normal and that I shouldn’t be telling myself to “suck it up” or give it time. Something wasn’t right. My doctor gave me exercises to do on my own to help heal my gap. I don’t have illustrations of these exercises, but this video features the activities that helped me. The compression crunch using a towel was the single best exercise I did. I noticed my gap closed dramatically after just a month of doing this daily exercise.

 

 

Proper postpartum exercises: There’s an unfortunate misconception that all women should bounce back quickly from childbirth. An expectation that by six weeks postpartum women should be back to “normal.” Sorry, but no. Childbirth is a huge physical and emotional event. And if you had a c-section (like me), that’s major surgery! Recovery time is different for everyone and should not be generalized in the way that it often is. This puts added pressure on new moms to return to their post-baby body and activity level.

That being said, I think one of the most important things to remember is that your body will recover at it’s own pace. Don’t force yourself to return to exercise or activity before you feel ready. Don’t worry – you’ll get there.

When you are ready to return to exercise it’s important to avoid movements that isolate the abdominal muscles which could cause added stress (and further separation). Crunches, sit-ups, and v-ups should be avoided. And research shows these movements are effective at targeting the abdomen anyway. Movements like squats, leg raises, and chin ups are great exercises for increasing core strength (among other things).

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I hope this article was helpful to you. Please let me know if you have dealt with diastasis recti. I’d love to know what may have worked for you. Please share this post in order to help other women gain an understanding of this important issue.

 

 

 

 

2 Comments

  1. It’s amazing how many issues can come up during or after pregnancy and it’s so easy to ignore those problems when you are busy caring for a little one (or two in your case!). I didn’t have diastasis recti, but I dealt with de quervain’s syndrome in my wrist and ended up having surgery, I actually posted about it on my blog last week (http://stitchesandpress.com/2016/06/14/when-picking-up-your-baby-leads-to-wrist-surgery/).

    Glad you are doing better now!

    1. Hi Bernice. Thank you for commenting. I agree, pregnancy brings about so many changes and some of these can happen post delivery or even many months after. I haven’t heard of de quervain’s syndrome, but I’ll look it up now and I’ll check out your post, too. I hope you have recovered well!

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