What Is Diastasis Recti? A Guide
Abdominal separation, or diastasis recti, is a physiological condition that has the potential to affect anyone, regardless of sex, gender or reproductive status.
Abdominal separation occurs as a totally normal part of the development of pregnancy, and can also occur in relation to excessive weight gain, muscle strain, during infancy and other conditions. It becomes dysfunctional when it leads to visual or aesthetic changes to the stomach or torso, or causes pain, discomfort, weakness, incontinence, prolapse or other related medical issues. Infants may have abdominal separation, umbilical hernias or other core dysfunctions that typically correct themselves as baby develops into toddlerhood.
If you are recently postpartum (0 to 20 weeks) regardless you may feel or experience the effects of ab separation from your pregnancy. Hopefully a perinatal professional in your life has expressed to you what safe and effective activity and exercise looks like during this time and has given you some tools to prevent further separation and help to increase your core stability during this time. If you feel like you are experiencing significant ab separation, core and pelvic floor weakness, please reach out to your local physical therapist, OBGYN or pelvic floor therapist to rule out significant conditions or prolapse that may require more specific or acute treatment.
Whether you're pregnant or postpartum, here's some basic guidance for preventing and healing.
DO:
Go for walks and move as frequently as you are able. Walking not only benefits our body, but also our mind, and fresh air is good for everyone.
Be mindful of your posture when standing, sitting and moving. Proper pelvis and spine alignment during pregnancy and postpartum is essential to ensuring your muscles and joints don't get more misaligned and imbalanced. Lifting and bending with your knees, instead of your back, will help you recover faster and avoid lifting injuries.
Perform movements like heavy carries, squats, deadlifts, arm raises, step ups and weighted marches to help engage your core that helps to activate the core canister and heal any separation or strain. Connect with a professional knowledgeable about postpartum recovery on how to specifically program exercise to benefit your process.
Listen to your body. If you feel pain or fatigue, rest. Especially after a cesarean or significant perineal tear or other birth injury, your body needs rest and time to heal. Significant pain or bleeding should be discussed with your doctor.
DO NOT:
Bend or lift with your lower back.
Start lifting heavy loads that require you to increase your intraabdominal pressure. IAP, or performing the valsalva maneuver, are excellent tools for lifting heavy loads or increasing core stability for certain movements, but should be avoided while your abdominal muscles are still in a weakened state.
Perform planks, sit ups, leg raises or rotational exercises. Until you are beyond the acute postpartum phase and have been cleared by a professional, these exercises may exacerbate any abdominal separation you have, or even cause separation. These movements also increase stress on the linea alba and increase intraabdominal pressure.
HOW TO CHECK:
Lie on your back with your legs straight. Slowly engage your abs by raising your head off the floor, only about an inch. Starting below your sternum, use your middle and index finger to feel in the center of your abdomen, moving down your stomach towards your navel. If you are able to put two or more fingers into the gap between your abdominal muscles, it's likely you have DR. A PFT or PT will be able to provide you with a confirmed diagnosis and proper treatment plan.
Just because you don't have measurable separation, doesn't mean you can't still suffer from long term effects of pregnancy, cesarean birth or other surgeries, or conditions that affect your core strength. Our pelvic floor, core and back strength and stability is reliant on multiple muscle groups moving in harmony with one another, and these big physiological experiences can affect us in major ways. If something doesn't feel right, it's worth it to seek guidance from someone who is familiar with treating these conditions. Pelvic Floor Therapists, Physical Therapists, OBGYN's and Perinatal Fitness Coaches are all great resources to help you recover and thrive into parenthood.