How to Identify, Prevent and Heal Diastasis Recti (Abdominal Separation)
How to identify, prevent and heal diastasis recti (Abdominal Separation)
After I had my son, I felt great. Not too sore (you know, down there), breastfeeding was proving much easier second time round and he was sleeping well. The perfect postnatal scenario, right? But when I decided to go for my first gentle walk with the pram, I felt like the top half of my body was completely separate to my bottom half. I was having trouble coordinating my stride and trying to turn the pram around a corner was really, really hard.
What was going on?
It turns out I had a wide diastasis recti, otherwise known as abdominal separation. If you haven’t heard of this before, then don’t worry, you are not alone. Postnatal assessment for diastasis are not routine so many women are never assessed, or they are assessed but never told what it really means. You could write a text book on this topic (and people have) but here is a quick guide to get you thinking about this issue so you can take control of your own health.
What is pregnancy related diastasis recti?
Diastasis Recti is the natural thinning and stretching of the connective tissue and muscles of the abdominal wall as a baby grows during pregnancy. For some women, this gap will gradually close during the postnatal period, but for others, this gap will remain, or worsen, and may contribute to other health complaints.
Myth – Your abdominals split when you have diastasis. They don’t actually split unless you have a hernia. In a diastasis, the connective tissue just thins, like when you stretch a balloon.
Why should I care if I have it?
Often diastasis is accompanied by symptoms such as lower back pain, a bulging tummy, pelvic floor issues and digestive issues such as bloating and constipation. None of these symptoms are fun to live with so addressing the diastasis may be an effective treatment for these other issues.
It is also important to note that your diastasis does not need to fully close to have a flat tummy or have a functional core. It is not just about the gap. As a postnatal trainer I am interested to see whether my clients can manage the internal pressure generated from simple tasks like breathing and how they transfer load through their core when exercising to get an idea of how their core is really functioning.
If your core is not strong/functional enough to support your body and manage the internal pressure generated by the activities you are doing, then you risk worsening your diastasis, creating a hernia and damaging your pelvic floor.
How do I know if I have diastasis recti?
If you get doming vertically down your tummy (like a Toblerone or a football shape) when you do a ab crunch, then you may have a diastasis.
I always recommend that mums see a women’s health physiotherapist around 6-8 weeks after birth for an assessment of their tummy and their pelvic floor. This service is offered through the public health system but you might have it request it. Private practice physiotherapists that specialise in pelvic health are also a great option.
If you have slipped through the cracks at the hospital and have never been checked (happens more than you would think) or you are curious to see where yours is at now, you can see our self-check video here
Can it be prevented?
100% of women will have a diastasis by the end of their pregnancy. The goal should not be to prevent it from happening but to prevent the severity and minimise the risk of creating a hernia.
There are some contributing factors to diastasis that you can’t control such as genetics and the size of your baby, however there is still plenty you can do during pregnancy to give your tummy the best chance of recovery:
- Engage an appropriately qualified postnatal trainer or exercise physiologist with training in diastasis or see a physiotherapist for suitable core exercises during pregnancy. Be mindful that there can be too much of good thing, so you don’t need to overdo the core work during pregnancy.
- Be aware of your body when you exercise. If you feel strange pulling sensations, see doming or have pain, see a physiotherapist.
- Employ abdominal friendly techniques when getting up and down off the floor or out of bed (rather than doing a big jack knife to get up).
- Avoid exercises that place a lot of forward pressure on the abdominal wall such as front planks, push ups on your toes, mountain climbers etc. Use the reminder – Just because I can do it, doesn’t mean I should!
- Think about your body alignment when you sit and stand. Think “Ribs over Hips” rather than slouching back on the couch. Also, if you are a rib thruster (stick your chest out), practice dropping your ribs so you aren’t constantly stretching the connective tissue on your tummy by flaring your ribs. A physio or postnatal trainer can help you with alignment.
- Keep moving. Doing nothing is not a great strategy. Our bodies were made to move, we just need to be smarter about how we do it during pregnancy. A Pregnancy and Postnatal Trainer such as Go Mum can help with this.
Myth – Binding my tummy after pregnancy will fix my diastasis. While some mums will benefit from additional support around the midsection for a short period of time, this should be done under the supervision of a physiotherapist. Using the wrong products, using products incorrectly, or using them for too long, may prevent your core from functioning optimally.
I think I have diastasis recti, what should I do?
If you have done a self-check or are displaying some of the symptoms we have mentioned above, then here are some suggestions:
- Seek Professional Advice. As we mentioned above, see a women’s health physio for a correct diagnosis and treatment plan. Your postnatal trainer can work with your physio to ensure your exercise program works with your rehabilitation program (we do that a lot at Go Mum).
- Follow the same guidelines for the prevention of diastasis as mentioned in the previous section.
- Be patient. It can take up to two years for your abdominals to fully heal depending on the severity of your diastasis and whether you are helping or hindering the healing process. There is plenty of exercise you can still do (and should do) during the healing process, so getting some professional advice and having a training plan can help ease the frustration.
- If you are early postpartum (first 12 weeks) a compression garment such as SRC Recovery Shorts may be helpful. Ask your physio.
- Be smart about your exercise choices (and the trainer you choose). Be aware that just because a trainer might be child friendly, they might not be postnatal body friendly. Check out the qualifications and philosophy of the instructor/trainer and decide if they are right for you.
I also encourage mums to engage in different types of exercise and ensure it includes functional movement that is relevant to motherhood. Pushing, pulling, lifting, rotating and bending are all part of a mums day, so training for those functions will give mums the best chance of managing daily tasks pain free.
Some final thoughts
Many mums are keen to get back into their exercise routines after pregnancy but it is important to consider the types of exercise you are doing and how it may impact your healing. Take the time to heal, seek advice from a health professional and choose your exercise options wisely and you will be well on the way to building a strong, functional core that can support you in your life as a mum and have you enjoying movement again.
If you would like to learn more about returning to exercise after pregnancy, join our Postnatal Return to Exercise Program at Go Mum! Group Fitness.
Christine is a mother of two and a pregnancy and postnatal trainer with a special interest in pelvic floor friendly exercise strategies. Her passion for mother focussed fitness was fuelled by her own experiences with prolapse and diastasis after the birth of her second child. Christine hopes to inspire more mothers to care for their whole wellbeing and not suffer in silence. Her life motto is “Happiness is not a destination, it is a way of life”.