Diastasis Recti

By Sofie Jacobs

Oh the incredible journey of motherhood! When we embark on the joys of birthing a child, we learn a variety of new terms that were previously foreign to us. For some of us, one such term is Diastasis Recti (DR).

Diastasis Recti is a common condition that can affect both women and men. However, it is more common in women and is typically noticed after giving birth but sadly it often remains undiagnosed. Diastasis Recti is the culprit behind the very much dreaded “mom tummy” or ‘mum tum’ – the one that most mamas struggle to get rid of post-pregnancy.

The ‘jelly belly’ is often seen as solely a ‘cosmetic’ issue, however the condition can cause symptoms such as lower back pain, urinary incontinence, constipation, sexual dysfunction. Psychological implications can include reduced confidence, negative body image, guilt and even shame. For all you wanting to know more about Diastasis Recti and how the condition can be managed, we’ve got you covered.

What is Diastasis Recti?

Diastasis recti is a partial or complete separation (Diastasis) between the left and right side of the rectus abdominis muscle (Recti), also known as the “six-pack” muscles. When the muscles separate the connective tissue (linea alba) joining these muscles stretches sideways. It’s very common in pregnant women – approximately two thirds of women suffer from it.

An expanding uterus (a result of an evolving pregnancy and growing baby(ies) puts exceptional pressure on the tummy and in some instances the muscles in front are unable to maintain their form.

Some women start to experience symptoms of Diastasis Recti towards the end of the second trimester or beginning of the third trimester. Others won’t know they have the condition until they’re in the postpartum period and sadly too many are left undiagnosed.

A few warning signs to indicate that you may have Diastasis Recti include; weak abdominal muscles, lower back pain, weak pelvic floor, a bulge, ridge or ‘gap’ that runs down the middle of the abdomen, difficulty lifting objects, poor posture, and it will be most noticeable when the abs are contracted or engaged.

Why does it happen?

During pregnancy, the body does many incredible things to accommodate a growing baby. One of these is the expansion of the uterus, which needs to be accommodated by the abdominal muscles – each side of the abdominis rectus muscle separates as the tissue between the muscles stretches to make room for the baby.

For this reason, many post-pregnancy women observe an indentation in the middle of their tummy – right down the center of the “six-pack” area. For some mammas, that gap closes over time, but for others, it may stay open.

This leaves an area of weakness in the abdominal wall, especially around the bellybutton. This weak spot can be between 2 or more centimeters wide and often causes a visible bulge or ‘mummy tummy’ as a result of compromised support. 

Every new mama familiar with the condition worries about ‘the gap’ and the number of fingers or centimeter gap there is. However, the number is actually not that important. What is more important is the actual core function and integrity of the connective tissue. For instance, a 2.5 cm gap with a core that functions well and connective tissue that is in a healthy condition is a better scenario than having a 1 cm gap with a core that doesn’t function well and connective tissue that is not in good condition.

How to manage Diastasis Recti

Protecting your abdomen during pregnancy can help keep the muscles from separating. For instance, always use the log roll maneuver when getting out of bed during pregnancy.

There are also a few smart and safe exercises that you can do during your pregnancy to increase your body’s resilience, prepare the body for labor, as well as optimise postpartum recovery. If you can, work with a Woman’s Health Physio or an experienced and certified maternity fitness professional to get a personalised plan. 

If you’ve already given birth and have been diagnosed with Diastasis Recti, know that the condition can get treated. Ask your doctor for a referral to a Woman’s Health Physiotherapist or work with an experienced trainer who has a special interest in this area.

Generally, you should start with foundation work that includes deep breathing and gentle core activation exercises in a comfortable resting position. You can progressively increase gentle exercise as the body allows (i.e. walking). Heavy lifting, crunches and planks are things that should be avoided.

As big believers in prehab, we encourage our clients to work with a woman’s health physio during pregnancy to get assessed if possible. After birth, it’s important to consult with a professional to ensure that you are on the right track to recover. We highly discourage anyone who has given birth to assess themselves as you won’t get a full picture and may even do more damage than good.

In my opinion, a postnatal check up with a woman’s health physio should become standard. However, I think we’re still years away from that. For now, remember that Diastasis Recti is a common condition that is treatable. Recovery requires a holistic approach supported by movement, nutrition, hydration and mindful breathing.

For regular expert and peer support in navigating pregnancy, early parenthood and postnatal period, join the HATCH™ community now.

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