WHAT IS DIASTASIS RECTI?

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Diastasis Recti, also referred to as ‘Divarication of the Recti’ or ‘Rectus Divarification’, is the widening of the gap between the 2 sections of the Rectus Abdominis (or 6 pack) abdominal muscle. The split occurs at the Abdominal Raphe (Linea Alba and Linea Semiluniaris), the mid-line collagen structures of connective tissue at the front of the abdomen.

100% of women have some level of diastasis of the rectus abdominis in the third trimester.(Gilliard and Brown 1996, Diane Lee 2013)

Importantly, for many women the gap remains widened at 8 weeks, and left untreated, this distance at 8 weeks remains unchanged at 1 year postpartum. (Coldron et al 2008, Liaw et al 2011)

66% of women with diastasis recti have some level of pelvic floor dysfunction (Spitznagle et al 2007). Diastasis recti and pelvic floor problems tend to go together.

The Abdominal Raphe (seam of tissue structures that form the meeting point of the 2 sides of all the core musculature) no longer provides tension and stability. Because ALL the muscles of the abdomen- Transversalis, internal and external obliques, as well as Rectus Abdominis – meet at this centre midline, all are compromised, meaning that this lack of protection and stability affects the whole body both aesthetically and functionally.

WHAT DOES A DIASTASIS LOOK LIKE?

You may see a ‘pooching’ or ‘doming’ of your stomach, especially when coming up from a lying position on your back. Sometimes you appear still a few months pregnant. As well as the aesthetic concerns, diastasis recti is associated with a weak core (and pelvic floor), leading to a lack of strength and stability in the entire pelvic region and midsection.

WHAT CAUSES DIASTASIS RECTI?

Diastasis Recti is the result of excessive intra-abdominal pressure or loading. It is common in the later stages of pregnancy, particularly second or subsequent pregnancies. It is important to note though, that pregnancy does not cause a diastasis. It is simply that the increased load and further shifts in alignment of pregnancy exacerbate the root problem – that of excessive, ‘un-contained’ intra abdominal pressure.

The Rectus Abdominis is only 1 of 4 layers of abdominal muscles: the Transverse Abdominis (deepest muscle layer) the Interior and Exterior Obliques (next 2 layers) that form your waist, and then the Rectus Abdominis is on the outside.

Unfortunately when the 2 parts of the muscle separate or come apart, the connective mid-line is stretched and weakened as it takes all other muscular and fascial support structures along with it. This leaves the front of the abdomen unsupported and unstable. The Raphe is designed to be taut, at full length and aligned in a vertical (breastbone to pubic bone) plane. But it cannot perform or function optimally when alignment is ‘out’. So it’s alignment we need to address to address a diastasis!

Diastasis Recti is a symptom of excessive and unsupported intra abdominal pressure, the same state that creates other pelvic and abdominal problems including hernia and prolapse. DR should therefore be treated as part of an integrated program designed to re-align, re-connect and then strengthen the entire core musculature, rather than be addressed in isolation (and rather than focussing only on ‘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 (palm facing you) 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 in around your fingers as you lift your head and neck. Don’t lift your shoulders. Repeat the test in two other place: directly over the belly button, and 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.

Even more important than the width of the gap though, is the tension (or lack of tension) in the midline – the linea alba. Contracting the muscles should create tension and resistance to your application of gentle pressure with your fingers to the midline. If it doesn’t – you have some re-connecting to do…

SHOULD YOU USE A SPLINT, BELLY BINDER OR ABDOMINAL WRAP TO BRING A DIASTASIS TOGETHER?

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, supporting the abdomen during and immediately after pregnancy may be helpful in some cases, and, used correctly, can help with awareness of the abs and for lower back support.

However, wrapping it up tight, pulling the two sides together… won’t make them heal or stay there. 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 and pressure within the abdominal and pelvic ‘canister’. Loading that your body can’t withstand as it should. 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 and re-engage an entire SYSTEM of muscles and fasica to put your tummy back where you want it for the long term.

MuTu System’s recommendation NOT to use a binder or splint to narrow a diastasis recti has been shown to be the anatomically correct approach according to recent research from globally respected Physiotherapist Diane Lee.

THE MUTU SYSTEM PROGRAM

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MuTu System is for women who want their bodies to look, feel and function better after having a baby. Even if it’s a long time since having a baby.

They want a core and a pelvic floor that work, that feel right and that do their job.

It’s for women who want to lose weight after childbirth and keep it off.

It’s the definitive, medically endorsed Mummy Tummy Workout System, created by postpartum fitness expert, Wendy Powell.

An international best-selling, industry acclaimed, award winning, holistic, realistic and supportive exercise and recovery program for Moms that truly works.

A proven, truly effective, tried and tested solution for ‘mummy tummy’, diastasis recti, pelvic floor weakness and core that isn’t as functional or strong as you’d like it to be.

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 and placing strain on the abdominals – such as straight leg lifts or holds from lying on your back and similar Pilates moves.

MY YOUNGEST IS AT SCHOOL…! CAN I REDUCE MY DIASTASIS OR AM I TOO LATE?

Activating and engaging your core transverse abdominis muscle and learning to re-align and and strengthen your core and pelvis can be done at any stage postpartum and will improve the gap. If you did a lot of crunches and/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 AND the way your tummy looks!

WHAT EXERCISES WILL HELP CLOSE A DIASTASIS?

GetStartedNowFirst, you need to FIND and connect with your deep core muscles. 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 and re-connect with it, if it is going to play its vital role in your core and pelvic floor system  again..

You need to correct your ALIGNMENT – the cause of that excessive pressure and loading.

Then you have to learn to ENGAGE  your transverse abdominis and pelvic floor muscles effectively and correctly, not only when  you exercise, but also during every-day movements like lifting, sneezing or twisting. This is a natural, reactive movement which you won’t always have to do consciously! But to re-conenct, to realign and to restore, we isolate at first.

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 and stronger.