Diastasis Recti Pregnancy
So exactly what is diastasis recti? Is diastsis recti pain causing you unnecessary discomfort or concern? I am here to help YOU. You see, healing diastasis recti takes time. Fixing diastasis recti cannot be done by some magic exercise. No exercises will cure or stop your DR completely.
But the right ones can assist in reducing the severity of abdominal separation and improve the healing process.
What Is Diastasis Recti?
Diastasis means ‘separation’ and Recti refers to your ab muscles called the ‘rectus abdominis’ which are the outermost abdominal muscles. So Diastasis Recti is a separation of the abdominal muscles.
What Causes A Diastasis?
The belly button is a weak spot in the connective tissue and continuous pressure, stretching, or intra-abdominal force placed on this weak spot of the connective tissue can cause the muscles to separate. (Abdominal wall)
What is the Transverse Abdominal Muscle?
The transverse abdominal muscle is also known as;
1. the transverse abdominis
2. transversalis muscle
3. transversus abdominis muscle.
It is a muscle layer of the anterior and lateral (front and side) abdominal wall which is deep to (layered below) the internal oblique muscle.
Diastasis Recti Symptoms
- Lower back pain
- Poor posture.
What Makes Separation Worse?
- Exercises like crunches, planking.
- Extreme weight gain.
- Certain activities and sports.
Things to avoid
- Carrying heavy loads.
- Holding your baby on one hip.
- Any strenuous exercises.
Diastasis Recti Complications
- Back pain.
- Pelvic pain.
- Damage to your posture.
- Hernia in extreme cases.
Diastasis Recti Test
The diastatis is measured by the number of finger widths or spaces that fit in between the two rectus abdominis muscles.
Normal = 1 finger space separation or less
Diastasis recti = a separation or gap between the rectus abdominis muscles of 2 or more finger spaces.
This means the tissues joining the rectus abdominis muscles have either stretched or split apart. The wider the gap, the larger the separation of these two muscles.
Self-check for DR
1. Lie on your back with your knees bent and your feet flat on the floor. You can place a pillow under your head for more comfort.
2. Place three fingers just above your belly button facing down towards your feet. Avoid abdominal pressure.
3. Gently lift your head off the ground and you should feel the ridges of the rectus abdominals.
You are trying to feel how far apart (in finger distance) these two ridges are away from each other.
Test at different locations down the mid-line from just above your belly button, to just below. It is most common for the biggest part of the separation to be around the belly button.
The depth that your fingers go down into your belly is a test to see the condition of the Linea Alba (the connective tissue between the rectus abdominal muscles).
The further down your fingers go into your belly, the weaker the Linea Alba. Avoid having your head up for too long, if needed lower your head and repeat to continue the check.
Your Recovery is Unique to You
You should always consult medical advice if you do have a diastasis. And I want you to only start an exercise program once you have been given approval by your doctor. Every woman will have their own individual needs and will recover in their own time.
Our Women’s Health Phyio Chats about Diastasis recti
Diastasis Recti Exercises
Pelvic Tilts with Gentle Abdominal Activation.
1. Start by lying on your back, bend your knees.
2. Gently engage your deep core abdominal muscles.
To feel this, place the heel of your hands on your hip bones and have your finger face down towards your pubic bone.
Then gently think about drawing your belly button inwards and feel your lower belly gently draw back.
3. Stay with just this, or add pelvic tilts by flattening your back and engaging your deep abdominals and pelvic floor. Then gently arching your back and relaxing all muscles.
Single or Double Knee Drops
1. Lying on your back with your knees bent and feet flat.
2. ‘Drop’ either one or both knees to one side. If you do single ensure the other knee stays still.
3. Gently engage your abdominals to lift the knee (or knees) back to the starting point.
1. Lying on your back with your knees bent and feet flat.
2. Slide one leg away from you, keeping the heel on the ground.
3. Slide it back in, keeping your pelvic floor and deep abdominals gently activated.
4. Alternate sides
5. Once you are ready to advance (remember not to rush into advancements!) you can lift the foot off the ground and lengthen it long without the heel touching the ground.
Single leg lifts
1. Lying on your back with your knees bent and feet flat.
2. Slowly lift one leg up so the knee is directly above the hip.
3. Ensure the heel is in line with the knee so you are creating a 90 degree angle at the knee.
4. Keep that same angle as you lower the leg back down.
5. Repeat on the other side.
6. To advance, add leg extensions.
When to Start Diastasis Recti Pregnancy Exercises?
You will most likely remain in hospital for several days (longer if you had a caesarean). Your nurse will assist you to gradually get out of bed and be active with short walks or gentle prenatal exercises.
If you had a caesarean your recovery will be quite different. Diastasis recti is a separation of the outer rectus abdominis muscles where they join in the mid-line of the abdomen.
We often see too many women return to inappropriate abdominal exercises after childbirth. This only prevents or delays their recovery and contributes to a range of associated problems.
So, get medical approval first. The degree of your abdominal separation may impact on your workouts.
Diastasis Exercises to Avoid
Immediately after childbirth, you must avoid intense core abdominal exercises. These include crunches, planking, abdominal curls and heavily loaded resistance exercises during your postnatal workouts.
Some trainers promote these exercises to a healthy population. However, these exercises will only increase unwanted strain on your upper and deep abdominal muscles post baby. This causes them to separate further which impacts on the healing process.
Does Exercising Help Diastasis Recti?
Including the right diastasis recti repair exercises into your workouts will help to restore deep abdominal control. AND promote abdominal muscle recovery after pregnancy and childbirth.
But, if you do the wrong ones, it can cause further harm.
Your goal when performing these exercises is to ensure you are using the correct deep abdominal activation technique. I talk about this in my video below.
Your exercises should progressively challenge the deep abdominal muscles to further promote core control.
Abdominal Exercises for Diastasis Recti
Immediately after childbirth is a time to allow your body to heal and recover. I know your primary focus is on looking after your beautiful newborn baby. AND my focus is to look after YOU and your health!
Therefore gaining access to safe postpartum exercises is essential for your recovery. I cringe when I see some new mothers jump straight back into their pre-pregnancy workouts.
Your First 12 Weeks After Childbirth
This very important postpartum recovery period is when your body needs to heal. You will be experiencing some new and possibly uncomfortable body changes.
I want you to continue doing your Kegels (Pelvic floor) as this will help to reduce or prevent unwanted leakage. During this period your focus is on recovery, and when ready, then you can start to think about losing unwanted baby weight.
How Can I Find the Time for Exercise?
When you are a new mother you will likely be sleep-deprived, tired, exhausted and will struggle to find the time for any exercise or activity.
This is why our postnatal program includes video workouts of only 15 minutes. Taking this time out of your busy schedule for yourself will provide some great benefits to you both physically and mentally.
Here are some tips:
1. Always be guided by your doctor.
2. Be kind to yourself! You are not trying to set any personal bests during this postnatal period.
3. Communicate with your partner, family and friends your need to get some time to yourself so you can workout.
4. Walking your baby is also a good way to get some exercise and fresh air.
5. Stop immediately if you experience any pain or discomfort.
6. Physical therapists can help you if needed.
Look after Yourself!
1. Wear an appropriate bra that offers good support.
2. Wear comfortable clothing and appropriate footwear.
3. Take regular rest periods when required.
4. Drink plenty of water to stay hydrated.
5. Start off slowly and if possible progress to getting 30 minutes a day of activity.
6. You can always have your baby near you as you perform a short video workout.
Do All Pregnant Women Get A Diastasis?
There are various degrees of a diastasis and the majority of women do get a diastasis.
Effects Of A Abdominal Separation On The Body?
The outermost muscles support your back and organs and when they separate the connective tissue then becomes your support system. As a result this thin connective tissue is not a good support system for your back and organs. Side effects include:
2. Back pain.
3. Poor posture.
4. Gastrointestinal disturbances (bloating, constipation).
5. Umbilical hernia.
Is Diastasis Causing My Back Pain?
Yes, a diastasis can cause back pain. As discussed above, your outermost abdominal muscles support your back. Your back pain can occur because the connective tissues no longer provide a good support system for your back.
Can a Diastasis Cause Constipation?
Yes, a diastasis can cause constipation. When the muscles separate the organs can get displaced. This displacement can put the bowel out of alignment which can cause constipation.
What Am I Checking For?
When you check for a diastasis you are checking for two things:
1. The ‘distance’ between the two muscles. You will check by seeing how many fingers fit between the two separated muscles.
2. The ‘condition’ of the connective tissue. Essentially, the deeper your fingers go, the weaker the connective tissue is likely to be.
When I Check Myself Why Does It Hurt?
When you place your fingers between the muscles it may hurt and this is because your connective tissue is very weak.
Why Do I Feel A Bulge?
When you get up from a supine position this bulge are your organs moving forward against this weak connective tissue. This bulge is a sign of a very severe diastasis.
How Long Does It Take To Close?
The time frame to heal a diastasis depends on the severity of your diastasis and will vary for each person. It can take anywhere from 6 weeks to a year or more. This is why it is essential you participate in a postnatal recovery program that continues for months and even years after your pregnancy.
Do Some People’s Diastasis Close Faster Than Others?
If you have weaker connective tissue it will take longer to heal. Everyone is different which is why some women heal faster than others. Hormones such as relaxin and also multiple births can weaken the connective tissue.
How Will I Know When My Belly Has Healed?
The key to closing a diastasis is all about healing the connective tissue. You will have a good idea of when you diastasis has closed when you conduct the diastasis check. You do this by placing your fingers in to check your diastasis and they do not go down that deep. A one finger diastasis with shallow connective tissue is what you should aim for.
Can A Diastasis Come Apart Once It Is Closed?
Yes, continuous intra-abdominal force and pressure on this weak spot in the middle of the connective tissue (belly button) will separate your muscles. This why is very important you participate in a specifically-designed post pregnancy workout well beyond the postpartum period.
Can A Diastasis Get Worse?
Yes, stretching, increased intra-abdominal force and pressure on connective tissue can make a diastasis worse if you have one. This is why you MUST participate in a specific program that takes into account your diastasis. Certain activities, sports, exercises and movements can make your diastasis worse.
Can Pushing Incorrectly Cause A Diastasis?
Yes, incorrect pushing in labour can create a diastasis or make an existing diastasis worse. This is why participating in a pre natal class is important as it can teach you the correct skills when it comes to pushing and what positions are best for you during labour.
Is Wearing A Baby Carrier Bad?
Yes, using a carrier where your baby is positioned in front of you can cause additional weight and pressure to be placed upon on the weak connective tissue.
When Is Diastasis Recti Surgery Necessary?
Your Doctor will guide you on your options for treating and managing your specific health matters. They may recommend surgery when the connective tissue has torn away from the muscle and the organs are exposed.
I am Here for YOU!
Our PregActive Tribe of pregnant women and new mothers, just like you, are here to help. We get it. We know what you are experiencing.