WHAT IS IT?
Recently there has been a lot of noise around Diastasis Recti and for good reason.
During pregnancy the uterus naturally stretches causing the rectus abdominis muscles that meet in the middle of the abdomen, to separate. This horizontal stretching of the abdominals is a natural process which occurs to allow the uterus to grow and house your growing baby!
This separation of the abdominals along with thinning and weakening of the connective tissue (linea alba) that runs down the center of the stomach, can heal itself naturally within about 8-12 weeks of giving birth. But for many new mums, the gap can remain and a delay in the healing process means the area stays vulnerable. Often the connective tissues no longer provide tension and stability and the stomach muscles are compromised. This lack of protection and stability affects the whole body both aesthetically and functionally.
Although a relatively common disorder, diastasis recti can often be overlooked. In fact, there is a strong chance that many of us have struggled with this condition, without knowing the real cause. A recent study showed that approximately 60% -70% of women have the condition six weeks post-delivery, with 30% still suffering up to a year after birth. If left undiagnosed, it can leave women with significant pain and discomfort in the pelvis and lower back. It can also result in a frustrating post-baby tummy protrusion that won’t shift even when any baby weight is long gone. The main thing is not to despair as there are ways to help your diastasis.
HOW TO CHECK FOR A DIASTASIS RECTI
A diastasis is a gap of more than 2.5 – 3cm between the rectus abdominal muscles. Confused? Don’t be. This can be measured from the comfort of your own home. Here is a simple step to help you check:
- Lie on your back, knees bent and feet flat on the floor
- Place your fingers onto your belly button
- Lift your head and neck slightly off the floor as if to do a stomach crunch whilst connecting your abdominals. Press down gently between your abs – if there is a gap here, that is the diastasis
- Perform these tests around your belly button (above, below) so you can measure if there is a gap in different places
- The tension (or lack of tension) of the linea alba (connective tissue) is as important as the width of this gap. Contracting the muscles should create tension and resistance when you apply gentle pressure with your fingers to the midline. If it doesn’t, don’t panic you just know you have some focused reconnection to do
If you believe you have a diastasis, firstly do not worry – you don’t need to suffer in silence. The information below is designed to help you understand what diastasis is and how you can overcome it safely to regain your strength and fitness. There are also many professionals – physios, Pilates teachers etc. who specialise in managing this during pregnancy and postpartum rehabilitation, so do contact your GP for further advice should you be concerned. My niix.fit app also has postpartum exercises and tutorials to help you get back into shape and above all, safely.
WHAT TO WATCH OUT FOR?
- During pregnancy, a diastasis is more likely to occur in the second and third trimester (or with multiples or large babies) once the uterus enlarges and the muscles separate to allow space. However, if a previous diastasis from a former pregnancy has not been addressed, you may notice this earlier and feel the effects through a lack of connection and strength, along with back and pelvic pain.
- Generally, a diastasis can be seen with a doming down the length of the stomach, particularly around the navel. You may notice this during everyday movements such as sitting up in bed or even relaxing back on the sofa.
WHAT CAN BE DONE?
Being aware of this from conception through to postpartum will help protect your body and lessen a diastasis. Although there can understandably be some confusion around what stomach exercises are safe to do during pregnancy, in fact, many are suitable. The key is to practice regularly, focusing on working your deep core stabilising muscles. And, above all, practice correctly, to lessen the risk of a diastasis whilst at the same time helping prepare for the postpartum healing process.
WHAT TO DO AND WHAT TO AVOID!
If you have been exercising before falling pregnant, with no obvious muscle separation, it is completely safe to continue with the same exercise, however as your pregnancy develops, adaptations need to be made.
During your first trimester continuing with flexion, rotation and side flexion exercises is safe to do in moderation and with good practice. HOWEVER if you have an early onset diastasis (more likely if it is your third or fourth baby) then these movements should be avoided. Usually diastasis becomes more pronounced as you progress into the second and third trimester, so being shrewd with the way you work out and during everyday movement is key. Although a diastasis cannot be healed during pregnancy there are many ways in which you can help minimise the damage.
During the second and third trimester, spinal flexion not advised whether there is a diastasis present or not. Instead this is a time to focus on keeping strength through the lower body, with exercises such as gentle squats, kneeling leg lifts and pelvic tilts and elevators to keep the pelvic floor and deep core strong. The upper body will also begin to tighten as the upper back is compromised, as it helps support the bump and the increase in breast size – so working the arms, back and opening of the chest during these months is essential.
EXERCISE TO AVOID WITH A DIASTASIS OR IN THE SECOND OR THIRD TRIMESTER
Flexion of spine -curl up/stomach crunches etc
One fundamental exercise is the use of your core breath. This is where the outbreath is used to connect the pelvic floor and abdominals prior to movement. This will create a connected place from which to move from, working the deep abdominal muscles rather than the superficial surface muscles affected by diastasis recti. Working the abdominals incorrectly or just too much during pregnancy can contribute to enlarging or worsening a diastasis recti.
My general advice is that if there is doming or if something does not feel right, it is probably not right, so look to avoid that exercise or movement. It is essential to listen to your body….it’s normally correct!
Below are three prenatal exercises that are safe to practice at home and will help with working your deep core stabilising muscles:
Core Breath: As you exhale, connect your pelvic floor from front to back. Then think about your abdominal muscles wrapping around you as you lift your belly button up and inwards towards your spine. Your bump/stomach will lift and visually reduce in size as you hold this connection. On the inhale release and allow the tummy to rest.
Lie on your back, with your knees bent. Breath in to prepare and on the exhale, connect your pelvic floor (zipping up back to front) and then your abdominals (as above). Gently tilt your pelvis drawing your navel to spine and imprint the pelvis and lower back onto the mat. Hold for the breath and on the inhale return to the start position.
Lie on your back, with your knees bent. Inhale to prepare and on the exhale (connect your pelvic floor and your abdominals) initiate the exercise with a tilt of your pelvis and then lift your spine off the floor in a sequential movement until you feel weight at the bottom of the shoulder blades and across the upper back (avoiding the neck). Maintain the position ensuring the pelvis is in neutral with a slight tuck of the pelvis. Avoid a high bridge. Roll back down initiating the move by softening the breastbone and then wheeling the spine down one vertebrae at a time onto the mat, finishing with the pelvis.