You may not have heard of it if you don’t have children. But if you do, chances are you will have heard a lot about ‘‘the gap’’ or ‘‘diastasis recti’’, which the majority of women experience after delivering a child.
Diastasis recti is the clinical term for ‘‘separation of abdominals’’. In this condition, the two sides of the rectus abdominis (your 6-pack muscle) stretch out and away from one another, pulling on the connective tissue that delineates them. This connective tissue acts very much like a tendon and is called the linea alba.
Diastasis recti does not happen only to expecting women. It happens to women or men who put on a significant amount of weight in their lower abdomen. It is absolutely normal for expecting women to get diastasis recti. If women did not get it, they would not have enough space to grow their baby. What is not normal is to sustain the separation long after the baby is born. Not normal, yet prevalent. Definitions vary but for simplification purposes, most clinicians refer to sustained DR when the linea alba is wider than 2.5-2.7cm at the level of the navel. If you believe you may have DR, do not panic! Not only is it common, but we offer a specific programme to help you repair it.
Why is it problematic?
Most women worry about their DR for aesthetic reasons. But DR also contributes to a number of women’s health ailments. When it lasts, it affects the support of your internal organs, which means it may contribute to incontinence or organ prolapses. Besides when a tear occurs in the linea alba and an umbilical hernia has formed, abdominal surgery becomes necessary. What causes pregnancy-related sustained DR ? Factors that a woman has unfortunately little control overcome into play such as:
- A big baby, most notably on a small frame.
- Twin or triplet pregnancies.
- Physiological issues, such as less collagen available in the body.
Other factors include:
- Poor exercise or movement practices during pregnancy.
- Resuming exercise or load postnatally too early or not progressively enough.
Lastly, having multiple pregnancies, especially when they are not spaced out or when women do not complete any form of rehabilitation in between, is a risk factor.
4 things you can do prenatally to prevent diastasis:
- Avoid practices such as getting out of bed or your reformer through a sit up. Rather, roll onto your side and use your hands to prop yourself up.
- Avoid over stretching the front of your abdominals (ie upward dog in yoga).
- Strengthen your transverse abdominis, as it is protective of your linea alba. Whenever you carry something heavy or use resistance in your training, engage your deep abdominals properly.
- Avoid too much weight gain, to the extent that you can.
4 things to do to speed up your recovery postnatally:
- In the early stages, do not carry your baby more than necessary and learn to gently activate your transverse abdominis through breathing drills – as early as 1 week postpartum in the case of a vaginal birth, or 3-4 weeks postpartum in the case of a cesarian.
- A pelvic floor rehabilitation with your Women’s Health physiotherapist, from 6 weeks postpartum onwards. It seems odd, but in many cases if there are scar tissue issues or simply tension in your pelvic floor, you may not be able to recruit your deep abdominals effectively.
- An abdominal rehabilitation with a specialized coach, from 6 weeks postpartum onwards: A programme that allows you to regain strength and endurance in your deep abdominal muscle, and to practice your reflexes.
- Naturally, your diastasis is bound to heal. So the most critical thing to do postnatally is to be patient and avoid resuming exercise all of the sudden. When your doctor clears you at 6 weeks, it does not mean your abdominals are ready to work out the way they used to. As long as you cannot hold a table top position whilst holding your tummy in and up, avoid impact, planks, and any kind of activity that does not take into account the fact that you recently had a child.
It is recommended you also avoid activities such as rowing, stand-up paddling, skipping rope, running, or activities with uncontrolled rotation of the spine for as long as your separation does not seem to heal. We’d be delighted to assist and answer any questions you may have and we’d be delighted to welcome you onto our next programme.
If you have any queries or you’d like to book a session please get in touch via firstname.lastname@example.org or call us on 04 518 5400.