Repairing a Diastasis Recti or Postpartum Diastasis of the Rectus Abdominal Muscle
Q:What IS Diastasis Recti (DR)?
A: Diastasis Recti, also referred to as Divarication of the Recti or Rectus Distension, is the widening of the gap between the 2 sections of the Rectus Abdominis (or 6 pack) abdominal muscle at the Linea Alba (mid-line connective tissue) at the front of the abdomen.
It doesn’t always return to its natural position after childbirth +, especially if a mother performs the ‘wrong’ type of abdominal exercises (read on for more information) the diastasis remains. This can cause a pooching or doming of your stomach, sometimes making you appear still a few months pregnant. As well as the aesthetic concerns, diastasis recti is associated with a weak core (+ pelvic floor), leading to a lack of strength + stability in the entire pelvic region + midsection. You can see an illustration of the muscles involved here.
Q. What Causes Diastasis Recti?
Diastasis Recti is the result of excessive intra-abdominal pressure or loading caused by non-optimal alignment of your entire body… + is common in the later stages of pregnancy, particularly second or subsequent pregnancies. The diastasis (the gap) narrows naturally in the days + weeks following childbirth, but often doesn’t come back together completely on its own, resulting in instability + weakness of the core + a ‘pooch’ stomach or ‘mummy tummy’.
But the Rectus Abdominis is only 1 of 4 layers of abdominal muscles: the Transverse Abdominis (deepest muscle layer) the Interior + Exterior Obliques (next 2 layers) that form your waist, + then the Rectus Abdominis is on the outside.
Unfortunately when the 2 parts of the muscle separate as a result of this increased pressure, the connective mid-line is stretched + weakened as it takes all other muscular + fascial support structures along with it. This leaves the front of the abdomen unsupported + unstable.
Important: Diastasis Recti is a symptom of excessive intra abdominal pressure, the same state that creates other pelvic + abdominal problems including hernia + prolapse. DR should therefore be treated as part of an integrated program designed to restore, re-connect + then strengthen the entire core musculature, rather than be addressed in isolation (+ rather than focussing only on ‘closing the gap’).
Q. How to test for Diastasis Recti
A: Lie on your back with your knees bent + your feet flat on the floor. Relax your head + shoulders + place your fingers (palm facing you) just above your belly button.
Lift your head, neck + shoulders slightly off the floor + press down with your fingertips. If you feel a gap, that’s the diastasis. You will feel the muscles close in around your fingers as you lift your head + neck. Don’t lift your shoulders up too high. Repeat the test in two other place: directly over the belly button, + a couple of inches below.
A diastasis recti gap is measured in finger width’s. You are aiming for a 1-2 finger gap or less, but don’t panic if it’s much bigger at first!
For more information on the MuTu System exercise programs to restore your core + repair your diastasis CLICK HERE
Q: Should you use a splint, belly binder or abdominal wrap to bring a diastasis of the rectus abdominis muscle back together?
A: Some advocate wrapping or binding the mid-section to draw the split recti muscles back together. Postpartum abdominal binding has also been traditional practice in many parts of the world for generations.
In my experience, it can be helpful when the gap is wide (4 fingers or more), +, used correctly, can help with awareness of the abs + for lower back support.
However don’t use a wrap or splint as a substitute for actually engaging the right muscles… otherwise you’re going to wearing that splint for a very long time.
Remember the diastasis is caused by inappropriate loading + pressure within the abdominal + pelvic ‘canister’. Wrapping it up in itself won’t fix it, it will just squidge your abdominal mass in a different direction (think of a tube of toothpaste squeezed in the middle…) You need to correct alignment + re-engage an entire SYSTEM of muscles + fasica to put your tummy back where you want it for the long term.
Q: How Common is Diastasis Recti?
Over a third of women will have a gap of two fingers or more after their first baby. After second or subsequent pregnancies, this figure is more like two thirds, especially if the gap wasn’t closed effectively after the first.
Q: What Exercises WILL Close a Diastasis?
A: First, you need to FIND your transverse abdominis muscle. Here’s how: Without raising or tensing your chest or shoulders, GENTLY draw your belly button back towards your spine as you slowly exhale. That’s the right muscle!You’re not ‘sucking in’ or making any forceful or exaggerated movement. Your pelvis shouldn’t tuck under as you do this – in fact nothing should be happening in your shoulders, chest or pelvis! – it is just a subtle drawing in at the lower abs.
You are not… sucking in your stomach, holding your breath, moving your ribs or your shoulders. You’re not tucking your butt / tailbone under you or thrusting your hips – all these pelvic tilts indicate the Transverse is not working – you have to isolate this muscle first + re-connect with it, if it is going to play its vital role in your core + pelvic floor system again..
You need to correct your ALIGNMENT – the cause of that excessive pressure + loading More on alignment + diastasis recti here
Then you have to learn to ENGAGE your transverse abdominis muscle effectively + correctly, not only when you exercise, but also during every-day movements like lifting, sneezing or twisting.
Then you need to STRENGTHEN your transverse abdominis muscle in a way that will draw your rectus abdominis muscle (the six pack, outermost one, the one that has separated) back in together, pulling your belly back in… flatter + stronger.
Note: Crunches, sit ups + some Pilates or yoga moves will make a diastasis worse!
Q: My Youngest Is At School…! Can I Reduce My Diastasis or Am I Too Late?
A: Activating + engaging your core transverse abdominis muscle + learning to re-align + + strengthen your core + pelvis can be done at any stage postpartum + will improve the gap. If you did a lot of crunches +/or oblique crunches post baby, then you may have developed a ‘cone’ shape on your abdomen where you have worked the muscles hard, but in the wrong direction. You may not bring the muscles right back together, but you can definitely make improvements to strength, stability + the way your tummy looks!
Q: Which Movements or Exercises Should I Avoid?
Crunches, sit-ups, oblique (twists) combined with crunches; anything that ‘jack-knifes’ the body, by pivoting at the hip + placing strain on the abdominals - such as straight leg lifts or holds from lying on your back + similar Pilates moves
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