Diastasis Recti is an abdominal separation which occurs at the midline of the paired muscle, the rectus abdominis, known as the abdominals or 'abs'. This muscle runs vertically from your pubic bone up to the top of your ribcage at the front of your upper body and is separated by a 'midline' technically called the linea alba or abdominal raphe. You may notice a brown line formed here during your pregnancy. The Linea Alba is a connective tissue or fascia and is stretched during pregnancy due to the growing baby and the intra-abdominal pressure that this causes. A separation of 1-2 fingers at this midline is generally fine but if your separation is more than 2cm or 2 fingers width, it is referred to as 'Diastasis Recti', 'Rectus Abdominus Divarification, Rectus Diastasis. Further down in this article, I'll show you how to do a test at home to measure the degree of your separation.
A diastasis is not harmful and you do not necessarily need surgery to fix it!
What you do need to understand is that when the midline, Linea Alba, is stretched it weakens which not only affects the rectus abdominus but also the surrounding and more internal stomach muscles; the Transversalis or Transversus Abdominus and the Internal and External Obliques that make up your 'core' muscles. This means this tissue is unable to do it's job of providing 'tension' to give your body stability physically but also means it can affect how your stomach looks aesthetically.
So with the biology part out of the way..what does this mean to your body...
This separation can cause lower back pain and/or a tummy that 'sticks out', is more pronounced or still looks pregnant. You belly button which may once have been 'inwards' may now 'pop out' and you may also experience some pelvic floor weakness.
How does the abdominal separation or diastasis recti occur?
Research from Boissonnault & Blaschak (1988) states that 66% of women may have a diastasis recti during their third trimester.
You may have a Diastasis Recti as a result of your pregnancies and their type OR from incorrect technique and performing certain inappropriate abdominal exercises over time. Diastasis recti is the forward pressure on the uterus to push forward into the muscle and actually it can occur in other populations too, not just pregnant ladies. It can happen in men and women and can be the result of poor posture or body alignment; caused by pushing the hips forward or frequently wearing high heels OR in people who are carrying extra weight around the abdominals or have a 'beer belly'.
Back to pregnancy though, some stretching and a small gap of the abdominal muscles is considered quite normal due to the growing foetus, uterus and hormonal changes softening causing laxity at the Linea Alba. In some women the abdominal separation may close within a few weeks after having their baby. However with other women it may remain the same that it was at 8 weeks postpartum to 1 year later according to research from Coldron et al (2008) if the abdominal separation is left without appropriate exercise training and physiotherapy.
What increases the risk of diastasis recti?
Research has shown that between 35 – 62% of women have diastasis recti postpartum and it is more prevalent if you:
- had multiple pregnancies; twins, triplets or more
- were are overweight prior or during pregnancy
- delivered a larger than average sized baby
- suffered from uterine fluid during pregnancy or had high amniotic fluid levels
- have laxity or muscular imbalances caused by overtraining the rectus abdominal muscles versus the internal 'Core' or transversus abdominal muscles.
- had your babies close together in age
- are of older maternal age
- have an 'anterior tilt' of the pelvis (that's the thrusting or pushing forwards of the hips I mentioned earlier) and poor alignment prior to pregnancy
What are the side effects of abdominal separation, diastasis recti?
- Lower back pain
- Pelvic region pain
- Upper back pain
- Pelvic floor weakness and incontinence
- Intestinal and digestive issues
- Inability of the abdominal muscles to stabilise the pelvis against any force or resistance
- Poor posture and ability to breathe effectively
- Correct movement and recruitment of the abdominal muscles
- Compromises vaginal delivery
- "A mummy tummy" which is a 'pooch' or bulging of a females' abdomen which diet and exercise doesn't fix.
How do I prevent diastasis during pregnancy or help heal it postpartum?
It's really important to be aware that hundreds of stomach crunches or planks will not fix it!
1. Learning to correctly engage your deep abdominal muscles. These muscles are the ones that act like a corset and wrap around your whole mid-section, it's the Transversalis or Transversus Abdominus and the Internal and External Obliques I mentioned before. Many people when they perform abdominal exercises prior and post baby recruit the more superficial Rectus Abdominal muscle as their breathing to technique isn't correct. They also perform too many abdominal exercises that just target the rectus abdominis, such as a crunch or forward flexion exercises which don't target the deeper muscles. To reduce your risk of diastasis, it's wise to learn the correct breathing and technique and appropriate exercises that target the deeper, inner most muscles.
2. Correct your alignment by standing with your ribs over your hips, rather than thrusting your pelvis or hips forward, and bringing your bodyweight back into your heels. Steer clear of high heels as they push your upper body forwards and cause mis-alignment.
3. Avoid sucking in your stomach and lifting the ribs (part of point 2!)
4. Keep a check on weight gain during your pregnancy. Piling on the pounds by over-eating eating or being inactive will lead to more pressure in a space where there is a growing baby.
3. Engaging your tummy muscles by drawing in your belly button (highlighted in point one) slightly when lifting other children, other objects or when exercising, particularly strength training.
4. Avoiding certain abdominal and pilates exercises - sit-ups, pilates 100's, planks, oblique cross-overs or bicycles, strong rotations or side flexion exercises will make the separation worse.
How to check for an abdominal separation.
This video will show you how to check for the width of your abdominal separation yourself at home and whether to classify it as a diastasis. It will also show you one key exercise to help heal it.
For two key postpartum core exercises to help heal diastasis preview TheBeezKneez Hive's Floor Core Postnatal Exercises by clicking here.