Diastasis Recti is commonly defined as abdominal separation. It is known to occur in pregnant and postpartum women, but also in newborn babies, and even gut-busting men.
Despite its often-ambiguous implications, diastasis recti is the hottest new topic in pre and postnatal fitness today. But is it an aesthetic issue, or a serious core-debilitating problem? Does it warrant closing via a surgical procedure, or can it be healed with exercise?
It is important to understand diastasis recti for several reasons. Diastasis represents a foundational core dysfunction that must be addressed for optimal function of your core. Core dysfunctions that result in diastasis are associated with or correlative to numerous other debilitations that are commonly exacerbated around the perinatal period. These debilitations are so common-place that our society now thinks of them as “normal.”
What causes Diastasis Recti?
Diastasis Recti typically occurs in pregnant and postpartum women, however factors such as, excessive weight gain, body composition, heredity, exercising incorrectly, extreme vomiting or coughing or straining on the toilet and number of pregnancies can contribute to developing Diastasis Recti.
What are the complications of Diastasis Recti?
If a diastasis separation weakens the connective tissue enough, intestines may protrude through, forming a hernia. Umbilical hernia – appears as a soft bulge at the navel (umbilicus). It is caused by a weakening of the area or an imperfect closure of the area in infants. This type of hernia is more common in women due to pregnancy.
When the muscles aren’t in the proper alignment (because they are separated), they can’t work as well as they should. This is one way that compensations and non-optimal strategies for movement and stability start to develop. When one part of the core is compromised so that it can’t do its job, something else has to step in and pick up the slack.
Pelvic Floor Dysfunction.
Again, Pelvic Floor muscles, Diaphragm and TVA (transverse abdominis Muscle) and Multifidus work as a team to regulate your intra abdominal pressure, excessive bulging may cause Pelvic Floor Dysfunction.
Lower back pain.
Weak abdominal muscles can cause lower back pain by encouraging a forward-leaning posture (which already exacerbated by pregnancy) and less stability when doing spinal motions. Weaker core might not support your proper alighnment when bending, straightening or lifting, therefore you could be more prone to back pain.
How to check yourself if you have DR?
One way to tell is to look for a torpedo-like protrusion in the middle of your belly, normally it shows when you get out of the bed or from leaning back on the couch.
Another way to check is to lay down on your back with your knees bent and feet on the floor. Then place one hand behind your head and place 2 fingers of your other hand on your belly button.Gradually move your fingers above and below your belly button feeling the edges of your rectus abdominis. Pay attention not only to the width of the separation, but to its depth. The depth of your DR is equally important as its width.
A separation of up to 2 fingers, as long as the gap is shallow, is normal. Anything over 2 fingers-width is DR.
How to fix Diastasis Recti?
Everyone focuses on the separation, or the distance between the two rectus muscles, which is fair given that the term diastasis recti means “separation” of the “rectus muscles,” but it is not the separation that is actually the main problem (other than aesthetics)—rather, it’s the loss of integrity in the connective tissue. The truth is, many times the muscles themselves actually do not realign completely, if at all, yet if the muscles around linea alba generate tension, then the core can be supported and considered “functional.” While closing the gap may be considered ideal, we need to pay more attention to the connective tissue—the linea alba. In order for the linea alba to heal, the core needs to be in optimal alignment, and all core muscles need to work together, at rest and when moving.
1. Abdominal splinting (immediate postpartum).
2. Movements to avoid: crunches, sit ups, full planks, jumping, twisting, heavy lifting. Once you master your Core Activation Techniques, you may gradually return to these activities.
Core activation during everyday movements:
1. Getting in and out the bed: Roll on the side first and then get up, because we have to avoid crunch like movements.
2. Breastfeeding: Nursing often naturally places you in a hunched, and rounded forward position. To improve your posture and reduce pain bring your baby towards your breast, not your breast to the baby. Get breastfeeding pillows to support your upright posture and avoid seated crunching. You can also perform some simple chest stretches by placing your elbow at a right angle against the corner of a wall and gently stretching in the opposite direction. In addition, work on strengthening the backs of your shoulders and mid/upper back muscles. You can do this quite simply by just squeezing your shoulder blades together, almost as if you are trying to make them touch. Do this for about 10-15 seconds and repeat 5-7 times.
3. Carrying a baby:
Try not to lean on one side. Lots of moms lean over or put the baby on their hip.Alternate sides! We should be avoiding twisting to give your linea alba a chance to heal. You can also try baby slings, baby carriers or baby wraps.
The core consists of a number of muscles that work together to support the spine and pelvis. We have outer core muscles which are rectus abdominis and internal & external obliques. And inner core muscles: diaphragm, the transversus abdominis, the multifidus, and the pelvic floor. These muscles work synergistically in anticipation of your every move. The growing belly during pregnancy tends to tip your pelvic forward and pull your back into an excessive arch.The more you can train your body to resist this alignment shift, the less pressure you will put on your external abdominal wall.