All you need to know about Diastasis Recti!
Disclaimer: I am not a qualified medical practitioner. I have used the information available from the Birth Healing Summit 2018. This blog also includes my own personal opinions. If you were unsure or struggling with your pelvic health then a visit to a women’s health physiotherapist would be advised.
What Is Diastasis Recti?
Diastasis recti is used to describe the separation of the rectus abdominis muscles. It is caused by a thinning or stretching of the linea alba. This is a line of connective tissue. It connects these muscles and runs from your pubic bone up to your sternum. Imagine that when strong and taught, the linea alba is like a supportive and elastic new swimsuit. Then during pregnancy it stretches and becomes lax, more similar to an older swimsuit. In other words, thinner and becoming a little bit see-through and baggy!
Diastasis recti is a normal change that happens in the later stages of pregnancy as your growing baby bump expands and more room is necessary than your usual abdominal cavity.
I think many women fear this “big gap”. I’ve heard women say they worry about the muscles “ripping apart” and worry about it not completely closing afterwards and leaving them with problems or a ‘mummy tummy’.
The Pressure System
Diastasis recti is in fact part of an inner pressure system. It is not just a gap in the abdominals.
Contrary to popular belief (and possibly outdated education) it doesn’t have to completely close to improve the function! In fact, ultrasound scans have shown that the function can actually improve as the gap gets wider. This is because the linea alba gets less distorted and gains more tension.
Many women want their bellies to look flatter rather than actually needing their diastasis recti to close.
This is not the responsibility of just one muscle. For a flatter tummy you need a collaboration of a collection of muscles. That being said, many feel the rectus abdominis is important for aesthetics, or that six-pack look.
Who Gets Diastasis?
Results from research conducted using ultrasound techniques indicates that 100% of women have a diastasis recti (or a thinning of the linea alba) in the third trimester of pregnancy. The linea alba is supposed to thin in the third trimester! But it should heal naturally in the early post baby phase. The critical healing period (or the 4th trimester as it is also known) is believed by many to be the first 13 weeks post birth. Problems only really occur if the integrity is still poor after this period of time!
Really there is no point worrying unduly!
It is important to make an assessment of the diastasis recti as a whole functioning unit (or pressure system) rather than just the separation.
It is pertinent to be mindful of this pressure system all the time. We need to ensure the inner unit is working well. We should aim for tension free diaphragmatic breathing or non forced breathing. Proper alignment is essential for this.
Optimal alignment and posture often takes the majority of people time to get right.
However, when mastered, it helps you gain core stability by setting you up for your breath to flow more easily and recruiting the core muscles (diaphragm, pelvic floor and surrounding abdominal and spinal muscles) to work together well.
With a posterior pelvic tilt (something pregnant women do a lot to counteract the baby bump and boobs as well as mums holding babies) the bum is tucked under flattening the lower back.
With an anterior pelvic tilt the bum is sticking out and the lower back holds an excessive arch.
Optimal alignment involves your ribs being stacked over your pelvis. There is a gentle arch in the lower back and the upper body is tall.
What Can I Do To Heal It?
There are a few things that are advisable to avoid in order to prevent any diastasis recti from worsening, or indeed a new diastasis from forming.
Many people say DO NOT do exercises in front loaded positions when diastsis recti is present. Examples of these exercises may include planks, double leg lifts, V-sits etc. As a general rule to be safe this is wise advice. However, these movements could still be used in training if tension can be maintained through the linea alba.
Ideally we should look to modify the task in hand if it involves any of the following.
(we are all individual and each case should be considered separately)
- The valsalva procedure (holding your breath, keeping the air internalised and bearing down or pushing). Really this is mismanaging your pressure system. Therefore it is not ideal. If you are doing something which involves this breathing technique then it would be advisable to reconsider. In labour many women use this as a breathing technique which isn’t ideal.
- Doming or coning (when a bulge or ridge is visible down the midline of your tummy during an abdominal contraction). This is an indication that your rectus abdominis muscle is dominant over your other ab muscles. So your rectus muscle pops up and the transverse abdominals, internal and external obliques are failing to keep your abs flat. So if you see this you may want to reconsider doing the movement. Alternatively you could pay attention to balancing all the abdominal muscles so they all work.
- Bracing (simultaneously tensing all layers of your core muscles). This is not an optimal compensation strategy. Again it is mismanaging your pressure system.
Don’t forget there is no point in avoiding certain exercises during training and exercise when life is full of bad habits all of the time. Examples of these would include breath holding, getting out of bed, straining on the toilet. Try to apply these principles to everyday life as well as in the gym environment.
Download my FREE ebook ‘6 Essential Exercises to Get Rid of Mummy Tummy‘ to see some examples of some great Diastasis safe exercises to try.