What You Need To Know About Diastasis Recti
Would you believe that there is a condition that at least 30% of pregnant women and 66% of women with 2 or more kids have and yet most of them do not know about? Diastasis Recti is the separation of the abdominal muscles and the thinning of the connective tissue between them. This condition is not solely the result of pregnancy, but it’s quite common. This article will outline the basics of what every woman should know–before, during, and after pregnancy, about conditioning and rehabilitating their abdominal muscles for better function and (bonus!) to improve their appearance.
What Causes a Diastasis Recti?
Diastasis recti is caused by intra-abdominal pressure. This can be the result of:
- poor alignment
- weak abdominal muscles
- excessive body weight
Even “fit people” such as body builders will develop a diastasis recti due to pressure from improper core engagement during heavy lifts and the intra-abdominal pressure created from doing crunches. Yes–crunches are not good for you! Keep reading for more on this last point….
How Do I check for one?
There are numerous programs on the web that will help walk you through how to check for a diastasis recti and then connect with you with their program for help with fixing this condition. For learning about how to check for one at home, please read the following instructions and then watch the linked video. It is important that you know how to properly check for a diastasis so that you do not do more damage to your core in how you check for one and so that you get an accurate reading. Many women check for a diastasis incorrectly, leading them to believe that they do not have one! Only later (sometimes years later!) they come to realize that their core and pelvic floor are not functioning optimally and it is all because of a diastasis created years ago. So…to check for a diastasis, do the following:
- Find a comfortable place on the floor where you can lay down.
- Kneel down and then progress to a seated position. From seated, slowly slide down on your side (many programs refer to this as the “sexy slide”) using your arms to help you down, engaging your core (if you can and know how) as you move.
- From your side, roll onto your back. Keep your back in neutral spine (the small of your back should have a small gap from the floor) and bend your knees with both feet firmly planted on the ground at hip distance apart.
- Lift up your shirt and unbutton the top button of your pants. You need to have access to the 2-3 inches above and below your belly button.
- With one hand at your belly button, slowly raise your head about 1-2 inches off the ground. Do not raise your head up too far or allow your back to come out of neutral spine! Your back should naturally stay neutral–assuming that you do not lift your head too much to engage in a crunch like movement.
- With your fingers, feel for a gap at your belly button. Many post partum women will have a slight dip here–but it’s only considered a diastasis when it is 2 or more finger widths apart and the connective tissue between the muscles are weak/deep. You are hoping to feel for a gap that is 2 finger widths or less AND for shallow depth, with connective tissue that is firm to the touch.
- Once you have checked at the belly button, check for a gap between your abdominals about 2 inches above and below this center point. For most women, the gap is largest at the belly button. Remember to check for not just the width, but also the depth of the gap.
- For a good understanding of the depth, feel a few inches higher on your abdominals. Here–they should be closed with strong connective tissue in between. If your connective tissue is weak, you may be able to put your fingers in up to the 2nd knuckles–almost like you’re reaching to touch your spine. You want the connective tissue to not only feel both firm and slightly spongy (it is just tissue and not a bone), but you should also not be able to press down more than about half of a fingernail deep.
What can I do about it?
Depending on the program, a few different theories abound about the “best” way to correct a diastasis recti. However, the practitioners behind each of these programs seems to be in agreement that it is never too late to heal your core! Do a quick internet search of diastasis recti programs and you’ll find stories from women who had kids 10 years ago and have been able to bring their abdominal muscles back together and strengthen the connective tissue. Still—there are some basic ideas that seem consistent across the board when it comes to restoring your core and pelvic floor.
- When you do any type of squatting, lifting (including a laundry basket, a child, and hand weights), pushing, or pulling movements, be sure to properly engage your core. You engage your core by drawing your transverse abdominals toward your spine. This is the internal corset that wraps around your body and helps to give you flat abs, provided that you have proper alignment and a healthy diet. When you engage your core, you are NOT sucking in or holding your breath!
- Healing your diastasis will often improve your pelvic floor function. The two work in conjunction and both are caused by too much pressure and poor/lack of engagement.
- If you are not yet pregnant, but planning on it, you can do your research now! Read up on how to check for a diastasis throughout your pregnancy and for pregnancy safe exercises to do throughout your pregnancy (although make sure to check these programs–any program that encourages pregnant women to crunch or do movements in a prone position like push-ups and planks are to be avoided!).
- Research the pros and cons of splinting during and after pregnancy. This is perhaps the biggest debate between the different programs. Some tow a middle ground and say that splinting in the immediate weeks postpartum are alright if it makes the wearer more comfortable, if their gap is large, and/or they are able to use a splint and maintain awareness of their abdominals (and not rely on the splint to do all the work). Other programs, however, claim that a splint is essential for approximating the two recti back together while doing the various healing exercises, and others advocate firmly against splinting, arguing that they increase intra-abdominal pressure that can worsen a stressed pelvic floor after delivery or even cause a hernia due to weak connective tissue. The bottom line is that there is a lot of research out there and it’s important to find what works best for you. The middle ground might be optimal if you are about to or recently had a baby–provided the splint is worn very temporarily. However, there are thousands of success stories by women using all of the various programs.
- If you do have a diastasis, refrain from doing crunches and movements in the prone position. You should also refrain from any exercises that you cannot safely do without proper core engagement. Many women come to find that their core is quite weak after pregnancy, but have continued to do exercises that they did not have the proper strength for in the interest of losing their “gut” or “mommy tummy”. These moves, however, are counterproductive and should be avoided at all costs.
- Read up on proper alignment. Alignment is not the same thing as posture. This blog, written by biomechanist Katy Bowman, has loads of free information on correcting your alignment, in addition to her several books for sale on her site. It’s worth a read to check out how your alignment and everyday movement affect your core and pelvic floor.
How important is it that I fix it?
One of the reasons that more women have a diastasis after multiple children is that they never fully healed their core after their first baby. Therefore, with each subsequent pregnancy, their abdominal muscles started in a more separated position and got stretched further apart. If you are reading this and considering getting pregnant again, check to see if you have a diastasis and work with a physical therapist specializing in diastasis and pelvic floor rehabilitation and/or check out one of the many excellent online programs. Fixing your diastasis is not just about looks. What we’ve tried to emphasize here is the importance of core function. Your core is used in nearly every movement, not just during “core exercises.” If the mind-body connection is missing in this region of your body, it is essential that you correct it to restore your overall health and prevent further injury.
What else would you like to know about diastasis recti? This article is meant to help be a primer to introduce women unfamiliar with the condition. Share this article with your friends and find a program that you can do together! Let us know if you have dealt with this condition in the comments and what questions you have.
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