PostnatalPrenatalWomens Health

Diastasis Recti: From How to Assess to Safe Exercises to Heal – A Few of My Favorite FAQs

By January 21, 2015 September 15th, 2015 No Comments

I have been receiving a lot of common questions regarding diastasis recti, “how do I know if I have a separation”, “what can I do to help heal it”, so I thought I’d write a quick post to share the Q&A with all of you.

diastasis-recti, abdominal wall separation

Photo credit: Healthy Moms®

What it is?

An abdominal wall separation, also known as diastasis recti, is the separation of the rectus abdominis muscle. Diastasis is a common feature during pregnancy, or after birth –approximately 66% of women have an abdominal muscle separation immediately following delivery.  During pregnancy your muscles need to expand to accommodate the growing uterus. During this expansion, in some cases, the connective tissue (linea alba) holding the muscles together thins and weakens. It doesn’t hurt, and you may not even be aware that it exists.

A separation reduces the integrity and functional strength of the abdominal wall and thereby can affect the back and pelvic stability – think low back pain, and/or urinary incontinence. A separation also cause the ‘baby pooch’ appearance.

What causes a separation?

A separation can occur to any pregnant woman. It doesn’t discriminate between fit, strong mamas, or mamas who may not have the option to exercise during pregnancy. Health professionals agree that women carrying multiples, age, joint elasticity, and number of births can be strong influencers for a separation to occur.

How do I know if I have it?

Ask your healthcare provider to assess you after having your baby. You can self-assess after birth, but it is recommended to wait 14 days after birth before you start.

  • Lie on your back with your knees bent and feet on the floor
  • Put your fingers at the midline of your tummy
  • Lift your head slightly with your abs relaxed
  • As you rise and lower slightly in this position, you may feel that your fingers sink in slightly and can feel the ridge of muscle on either side as you rise
  • If you rise up in a full sit up type movement, and see your tummy rise in a ridge or cone shape, this is a sign that you have a diastasis also
  • If you feel a painful bulge in the diastasis consult your doctor

Once identified, diastasis can be measured for its length, width and depth. (Depth is most telling of severity, followed by width then length.) A women’s health specialist can help you with an assessment if you are concerned and would like a thorough assessment and treatment plan

When is surgery necessary?

In the 11 years I’ve been working with prenatal and postnatal women, I have only seen two severe cases of a separation that required surgery. The average separation is 1.5 – 2.0 fingers wide and can heal by itself or with specific corrective exercises to target deep abdominals.

What can I do to help heal it?

With dedication to basic abdominal rehabilitation exercises you can begin to reconnect the muscles. By basic, I mean, you need to master and practice the simplest exercises and breathing techniques daily – which may seem really really easy, and a ‘waste of time’. The connective tissue itself can remain weak for some time after birth due to the presence of pregnancy hormones in your body, so you may need to have patience with your body to regain full strength.

The corrective exercises teach you to isolate the contraction of your transverse abdominal (TVA) muscles – the deepest layer of muscle that runs horizontally around your torso. You can read more about abdominal rehabilitation exercises here. For every woman wishing to return to exercise after having a baby, these rehab exercises should be your starting point. Rushing into other forms of exercise without core rehabilitation is ill advised (and extremely common in the pursuit of weight loss and pre-pregnancy physique).

An important step to repair a separation is to avoid exercises (crunches, V-ups, side planks, oblique sit-ups, Pilates 100’s) and DAILY MOVEMENTS (sitting up straight to get out of bed) that can provoke a separation.

What Active Moms’ Club services are available to assist?

  • From the Core: Postnatal Recovery” classes – are for moms who are ready to exercise after pregnancy and are at least six weeks postpartum. This mom and baby class is designed to work with your recovering body. By the end of the six weeks, you’ll feel stronger and more confident about what your body can do.
  • Post-Baby Body Express Training – over the course of three one-on-one training sessions and a series of customized at-home workouts, you’ll learn the (level appropriate) corrective exercises to address your post baby body.

Yikes, my baby is over 1, is it too late for me to heal it?

No. It is never too late to rehabilitate your abdominals and start rebuilding a strong core.

Why does advice out there differ so much?

Sometimes you will find fitness professionals prescribing unsafe exercises due to lack of knowledge or because they themselves or their clients have utilized those exercises without ill effect. This is because every physical body is different. Every woman’s physical strength and condition, the size and shape of her muscles are different. Every woman’s pregnancy is different. Therefore, the advice above of what to avoid is general advice that is cautious and sensible for the general population. Become knowledgeable on the condition, get to know your own body, and you can then make an informed decision about what is best for you.

I hope you all found this helpful. Knowledge is power. Please share this article if you know others who would find it helpful.

~ ~ ~ ~ ~ ~

Other related articles from Active Moms’ Club blog:

Top 3 Exercises to Strengthen Core Muscles During Pregnancy

New Moms’ Postpartum Body: From the Baby Blues to Kegel’s, A Few of My Favorite FAQs

Your Body After Baby & Exercise

3-Steps to Flatten Post-Pregnancy Abs