Diastasis recti is a very common problem in women post-nataly. It is the widening of the gap between the 2 sections of the Rectus Abdominus ("6 pack") abdominal muscles. It is very natural in pregnancy and and happens in 100% of pregnancies during the third trimester in order to allow the foetus to grow. However problems may start when the gap does not close post-nataly. Here's how to check if you have the condition, what to do about it, and what not to do.
The diastasis split occurs at the Linea Alba, the mid-line collagen structures of connective tissue at the front of the abdomen. Diastasis recti occurs when the muscles do not rejoin after pregnancy. If it has not closed 8 weeks post-nataly and is not treated the gap often remains 1 year later. Along with pelvic floor issues, this is one of the most common problems in post-natal women. 66% of women with diastasis recti also have some form of pelvic floor dysfunction. Many of my PT clients have these issues, and I have had clients who are still unknowingly suffering with diastasis years after they have given birth. It can affect many areas of their lives and cause other related problems such as back problems due to the lack of stability in the core muscles.
Why does this problem happen? The Linea Alba (seam of tissue) is no longer providing the tension and stability required in the core. All of the muscles of the abdomen meet at the centre midline, so all are affected by the lack of protection and stability provided. This can affect the whole body both in terms of look and function. But the good news is it is possible to improve the situation, if not fix it all together.
How do I know if I have this problem? Well, there are several symptoms you may have including back pain and you may notice your belly still looks pregnant, even though you no longer are. You can also test yourself, be tested by a pre and post-natal qualified PT or you can also be checked by a women's health physio. To test yourself it's quite simple, just follow the steps below:
How To Test Yourself for Diastasis Recti
1. Lie on your back with your knees bent and feet flat to the floor. Relax your head and shoulders. Place your fingers (palm facing you) just above your belly button.
2. Lift your head and neck very slightly off the floor and press down with your fingertips. If you have some excess belly fat don't be afraid to push down further, this test should not be painful. If you can feel a gap then this is the diastasis. You will feel the Rectus Abdominus muscles either side of your fingers.
3. Remain in this position and repeat the same test above your belly button and a couple of inches below.
4. The extent of a diastasis is measured in finger width's. You are aiming for a gap of 1-2 fingers or less. But if it's more don't panic, it is possible to improve this.
So, if you have identified a gap of more than 2cm what should you do next? Well it's important to note that this can be improved and you should not feel bad about your situation. Now you know what it is it's possible to do something about it and improve it. Treatment is usually in the form of corrective exercises. You should also be very careful when lifting anything, ensuring you engage your core muscles and using your legs (not your back) to lift anything from below you.
Here are three exercises to try, do them at least once a day and more if possible.
Firstly you need to engage your core muscles. To do this, stand up straight and without raising or tensing your chest or shoulders, gently draw your belly button back towards your spine as you slowly exhale. This is the muscle you need to engage. You should not be "sucking in" and nothing should be happening in your shoulders, pelvis or chest. It's just a subtle drawing in of the lower abs.
1. Wall plank - stand facing a wall, both feet flat on the ground. Lean towards the wall with your hands in front of you at shoulder height until you touch the wall. Keep your core muscles tight and engaged and your back straight. Keep your arms straight and your feet flat on the floor. Maintain this position for up to a minute at a time.
2. Side bends - stand up straight with your legs just wider than hip width apart. Let your arms hang down straight by your sides, with palms touching your sides. Keeping your back straight and your core muscles engaged bend to the side, sliding your hand down your leg as far as you can. Repeat on the other side.
3. Glute bridge - lie on your back with your knees bent and your heels tucked as close in to your bum as possible. Now lift your bum and hips up off the floor, keeping your shoulders and head on the floor. Lift your hips so they align with your thighs and hold this position for up to a minute at a time.
These exercises will engage the use of the core muscles without directly using them, and this will encourage your gap to close.
What should you avoid doing if you have a diastasis recti? Anything that directly strains your tummy muscles, so this includes normal plank, sit-ups, crunches, straight leg lifts, twists and most other abdominal exercises. You could be inadvertently making your problem worse by doing these.
So that's pretty much the basics that you need to know about diastasis recti. As always, this is only general advice. If you are unsure about any of the above please seek the help of a qualified Personal Trainer or women's health physio.
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Exercise For Mum's was created by PT mum Susan Flintoff. Susan is a busy working mum of two who specialises in helping other busy mum's fit health and fitness back into their lives, and hopes to inspire them to be the best mum they can be!!