During pregnancy, the abdominal wall has to make room for the baby. The six-pack muscles (rectus abdominus) separate along the vertical line of connective tissue that normally holds them together. If the muscles don’t come back together after pregnancy, this is known as diastasis recti.
Unfortunately this is not a well known condition among the people who may be suffering from it. As a result, there is a lot of misunderstanding around the topic. It is important to know a few things:
- This is not the same as a muscle tear.
- Developing diastasis does not mean your muscles were weak to begin with, or that you are weak now.
- Exercise will not prevent the muscles from separating during a full term pregnancy. Baby needs room!
Guidelines are unclear, but there’s no point in trying to diagnose this condition in the first few weeks after birth. The body needs time to heal!
A separation can be anywhere between sternum and top of pubic bone (the lowest point of the abdomen where the midwife would place the tape measure to measure the size of your bump). It most commonly occurs just above or below the belly button. You can test for diastasis at home, or if you suspect it you can have it checked at your appointment with us. To check yourself at home:
- Lay on your back with your head and feet on the floor and knees bent
- Place your fingers somewhere in the centre of your abdomen. You might want to start just above and below the belly button and then move away from it
- Raise your head, and as the muscles tense, feel for a dip under your fingers
If you can feel a dip that is wider than a couple of fingers width and deeper than about an inch, you could be considered to have diastasis recti. Don’t panic! 40% of women have a gap six months after pregnancy, and some women don’t even realise that they still have it years later. It absolutely can be a silent condition, but if it bothers you, you don’t have to live with it.
Our sports therapist Boo has had Diastasis twice, and rehabilitated them both herself.
After my first child I experienced a mild Diastasis Recti where my tummy button protruded slightly. I started running properly again at 3 months pushing the buggy. A year later I ran a PB 10Km race and came 3rd woman.
As an active person I kept moving all through both of my pregnancies. I ran and worked out in the gym until 27 weeks and 25 weeks respectively then I only used the gym non-impact CV machines such as the cross- trainer and bike and did strength work with the free weights. People sometimes try to blame what they did in pregnancy to fathom why they now have Diastasis Recti but the truth is there is no rhyme or reason. It can just happen.
As a Sports Therapist I knew there were a few exercises to avoid such as oblique work against gravity as this can pull the abdominal apart.
After my second child I now have a 3 finger gap in standing and when lying in a crunch it is 2 fingers. I am able to close it by working on my deep core muscles, namely transverse abdominals. This creates a girdle like effect.
Exercise and rehabilitation
I have always been a very active person, my slim frame always suited middle distance running. After two large babies, 9lbs 9 and 9lbs 3 respectively my body has altered in shape but not ability. My abdominals were always solid and my core supported me through my speed work. It has taken time but I feel confident in the stability of my core and after my first 10 mile run a few weeks ago I felt just like I used to.
I am now 17 months postpartum and am running with both girls in the buggy regularly. I do a couple of strength sessions a week and walk most days. It has been a long road. The early weeks after birth I walked everywhere (3 dogs tend to get you out!) and performed gentle breathing exercises lying on my back concentrating on using my stomach muscles to close the breath. After my 6 week check my doctor told me I had significant split in my abdominals so I waited a little longer than after my first child to start running. I bought a spin bike so I could work my cardiovascular with no impact and this was a great way to start rebuilding fitness. I also did gentle Pilates movements targeting the deep core and pelvic floor.
I can now do most core exercises but avoid explosive movements such as burpees (what a shame!).
Other causes of diastasis
This condition is not limited to pregnancy. Obesity can cause the abdominal muscles to separate in the same way, and they can stay separated after weight loss. In this case, management is similar to a pregnancy-related diastasis.