Diastasis Recti: the story of the separating stomach!

Being a woman is not only about being strong mentally but also physically. With our current lifestyles, the stress of juggling home and work, and a social calendar that’s always full, taking care of our health and wellbeing becomes a challenge. Another joy of being a woman is, of course, MOTHERHOOD!

As beautiful as motherhood is, it’s usually the abdominal muscles which pay the biggest price.

DIASTASIS RECTI is a condition that deserves the limelight. It’s the separation of the outer abdominal muscles. Though at this point I should tell you that diastasis recti doesn’t affect only women but can also happen to men and children. So gents, if you feel those six-pack abs forming a gap, it’s time to go see your physio! But, more often than not, women are more commonly affected by it especially after the birth of a child.

What causes the muscles to separate?

One of the most common causes is weak abdominal muscles. The outer abdominal muscles called the rectus muscle is not strong enough to handle the pressure and support the abdominal internal organs. The continuous stretching of the abdomen and the abdominal pressure exerted on connective tissues are other important causes to be aware of. During pregnancy, it’s commonly seen during the second trimester and the chances of reoccurrence increases with subsequent pregnancies. It’s even more common when a woman is expecting twins or triplets.

What do you have to look for?

The most common sign is doming of the abdomen. It’s more apparent when coming from a lying position into a sitting position.

In case you suspect it

If you suspect you have separated abdominal muscles, lie on your back with both knees bent then place your fingers just above your belly button and lift your head and neck off the floor while pressing your fingers into your stomach. A gap of 1-2 finger widths is considered relatively normal. You should also feel for tightening of your abdominal muscles. In case the gap you feel is more than 1-2 finger widths, talk to your physiotherapist for a full assessment and exercise prescription.

Like I said before, there is nothing that exercise can’t fix!

Now for the most important part—what can be done to resolve this little problem? Diet and regular, monitored and, more importantly, tailored exercise programs are excellent tools for combating abdominal separation and strengthening those core muscles without excessively increasing the intra-abdominal pressure.

Broadly speaking, research shows exercises divided into 3 phases of 4-week cycles.

Phase 1: Before you start doing any heavy ab work, let’s begin by concentrating on the fine-tuning and activation of our deeper abdominal muscles that help stabilise our pelvis, lumbar spine and in turn, abdominal strength.

Phase 2: Continue the basic stabilising and strengthening exercises you started in phase 1 but with added resistance like kettlebell workouts to build strength. Keep the volume high but with low load or resistance to build endurance.

Phase 3: Continuing phase 1 and 2, add cardiovascular workouts to the regime and increase the resistance keeping the number of repetitions the same to build power.

Apart from exercising, research shows that abdominal bracing in conjunction to strengthening and stabilising exercises yields better results and avoids the need to undergo surgery to correct diastasis recti. Exercises like static abdominals, head lifts and pelvic tilting with bracing and pelvic clock exercises help reduce the gap between the muscles and strengthen abdominal muscles.

In recent times, Pilates as a method of working on core strength, stability and core control has been studied extensively and has yielded excellent beneficial results to combat all issues related with pregnancy and weak core muscles. Pilates works body and mind as a unit and provides a comprehensive approach regardless of a person’s age, fitness level or the ability to work specific muscles. Programs are tailored to suit individual needs and can be modified and progressed often.

The Tupler Method

It’s the only research-based exercise program proven to effectively treat diastasis recti. The main aim is to heal the weakened connective tissue and this is done and progressed over 18 weeks. It’s divided into the above 4 stages and is a process of learning to do the exercises correctly while also maintaining a good posture and the correct way of getting up and down.

To conclude

Dealing with diastasis recti can be a bit tricky but not impossible to conquer. It’s all about knowing our body and figuring out what it needs to work efficiently with minimal grief! Safety is important when dealing with issues related to our core and pelvic floor.

At Therapia, our Adelaide physiotherapists specifically design protocols suited to your individual needs. Don’t ignore your core muscles—book an appointment with one of our therapists to have a full assessment of your signs and symptoms so we can help you maintain your post-baby glow!

We wish you an active, healthy and pain-free life!

References

Pascoal P, Carita A, Bo K 2014, ‘Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain’, Manual Therapy, doi:10.1016.

Acharry N & Kutty R 2015, ‘Abdominal exercise with bracing, a therapeutic efficacy in reducing diastasis recti among postpartal females’, International Journal of Physiotherpay and Research, Vol 3, No 2, pp.000-1005.

Wright A 2014, ‘Pilates for new mothers’.