A Diastasis Recti or DR is the widening of the gap between the 2 sections of the Rectus Abdominus or (6 pack muscles)
The split occurs at the Linea Alba, the mid line collagen structures of connective tissue at the front of the abdomen. (see image)
100% of women have some level of diastasis of the rectus abdominis in the third trimester (Diane Lee, 2013)
66% of women with a DR have some level of pelvic floor dysfunction
The Linea Alba no longer provides tension and stability. All the muscles of the abdomen, which includes the Transverse Abdominus or TVA, internal and external obliques and Rec Abdominus meet at the center of the midline. When this gets stretched the Linea Alba is no longer able to provide tension and stability for the body. Therefore your whole body is affected by this weakness.
WHAT CAUSES DR?
DR is a result of excessive intra-abdominal pressure or loading. It is common in later stages of pregnancy but can occur earlier and in multiple pregnancies. When the Linea Alba is stretched due to a growing bump, the connective tissue is weakened and this affects the surrounding muscles and fascia. This then leaves the front of the abdominals very weak and unsupported. This connective tissue down the mid line is meant to be taut and at full length and aligned from breastbone to pubic bone, when it is pulled wide due to a growing bump then it is not at full strength and cannot work optimally, therefore we need to address this line and get it ‘in line’ to restore full strength of the abdominals and repair the diastasis.
Diastasis is a symptom of excessive and unsupported intra-abdominal pressure and therefore should be treated as part of an integrated programme to re-align, re-connect and re-store strength to your whole core structure not just ‘closing the gap’.
HOW TO TEST FOR DIASTASIS RECTI?
Lie on your back with your knees bent and your feet flat on the floor. Relax your head and shoulders and place your fingers just above your belly button.
Lift your head and neck very slightly off the floor and press down with your fingertips. If you feel a gap that’s the diastasis. You will feel the muscles close around your fingers as you lift your head. Relax your head down and move fingers to below belly button and repeat the movement and then repeat this movement with fingers on your belly button.
The gap is measured in finger width’s.
EXERCISES TO AVOID IF YOU HAVE A DIASTASIS
Crunches
Sit ups
Oblique twists
Scissor legs (both legs at the same time)
Roll up
Roll over
WHAT EXERCISES CAN I DO TO HELP CLOSE A DIASTASIS?
BREATHE
If I just highlight what I mentioned earlier that a DR is about too much excess and un-supported intra-abdominal pressure, therefore we need to FIND and connect with your deep core muscles first. So, lets breathe to find it. Take a big breath in through nose and expand ribcage and belly, as you breathe out gently draw pelvic floor upwards and feel a light connection in your stomach. You are not ‘sucking’ it in, holding it flat or forcing a movement to occur. Let your breath do it for you! You should feel your breath expand the ribs and belly and avoid lifting shoulders as you breathe. As you breathe out you should feel your ribs soften in and down and your belly flatten towards spine gently!
POSTURE
You need to correct your posture and address your alignment. The cause of the excessive pressure and loading was due to the bump expanding. We need to teach our bodies where we are again in space without a bump and if we can align our pelvis and ribs this can help correct our diastasis. A correct alignment can also address any pelvic floor issues as it is more likely to function more effectively if your pelvis is in neutral.
CONNECT
Then you can learn to engage and ‘switch on’ your TVA and Pelvic floor muscles not only when you doing exercises but also when you performing your day to day tasks. You wont always have to do this but whilst there is an imbalance through the body we need to teach these muscles to engage when you doing movements in order to support our body.
STRENGTHEN
Once your pelvic floor and TVA are connecting then you learn to strengthen and load your core to pull the midline back together and ensuring that your stomach can take load again with a flatter and stronger stomach because of all of the above steps!
WHAT I SAY……
It’s a journey that won’t last forever. It’s a process. Follow the steps, get some support from a women’s physiotherapist or a local personal trainer who specializes in pre and post-natal wellbeing and start with your foundations. Once this is connected and strong you can do all the things you so want to do, but get strong and connected first! Don’t rush it, healing will happen if you practice and give it time. But more importantly practice it correctly!
