WHAT IS IT -
The widening of the gap between the rectus abdominal muscles due to stretching of the connective tissue between the muscles which is called the Lines Alba. The Lines Alba runs between the Rectus Abdominus muscle and during pregnancy is stretched beyond its normal capacity which causes the distance between the muscles to increase this is a Diastasis Recti. After pregnancy if it to fails to return to its pre pregnancy tension the gap remains. This often causes a loss of the ability to control intra-abdominal pressure within the whole core which often then associated with other symptoms such as low back or pelvic pain, pelvic floor dysfunction or a change in the appearance of the abdomen.
WHAT IT IS NOT-
Splitting or tearing muscles. There is no muscular tear or strain although the muscle is often weaker.
This condition has no known associated morbidity or mortality.
EVERY WOMAN HAS A DIASTASIS RECTI BY THE END OF THEIR PREGNANCY IT IS TO BE EXPECTED.
By 6 weeks post delivery 60% will have recovered naturally
However 33% of women will still have some degree of Diastasis Recti at 1year post birth. (Sperstad et al 2016) It is never too late to improve the muscular function of your abdominals.
WHAT CAN BE DONE
1) Individualised exercise plan------- after assessment of abdominal, gluteal, pelvis, pelvic floor and spinal systems, utilising a whole body approach.
2) Advice on how you can safely return to doing the type exercise you enjoy.
3) learning to control Intra abdominal pressure correctly utilising breathing, deep abdominals and pelvic floor muscles..
4) lift with your legs not your back..
5)Optimising breathing especially during tasks which increase pressure on the abdomen.
6)Postural awareness reducing pressure on the abdomen during sport and whilst looking after your baby.
7)Book in for an assessment with a pelvic health physiotherapist to assess you and give you a personalised exercise plan.
WHAT SHOULD BE AVOIDED
1)Don't focus solely on closing the gap.
2)Don't perform exercises where you have to hold your breath or that you can't control intra-abdominal pressure causing doming or invaginating or pressure in your pelvis.
3)Avoid poor posture habits.
4)Avoid poor lifting techniques.
5)Don't worry that you can't ever return again to what you love doing, rehabilitation is possible.
6)Don't concentrate solely on rectus abdominal exercises focus on balancing the whole core..
7)Rushing rehab and expecting results quickly it took 9 months to make a baby give yourself time to rehabilitate properly. Everybody has a different set of circumstances do not compare your recovery to others
HOW DO I CHECK MY ABDOMEN.
If you lie on your back knees bent up and put your fingers in your belly button. If you then lift your chin to your chest and while you are doing this feel the edges of the Rectus Abdominal muscle and run your fingers down towards your pubic bone and up towards your sternum (breast bone). Measure how many finger breaths you can fit in between the edges of rectus abdominus if you can fit more than 2 fingers at any part of the length of the Linea Alba then an assessment is advised. Also be aware of the depth and tension of the gap as this is also relevant.
It might be the whole length, just at the umbilicus or just above or below the umbilicus.
If it is less than 2cm but you are still worried about your tummy appearance or function you can still request an assessment. Sometimes the change in appearance of the tummy is due c-section scar tightness and someti
mes by changes in skin tension due to stretch marks and sometimes due to postural changes that are common during pregnancy. It may also be due to weakness in the abdominals The function and strength of muscles may still be improved and rehabilitated but
we are unable to resolve change in appearance due to skin stretching alone.
If it is more than 2cm then what should I do;-
Review with a Pelvic health Physiotherapist for an assessment and rehabilitation plan or speak to your Doctor. If not resident in Guernsey find your nearest Pelvic Physio with experience in treating Diastasis Recti on the POGP website link here www.thepogp.co.uk. They will help to set up up with an individualised exercise program and advice you on what is best for you. Having a detailed check up post-delivery enables you to return to all you love doing safely and with reduced risk of injury.