Diastasis Recti (Abdominal Wall Separation) After Pregnancy

Motherhood, for most women, is the most cherished experience. However, it comes along with physical and hormonal changes that can become an inconvenience.

What Is Diastasis Recti?

The term diastasis recti refer to the abdominal wall separation after the pregnancy. ‘Diastasis’ means separation and ‘recti’ means rectus abdominis or the ab muscles.

In simple terms, the protruding belly pooch or the bulge that remains apparent for some women, even after losing pregnancy weight can be diastasis recti.

What Causes Diastasis Recti

There are two parallel bands of vertical muscles in the abdomen which are connected by tissues. These abdominal muscles are responsible for stabilizing the core and holding the internal organs together. During pregnancy, as the foetus grows, the uterus pushes the muscles in the abdomen to stretch on either side. This stretch causes the abdomen muscles to separate and this leads to the muscles losing their shape and create a gap in the middle of the abdomen.

It is a natural process during pregnancy for the muscles to separate. In due course of healing, it attains the previous form. If it does not, for a prolonged time, then you may have chances of having diastasis recti.

How to Know If You Have Diastasis Recti

A common DIY technique is followed by women to identify the separations. The steps are –

Step 1: Lie down on the floor on your back with your knees folded and feet on the ground.

Step 2: Place your palms on your stomach on the two sides of the belly button. Now, very gently lift your head, not as much as you would do for your crunches, but just a slight lift.

Step 3: Move your fingers on the line of the belly button; you may feel that you are able to dig your fingers in what may appear as a gap in the belly.

Diastasis is commonly measured in terms of how many fingers deep the separation of the two muscles is felt. You can verify the same with your gynaecologist before arriving at a conclusion.

Other Complications Due to Diastasis Recti

Mentioned are a few problems that are related to Diastasis Recti :

1. Umbilical Hernia

The likelihood to have a hernia, in the future, increases, if you suffer from abdominal separation for a long time. Hernia surgery may relapse if the diastasis is not treated properly.

2. Poor Posture

The ridge created in the abdomen results in a poor posture.

3. Lower Back Pain

Another associated complication is the lower back pain. The separation of the abdominal muscles leads to chronic back pain.

Dos and Don’ts

Just like any other physical ailment, Diastasis Recti can be healed by following the right steps such as Kegel exercises. However, it can also be aggravated by issues like constipation.

Dos:

Perform the exercises which gently work on your abdomen muscles. These suggestions are made for all women in the post-partum phase.

1. Kegel Exercises

Kegel exercises are essentially about increasing pelvic muscle strength.

• Kegel can be practised anywhere, anytime. You need to imagine trying to stop the flow of urine without moving your body.
• It strengthens the pelvic muscles and prepares the body for labour and natural birthing. Body is better prepared to relax and control the pelvic muscles.

2. Core Strengthening Exercises

It is a good idea to start core strengthening exercises before you get pregnant. Benefits of core strengthening exercises :

• It brings a balance in the body by training the pelvis, lower back, abdomen and hips, which results in fewer aches and pains during the pregnancy.
• Strong core adapts better to the changes in the body and it is easier for the abdomen to get back in shape after the delivery.
• Results have also shown that it minimizes the risk of diastasis recti and even improves it.

3. Body Postures

A corollary to the previous point, it is very important to maintain a good body posture.

• A good posture reduces the pain at the lower back, pelvis and neck.
• Allows more space for your baby to grow well.
• Most importantly, it minimizes the chances of developing a diastasis recti and allows the muscles to get back to its form after the pregnancy.

4. Breathing Exercises

Benefits of breathing increases manifold for women during pregnancy.

• It provides the body and brain with the required oxygen supply for the foetus.
• Reduces stress and keeps the body at ease, so that it the muscles remain taut and recover quickly.

Don’ts:

Here are some of the things you shouldn’t do:

1. Exercises Which Put Pressure on the Abdomen

Avoid push-ups, sit-ups, crunches and planks, which put a direct strain on the abdomen and pelvic muscles. Also, avoid yoga and swimming postures that put a strain on the body.

2. Lifting Heavy objects

Lifting heavy items can put undue strain on your body.

3. Constipation

Constipation can lead you to exert pressure on the abdomen causing the condition to get worse. Always have a fibre-rich diet and plenty of water to prevent constipation. If you have constipation, avoid straining for too long and pass motion only when there is an urgency to do so.

Treatment for Diastasis Recti

Here are some suggested measures on how to cure diastasis recti:

1. Physical Therapy

Diastasis recti physical therapy involves a trained therapist who provides postural training. He/she will also suggest some low impact, moderate intensity exercises to stabilize your core without disturbing abdominal muscles.

2. At-home Exercises-Tupler Technique or Mutu System

These techniques have gained popularity in the recent past. Backed by research and proven techniques, these at-home treatment series helps in healing diastasis recti by 55 percent. The focus is on training the separated muscles to become stronger and within a passage of time come together.

3. Surgery

If the above mentioned corrective actions fail or the results are not satisfactory, the last option is to undergo surgery. Also, a prolonged diastasis may lead to an abdominal hernia. The surgery, abdominoplasty, surgically reduce the gap between the two muscles. It is important to keep this as a last resort and to speak with the specialist on the process and the possible repercussions of the surgery.

Can a Splint or Binder Help?

Specially designed for pregnant women, these maternity belts or abdominal binders have traditionally been used in different cultures in the post-partum phase. It is a non-invasive intervention that supports the abdominal muscles and controls the pain. The restricted muscle movement provides a natural tummy tuck and the firmness enables a good posture. Please consult your gynaecologist before you start wearing the belt.

Splints may help in the early stages by providing abdomen support, however, wearing splint alone may not substitute for the treatment of diastasis. The abdomen muscles need to get back to a correct alignment which may get restricted with the external pressure of the splint.

Exercises for Diastasis Recti

Diastasis can be corrected with the help of exercise. Here are a few abdominal separation exercises that you could do:

1. Belly Breathing

Lie on the floor on your back. Keep your palms gently on your lower rib cage. Next, inhale deeply but gently and allow your chest and belly to rise and feel the pressure on the diaphragm. Exhale.

2. Standing Push-ups

Stand facing the wall. Let the distance from the wall be an arms’ length. Keep your feet wide. Now place your palms on the wall and inhale. While you exhale, push your belly to the spine. Lean in towards the wall when you inhale and push outwards when you exhale.

3. Lower Abdomen Exercise

Lie on your side. With the other palm, feel your abdomen muscles. Then, gently pull your lower abdomen muscles towards your pelvic bone. Breathe normally throughout. Relax in between two sets.

4. Bent Knee Fallout

Lie on your back and keep your knees bent and feet flat on the floor. Now inhale gently and lower one leg to the side while the other leg remains stationary. Repeat this with both legs.

How Often Should You Perform These Exercises?

You can start practising it from one week to three weeks after pregnancy. The breathing exercises can be done for 5 to 10-second hold. You can start with 2-3 iterations and increase as you get comfortable. It is recommended to consult your gynaecologist or a trained practitioner on your exercise patterns.

Is It Ever Too Late to Heal Your Diastasis?

No, it is not. Treating a diastasis recti post pregnancy is all about healing the connective tissue that brings together the abdominal walls back to its shape. Just remember that –

• The process is gradual and slow, however, not impossible. With the correct exercises and techniques, it is possible to correct the diastasis.
• Follow techniques which are scientifically backed and time-tested and if possible, under the guidance of a trained supervisor.
• The time required to heal largely depends on your body constitution and the width of the separation.

Motherhood brings along a plethora of changes in a woman’s life. While it is truly rewarding basking in the joy of being a new mother, it is also of utmost importance that women take care of themselves. A problem like diastasis recti is extremely common, yet, the most under-noticed and least talked about. It is time that women take charge of their self and take necessary actions. So, stay aware, stay healthy and stay happy!

Also Read: Pregnancy Massage: Benefits & Techniques