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Diastasis Recti

If you are a mom, then there is a good chance you have experienced Diastasis Recti. Diastasis Recti is a separation of the rectus abdominis muscle down the center of the abdomen at the linea alba. The connective tissue stretches and thins to accommodate the size of the baby causing the abdominal muscles to separate. This can affect abdominal strength and can result in decreased support for the low back and internal organs, a very real problem.

Diastasis Recti occurs in 27% of women by the second trimester and up to 66% of women by the third trimester. It is present in 52% of women at 6 weeks postpartum and remains in 39% of women by 6 months postpartum. A positive test indicating a separation width of greater than 2 fingers can create limited force closure of the abdominal muscles resulting in impaired load transfer and spinal instability with vertical loading tasks such as squatting, lifting, and going up and down stairs. This could ultimately lead to pain and dysfunction.

To test for a diastasis recti, lie on your back with one hand supporting your head and the other hand on your abdomen with your fingers on your midline just above your belly button. Slowly roll your head up off the floor, bringing your rib cage toward your pelvis. As you lift, move your fingers back and forth across the middle of your abdomen. Measure the amount of separation that occurs along your midline with your fingers. A separation of more than 2 finger-widths is considered a positive test for diastasis recti. Make sure to perform the test palpating above and below your belly button. In most cases the separation will decrease as the connective tissue heals and the abdominal muscles get stronger, however surgery is sometimes considered in women at least 1 year postpartum if the separation has not improved with more conservative interventions.

Certain exercises such as crunches, forward planks, roll ups, or anything else that causes the belly to bulge out upon exertion can make your diastasis recti worse and should be avoided. Women are encouraged to exhale during activities such as bowel movements, bending, lifting, pushing, and pulling to help decrease strain on the muscles and soft tissue. Proper body mechanics such as performing a “log roll” when getting out of bed are also important to avoid repetitive stress.

Strengthening your pelvic floor and Transversus Abdominis muscles will help re-establish the body’s internal “corset” for support of the pelvic girdle, low back, and abdominal wall. If needed, manual splinting of the rectus abdominis can be performed during exercises and activities for additional support. In severe cases, external bracing may be necessary. Kinesiotaping can also be effective at addressing diastasis recti by providing muscle facilitation and increased support.

Recently, diastasis recti has been a hot topic when it comes to postpartum recovery. We believe it is a significant problem that warrants discussion and research and should be addressed as part of a comprehensive postpartum recovery program. To only discuss diastasis recti though is missing the forest for the trees. Pregnancy comes with a multitude of musculoskeletal changes and it is our belief that we need to shift our focus from one muscle, and one issue, to treating the woman as a whole person.

The separation of the rectus abdominis muscle does not occur in a vacuum. The body is a kinetic chain and when one change occurs others follow suit in order to maximize function, no matter what the cost. If you have experienced diastasis recti, you more than likely have additional muscle imbalances that are contributing to altered movement, pain, and dysfunction. Back After Baby offers a comprehensive plan for postpartum recovery and is appropriate for all moms at any stage of motherhood. Click on the sign up link to get started with your program today! You can also follow us on Facebook, Instagram, and Twitter to learn more!