I Had Diastasis Recti Abdominis - Do You?

Six-pack. Washboard abs. Strong core.
These are all terms that are often used when training the abdominals. And it is often one of the first places people look to address when they start on a fitness training program!

But there's another term that has to do with abdominal training that gets talked about less frequently, yet affects quite a number of people.

What is this, you may ask? A condition known as diastasis recti abdominis (DRA)!
Did you know that about 66% of mommas have had DRA (1)? Personally, diastasis recti was mentioned to me by my wonderful mother as something to watch out for during pregnancy.  But I figured it would just resolve itself after the pregnancy, and my body would be back to where it was. As a physiotherapist, my mom used to give prenatal classes, so I had genetic connections! However, most women have never had anyone educate them on DRA. Add to that the fact that the topic of rehab, or diastasis recti recovery, or any of the other common post-pregnancy issues are all things rarely ever mentioned.

SO WHAT IS DIASTASIS RECTI?
[caption id="" align="aligncenter" width="329"] Notice the line running vertical between the left and right abs? That's the linea alba.


DRA, quite simply, has to do with the abs. And it doesn't matter whether you have a six pack (like Ryan up above) or are closer to a full keg, we all have the same muscles. Only the level of leanness and strength varies amongst all of us.

So, dear mom, although not everyone's abs look like Ryan's, we all do have them! But let's focus, he's purely here for educational purposes. Those ab muscles are actually called your Rectus Abdominis, and are the outermost layer of your core. So, although you could probbaly see Ryan's his six pack (this is the rectus abdominis) through a down parka, focus on the line running vertically between all the squares. That line is called the linea alba. It's made up of connective tissue, and is what holds the right and left sides of your rectus abdominis together. During pregnancy, this connective tissue stretches, mainly because of 2 things:

1. Relaxin (a fantastic hormone that relaxes your muscles and ligaments in preparation for your baby coming), and
2. the tiny bundle of joy taking up more and more space inside your body, pushing everything outwards! AKA persistent intra-abdominal pressure

This stretching of the linea alba is what the professionals call diastasis recti!

OKAY, SO MY ABS DON'T LOOK LIKE RYAN'S. AND THE LINEA ALBA IS STRETCHED. SO WHAT?

Diastasis recti is actually just one of the things resulting from (or contributed to by) a weak outer core. Here are some others:

• Weakened postural support
• Can lead to low back pain
• That blasted 'mommy pooch' some of us struggle with (my middle is the last place I gain weight, and so I never really had a tummy to get mad at, even when I had more fat than I was comfortable with)!
• Incontinence
• Pelvic pain

OH SHOOT! HOW SEVERE CAN THIS ACTUALLY BE?

It is normal to have a slight separation in between your abdominal muscles. Up to 2 finger widths is considered healthy (more on how to measure this later). Anything more than 2 fingers can be cause for concern. HOWEVER, the most important thing about DRA is not the width of separation, but the ability/inability to create tension along the linea alba!
Most cases of DRA can be treated and healed with an appropriate rehabilitation program and exercises. Those, we can DEFINITELY help you with! However, there are some cases where surgery is necessary. If you are concerned about this, please don't hesitate to contact us, or consult with your physician, pelvic floor physiotherapist, or midwife.

SOUNDS SERIOUS, HOW DO I KNOW IF I HAVE IT?

Well, dear fellow mom, I'm so glad you asked!

Check out this video below from noted physiotherapist Diane Lee:

https://www.youtube.com/watch?v=cNpuD72QYsU

 
 

AH! I'M PANICKING! THIS IS EXACTLY WHAT I HAVE!! WHAT DO I DO??

First, breathe! Second, chill out on the panicking part of that. Like I said, most cases can be healed with proper exercises! However, it is really important to know that there are some exercises you should most definitely NOT be doing! If you are doing these... well... STOP!

• Crunches. In general, these are not recommended as useful exercises in most ways, but ESPECIALLY for those with diastasis recti.
• Planks (or any forward weighted exercises, pushups included)
• Any aggressive rotation exercises
• Any exercise that makes the abdominals bulge out (sit-ups, double leg raises, even getting up out of bed by sitting up quickly from laying to seated!)

One of the first steps to working towards having an incredible body post-baby, and rehabbing your diastasis recti is learning proper breathing, along with strengthening your transversus abdominis (one of your deepest core muscles).

[caption id="attachment_4807" align="aligncenter" width="300"] Notice the transversus abdominis is below 2 other layers of muscle.


Here are 2 exercises you can try:

1. Laying on your back, with your knees bent and feet on the ground, put your index and middle finger just on the inside of your hip bones. Now pull your belly button to your spine, imagining that you're zipping everything  up to your rib cage (set your core). You should feel some tension under your fingers. Hold for 5 seconds, pull your belly button a little more to you spine, and relax. Do this 10 times.
2. In the same position as before, set your core, and very slowly take the weight out of one foot. Don't actually pick your foot up off the floor at all, simply take the weight out. Hold for 5 seconds, then relax. Make sure you keep that tension under your fingers the whole time! Do this 10 times.

AWESOME RITA! BUT WHAT MORE CAN I DO?

Again, dear momma, I'm so glad you asked!

1. We, here at OPP, are hosting a Fitness Seminar, specifically for moms, talking about this issue! It is set for January 14th, 2016. There will be other moms, some healthy snacks, and fantastic information about everything we just talked about!
   Email us at This email address is being protected from spambots. You need JavaScript enabled to view it. to RSVP!
2. We have a Mom's Fitness Training Program starting in the new year on January 18th, 2016, tackling exactly these issues! If you're interested, stay tuned for more details, or email us any questions!
3. If you've like this post, we would love to read your comments, or even click the like button! If you found this valuable, feel free to share with friends or family as well!

Until next time!

Rita [fb-like]

http://www.scielo.br/pdf/rbfis/v13n4/en_aop035_09.pdf