This postpartum condition impacts more than half of new moms but it isn’t as scary as it sounds.
Diastasis recti is the partial or complete separation of the rectus abdominis, or “six-pack” muscles, which meet at the midline of your stomach. There’s something called the linea alba, which is hard connective tissue that connects the six-pack. What happens with diastasis recti is that the linea alba either tears or pulls and stretches so much that it becomes very weak, and the two sides of your rectus pull apart.
For many women, diastasis recti is a natural result of their growing bump.
Diastasis recti is very common during and following pregnancy, in moms who have repeated pregnancies, are older than 35, or deliver twins, multiples, or a baby with a high birth weight. This is because the uterus stretches the muscles in the abdomen to accommodate your growing baby.
The most common symptom of diastasis recti is a pooch or bulge in your stomach, especially when you strain or contract your abdominal muscles. Some additional symptoms may include: lower back pain. poor posture, weak pelvic floor…It’s not physically dangerous, but many times, that bulge is what’s referred to as a “mommy pooch,” because it’s so common in women who have given birth, especially if they’ve had multiple births or C-section.
The degree to which your abdominals separate matters. When you have diastasis recti, it creates less protection from the inside out of your body, which can produce a hernia. That’s when it’s time to get your doctor involved.
Diastasis Recti can lead to side effects like:
Lower back pain,
Constipation,
Urine leaking,
In some cases; difficulty with both breathing and movement,
In some rare cases, tissue may tear and form a hernia.
How do I know if I Diastasis Recti
Mostly women don’t really know they have diastasis recti until someone tells them. It is recommended to check with an expert, like a Pilates instructor trained in postnatal exercise, to palpate the abdominal area.
The good news is that the “test” is simple and gentle.
To do a self-test for diastasis recti, lie on your back with your knees bent and feet flat on the floor. Place your fingertips across your midline and parallel to your waist at you navel. Place your other hand behind your head and lift your head up while gently pressing your fingertips down.
If you don’t feel the space between your muscles narrowing, or your fingers sink into the gap, you may have a diastasis. Move your fingers down your abdomen below your bellybutton and keep testing along the way. Some of you can have a separation as wide as four fingers or more. If you are not able to check yourself, please get a professional to check for you.
Even if you have diastasis recti, it can be “safe and fine. In most cases you only have to exercise to strengthen the abs and close the gap. But If the space is more than the width of your fingers, it needs to be evaluated by a doctor to determine if surgery is needed.
What should I do if I have Diastasis Recti
I personally didn’t know I was dealing with diastasis recti when I first started exercising again after 3months of my C-section. I was eager to get back into my yoga routine, and probably doing too many things, too quickly, without a proper focus on healing and strengthening my core. That’s why I want to warn all postpartum moms to check if they have diastasis recti, since so many things (including crunches) can make it much worse. Aside from the pooch, the condition can cause low back pain, low pelvic floor (with incontinence problems).
The key to healing diastasis recti is rebuilding your core from the inside out. You need to strengthen the transverse abdominis (TVA) muscle, which is the deepest abdominal muscle and can provide support for those muscles that have been stretched.
In most cases, recti diastasis usually heals on its own over a postpartum period of 6 weeks to 3 months. However, Diastasis Recti Abdominis may also persists long after the woman delivered. In more severe cases, further intervention may be required if the recovery of Diastasis Recti Abdominis does not occur.
If you are dealing with diastasis recti, you should avoid doing exercises that can make the separation worse, such as crunches, planks, and deep twists. Any movement that causes a visible coning, or doming, in your ab muscles should also be avoided.
Pilates can be highly supportive for the postpartum woman.
How to exercise?
If you are pregnant and have this condition, there are precautions and actions you can take before, during, and after pregnancy to reduce your chances of developing a serious case of diastasis recti.
1. If you’re planning on getting pregnant, take a break from sit-ups.
Although there’s a genetic component to whether you might develop diastasis recti, the likelihood of separation also depends on the condition of your abdominals before you get pregnant. If you’ve done a lot of sit-ups and have a toned rectus, it’s tighter and those tissues are already being pulled and when you start to add pressure [from the pregnancy] they can tear more easily. So, doing crunch after crunch after crunch, even before you conceive, can actually work against you.
2. The right prenatal exercise can be preventative.
Feel free to stick to your usual routine during your trimester (as long as you’re up for it, with all the nausea and fatigue you might be experiencing!), but make adjustments as your belly expands. By three months, when you start showing, stop doing forward flexion and holding planks for a long time because there’s nothing to be gained by working your rectus abdominis. Your abdominals are trying to relax and expand to make room for the baby, but [by working the rectus] you’re tightening it.
Instead, you want to be working your transverse abdominis to provide support around your abdomen and to help push the baby out.
A strong transverse abdominis, your deepest layer of abdominals that forms a “corset” around your torso, gives your torso and back more support not only in Pilates, but during other activities. Pilates gives you that awareness, and helps you understand what’s good and bad for your body when you do other forms of fitness.
3. Everyday movements aren’t likely to cause an abdominal separation.
It’s time to breathe a collective sigh of relief. There’s not a lot you can do to prevent diastasis recti while you’re pregnant aside from doing those exercises that would antagonise it. In short, your everyday activities shouldn’t cause any strain except twisting and picking something up which could put pressure on the abdominals, because the tissues are stretching and then pressure is being applied. So just be careful with heavy lifting and try to avoid it.
4. Avoid forward flexion pre and post baby.
If you have diastasis, you don’t want to do forward flexion in Pilates until you close the gap. “If you’re only using the rectus abdominis [those six-pack muscles] during The Hundred or Series of Five, you’re making it worse.”
Exercise can help improve diastasis recti. Focus on movements that pull the abdominals in, like abdominal compressions, pelvic tilts, toe taps, heel slides, and single-leg stretches.
On the other side, doing exercises that are too difficult can make the separation worse, you need to avoid any crunches and planking and twists. until you have regained strength in your abs and have started to close the gap. Jumping out of bed is also a no-no (always roll to the side first), as is any movement that causes a visible coning.
Other exercises to avoid: Mostly any movement that will cause extra intra-abdominal pressure like holding planks, push-ups, sit-ups.. Exercise like running, jump rope or cardio class may cause other symptoms to arise. But once you get that transverse abdominis strong enough, you can do them because it’s supporting the movement.”
Also avoid heavy weight lifting during this time, especially while squatting or doing deadlifts.
