WHAT IS DIASTASIS RECTI?
Diastasis Recti is the stretching, lengthening and weakening of the entire abdominal wall that occurs during pregnancy and remains into the postnatal period.
Diastasis means separation and during pregnancy we refer to the Diastasis of the Rectus Abdominus muscles.
Although it is the Rectus Abdominus muscles that separate it’s actually the connective tissue, the Linea Alba that holds the Rectus muscles together that widens.
How much the Linea Alba has to stretch to accommodate a pregnancy will generally determine the width and depth of separation.
WHAT DOES IT LOOK LIKE?
A Diastasis Recti can look very different from person to person. It doesn’t matter what shape or size you are, you can have a Diastasis with a flat stomach and you can have a separation with a stubborn mummy tummy!
Common signs of a Diastasis Recti are:
- A mummy tummy
- Protruding belly button
- Back and hip pain
- Leaking issues (sudden urinary incontinence)
- Abdominal protrusion when you do crunches or lift heavy weights for example.
- Stubborn pregnancy pooch
HOW TO TEST FOR DIASTASIS
It is quite common practice to just assess the width of a separation, however there is so much more to assessing a Diastasis Recti than just the width, as the gap may never fully close. It is important to measure:
- Tension of the connective tissue (Linea Alba)
Measuring the length and width are good indicators that a Diastasis is healing as these measurements should reduce over time. However, as a gap may never fully close it is also important that we assess the tension of the connective tissue and the ability of our core to withstand intra abdominal pressure, which means it can transfer any load and force placed up on it.
You can check yourself to see if you have a Diastasis , see below for a step by step guide on how to check the length and width.
DOES IT HEAL ON ITS OWN?
Sometimes, however, this is not the case for many women.
Unfortunately, it is not quite as simple as prescribing a few exercises. Healing a Diastasis requires a holistic whole body approach. What works for one may not work for another. After all we are all individuals, we all lead different lifestyles and we all had a different pregnancy and birth experience. There a number of factors that we need to address.
Here are my 7 steps to Healing a Diastasis:
The first step is to assess your Diastasis. We need to measure the length, width and depth and assess the tension of the midline (where the gap is). This test gives us our starting point so that we can measure improvement over time.
The way in which we breathe has a huge impact on the body’s ability to heal a Diastasis. You will be surprised how much your breathing may have changed since you had a baby! It is important that we correct your breathing pattern before we do anything else.
Learning how to breathe and activate the 4 core muscles (Diaphragm, Transverse Abdominus (TA), Pelvic Floor (PF) and Multifudus) correctly will help the healing process.
Breathing is important not only because we need do it all the time but we use our core muscles to breathe! If we are not breathing and recruiting the core muscles correctly then the Transverse Abdominal muscles are not contracting optimally. We need all the core muscles to activate correctly to assist with the closure of the Diastasis.
Learning to breathe and activate your core muscles correctly is one of the first steps in the healing process.
Changes to our posture occur during pregnancy and stay with us into the post natal period. Posture is something that will not just correct itself, but in fact, may become worse as we sit for long periods feeding our babies and we are lifting more and carrying heavy items such as car seats and prams.
It is impossible to heal a Diastasis without correcting your posture first. The way in which we correct our posture is to first of all identify what is out of line, then we have to release what is tight and then strengthen what is weak.
The healing process requires a degree of loading, through exercise, to help heal and regenerate. However, it must be the right kind, the right amount and at the right time!
Poor exercise choices, such as high impact exercises, running, abdominal crunches, planks to name a few will only result in your Diastasis becoming much worse.
This is massive! Nutrition and hydration is a key piece in the puzzle to healing a Diastasis. I cannot stress enough how important this is! We need to ensure that we are eating nutrient dense food that helps our bodies to heal. You can read more about this in my other blog ‘Desperate to lose the baby weight? You need to read this first’
Rest is absolutely key! You know yourself when you are ill that rest helps you to recover more quickly. The same applies to tissue trauma – when we give birth, tissues, tendons, deep core muscles and the pelvic floor have all been through some degree of tissue trauma and need time to heal.
Yes I know it’s impossible to rest with a baby and get a decent nights sleep, however, as this is a key component to the healing process I had to mention it here. So, take the opportunity to nap when you can!
It is possible to undo all the good work if we return to inappropriate activities too soon. We also need to continue to manage intra abdominal pressure which is done by engaging our core and pelvic floor correctly with the breath. The more you practice doing this the more it becomes second nature allowing us to continue protecting our core during daily life and the activities that we choose to do.
HOW LONG WILL IT TAKE THE GAP TO CLOSE?
This is a question I am often asked. Unfortunately, there isn’t an answer. Taking into consideration all the points above and the fact that we are all individuals it is impossible to put a timescale on this. The healing process is different for every women as every women is different and has had a different pregnancy and birth experience. One thing I can say though is that following a programme that addresses all the points listed above, you will see results much quicker than doing nothing at all!
WHEN WILL I KNOW MY DIASTASIS HAS HEALED?
There are a number of factors that indicate that your Diastasis has healed or is in the process of healing. One of these is the fact that you just feel stronger in the core. As someone said to me once ‘I just feel stronger in the core and more put together’! Other signs of healing include:
- The gap may have reduced and / or the tissue between the gap becomes stronger
- A reduction in urinary incontinence
- Reduction in any back pain
- Reduction in bulging of the abdominal wall
DOES THE GAP HAVE TO CLOSE COMPLETELY?
NO – as I mentioned above, the gap may never fully close. It is all about the tension of the tissue between the gap and the ability of the core to withstand intra-abdominal pressure! Basically what this means is that if we perform an exercise or even a daily task such as lifting a heavy weight our tummy doesn’t bulge!
WHY IS IT IMPORTANT TO HEAL A DIASTASIS?
The Rectus Abdominus muscles make up part of your core and your core is vital to how the body functions as a whole. When we move, lift, jump up and down, all the energy, load, force is transferred through the core.
If the strength of our core the ‘Inner Unit’ is compromised, then any movement at the ‘Outer Unit’ (the rest of our body) will have a poor foundation and lead to pain and / or injury.
A Diastasis leads to chronic dysfunction throughout the body resulting in pain and discomfort. This can affect everyone regardless of whether you take part in any form of exercise or not. Being a mum is physically demanding, we push, we pull, we lift, we bend, we carry, we twist and turn. Doing all of these movements on weak foundations will only lead us to long term problems and pain.