Diastasis Recti – Top Tips

What is Diastasis Recti?

If you still look pregnant months after giving birth, then you may have Diastasis Recti. Diastasis Recti is a condition of the abdominal muscles that can occur after pregnancy. It is a separation of the two sides of the abdominal muscles.

How Common is Diastasis Recti?

Diastasis recti is relatively common and can have negative health consequences during and after pregnancy. It is associated with lower back pain and instability. Up to 53% of women have Diastasis Recti immediately after delivery and up to 40% six months post- pregnancy.

How does Diastasis Recti Occur?

During pregnancy, as the belly grows, changes occur not only to the skin and uterus, but also to the abdominal muscles “six-pack”. As the baby grows larger towards the later stages of pregnancy, your belly must expand out further than the abdominal muscles allow. This expansion is possible due to the linea alba – a line of connective tissue that runs through and connects both sides of the abdominal muscles. Pregnancy hormones also play a role as they relax the connective tissue to accommodate the growing baby. This increased laxity of the connective tissue often leads to a separation between the abdominal muscles that can stick around long after pregnancy. The separation is called Diastasis Recti Abdominis.

It is commonly the cause of stubborn post-baby bellies. As the connective tissue has become more stretched there may be a noticeable separation between the two sides of the abdominal muscles. The separation can vary in width and shape. This can extend all the way from the chest bone to your pubic bone with the largest separation typically around the belly button. Some are noticeable at rest and some with abdominal contractions only.

‘Doming’ – What is it and what causes it?

Abdominal Doming is when your rectus abdominis muscle (6 pack) becomes dominant over your other core muscles. We see this when the rectus pops up and you don’t have activation of the other abdominal muscles. These supporting muscles should kick in when doing core exercises correctly and the abs should flatten. If they don’t your abs will ‘dome’ or stick out. This is a classic sign associated with diastasis recti. A dominant rectus abdominis or ‘doming’ effect often goes hand in hand with stubborn post-baby bellies and back pain.

Does Diastasis Recti cause my back pain?

With a Diastasis Recti you may feel as though you lower back, and pelvis are not as stable and strong as they previously were as the muscles of the abdomen have weakened. It can impair the capacity of the abdominals and other core muscles to do their job correctly. This mean that you may have lost some of the support network for the core, spinal and pelvic muscles. The loss of support and control is often the cause of lower back pain following Diastasis Recti as the risk of injury to the lower back and pelvic floor is increased.

How can I check if I have Diastasis Recti?

You may notice the separation becomes more prominent when coughing, sneezing or sitting up. It may disappear when you lie down or relax your stomach muscles.

Test:

1. Lie on your back with feet flat on the floor and knees bent.
2. Place your hand over your belly palm down with fingers pointing towards the feet.
3. Gently press fingers into naval area and slowly lift head and shoulders slightly off the floor. This causes the abdominals to contract.
4. If there is a gap of at least 2-3 fingers between the muscles as they contract, you have a diastasis.

• Test above and below the belly button.

Some Common MTYHS about Diastasis Recti:

• The separation causes permanent damage to your abdomen.
• It always requires surgical repair.
• The abdominal muscles will always be weaker after childbirth.

The Facts About Diastais Recti:

• The vast majority of women can correct diastasis recti with the proper rehabilitation exercises.
• The abdominal wall can get as strong or stronger after diastasis recti.

Don’t stress!! – DRA is very common post pregnancy and can be healed.

How can Physiotherapy help Diastasis Recti?

Diastasis Recti can be corrected with specific exercises, but you will need the guidance of a Physiotherapist or Rehabilitation Specialist. Doing traditional exercises such as heavy weights, sit-ups (crunches), planks and push-ups can make the condition WORSE. A specific rehabilitation program can also help women who have trouble strengthening their core, even if they don’t have diastasis recti. Physiotherapy can help you regain activation and control of the core and pelvic muscles to decrease the separation of the abdominals. This decreases the risk of lower back pain in the future.

How the Diaphragm is involved with your Core Control

Breathing matters! The diaphragm, pelvic floor and abdominal wall all need to work in sync for the pelvic floor to work optimally. This is why correct breathing is very important for core and pelvic floor control. When we inhale the diaphragm should lengthen and the pelvic floor should relax down. When we exhale the diaphragm shortens and the pelvic floor should rise and contract. With deep breathing you should aim to feel both your belly, rib cage and chest rise and relax evenly. This will help heal diastasis and pelvic floor issues by allowing your system to work properly.

Top 3 Exercises to help with Diastasis Recti.

Learn to relax and contract the pelvic floor muscles

1. Diaphragm Breathing with Pelvic Tilting (Anterior & Posterior)
2. Pelvic Floor Control:  As you breath in imagine filling the pelvic floor with air (pushing pee out), as you breath out imagine lifting the pelvic floor muscles up (stopping pee going out)
3. Dead Bug Progressions (with pelvic floor control & diaphragmatic breathing).

Take a look at this video on our You Tube Channel  – Breathing Techniques For Diastasis Recti

Exercises to AVOID with Diastasis Recti

• Sit-ups
• Front Planks
• Push- Ups
• Squats

What increases the risk of Diastasis Recti?

• Multiple pregnancies
• Poor posture
• Larger Babies
• Incorrect abdominal activation

How can I avoid Diastasis Recti?

If possible, it is a good idea to begin specific exercise before you become pregnant. Once you are pregnant you can continue some of them through the first trimester. Either way it is likely that staying active can help and women who exercise regularly throughout pregnancy are less like to end up with diastasis recti. By the way, if you plan on having more children, it’s worth investing time to repair a diastasis with exercises (not surgery) to strengthen your core before your next pregnancy. It may re-occur, but it is likely to be less severe.

If you have any questions, don’t hesitate to contact our team and see how we can help.

Want to know more…… try this blog on Pregnancy and low back pain