diastasis recti

The Postpartum Mom’s Guide to Diastasis Recti

What is it?

Diastasis Recti is an unnatural distancing of the right and left halves of the rectus abdominis. The rectus abdominis is a muscle separated by fascia into compartments leaving the left separate from the right1)Bowman, Katy. Diastasis Recti: A Whole-Body Solution to Abdominal Weakness and Separation. Propriometrics Press, 2016. Print.. In other words, diastasis recti is an unatural separation of the left and right abdominals and commonly occurs during pregnancy.

diastasis recti diagram

Image credit: healthyhabitshappymoms.com

When is it natural vs unnatural?

When a woman is pregnant, a distancing of the rectus abdominis is natural. The connective tissues soften due to hormones and the abdomen experiences the internal force from the uterus. A normal width of the linea alba is between 15mm (1.5 cm) and 22mm (2.2cm)2)Beer, G.M., Schuster, A., Seifert , B., Manestar,M. Mihic-Probst, D., & Weber, S. A. (2009). The normal width of the linea alba in nulliparous women. Clinical Anatomy, 22(6), 706-711. <http://www.ncbi.nlm.nih.gov/pubmed/19637295>.

The integrity of the core is lost and functional strength of the abdomen is reduced with diastasis recti. These weak points in the core can cause other problems including low back pain and pelvic instability that can lead to pelvic pain. For the postpartum mom, her pelvic floor (the bottom of the core) can often have weak points as well from the increased pressure during pregnancy and from a vaginal birth.

The Dreaded “Take it Easy Until 6 Weeks” Postpartum

nichelle gurule

If you’re a mother, you know that waiting 6 weeks to do approved activities seems like forever. The best advice I ever received was to “take it easy and allow your body to heal. You have your whole life to get back into shape.” While this can be frustrating for some, particularly athletes, the advice is solid. That being said, both “taking it easy” does not mean “do nothing.” Some activity can be achieved in the first 6 weeks postpartum3)Byrne, Helene. Exercise After Pregnancy: How to look and feel your best. 2001.Print..

GASP! It’s true!

First: work on your posture. Correct poor quality positions you find yourself in throughout the day. How you sit, how you nurse, how you stand, and more.

Next: work on your core.

sit ups, push ups and plank, should be approached with caution!

Most postpartum moms want their pre-pregnancy tummies back yesterday. Unfortunately, our society has done a fantastic job of perpetuating the idea that toned and chiseled abs come from crunches, sit ups, v-ups, and plank. The reality is that toned abs come from varied movements and low body fat percentages. Performing the above-mentioned exercises places unnecessary and improper forces on the core and often do more damage, especially if performed when you have a diastasis recti. Movements that pull from the midline such as isolated oblique work and movements that create a lot of outward force on the midline such as a sit ups, push ups and plank, should be approached with caution!

When we talk about regaining that core integrity, change your mindset from how you look, to how you function. Poor core integrity results in various degrees and regions of pain and instability. The increased risk of injuries from a weak core is why you want to focus on your deficiencies to become functionally strong.

Okay, Now You Get it… but Where do you Begin?

To start regaining your core we need to begin with what muscles are involved, as the core is often misunderstood to be just the abdomen. The core is a four-sided cylinder and consists of the diaphragm (top), pelvic floor (bottom), deep muscles of the abdomen (front), and deep muscles of the back muscles (back). If one of these regions is weak due to an internal or external force, the entire core is weakened. This creates an issue with the entire body because the core links the top of our body to the bottom, including our arms and legs. Research has shown that having greater core stability is related to lower injuries.

core diagram

For more information, and a great description on the core, check out the article “[d]o you know what your core really is and what it does?” by Jeff Kuhland4)Kuhland, Jeff. Breaking Muscle. Do you know what your core really is and what is does? <http://breakingmuscle.com/mobility-recovery/do-you-know-what-your-core-really-is-and-what-it-does>..

How Posture Plays a Role

Posture plays a huge role in how we begin to heal our bodies. How we position ourselves throughout the day makes a huge impact on applied forces through the body, specifically the core, which can create unnecessary strain.

Many people want a quick fix to a problem that did not occur overnight. For a majority of people, the unnatural distancing is a result of different forces on the linea alba, which through postural corrections and attention to abdominal stressors, we can reduce. While for many the diastasis recti occurs from pregnancy, it is essential to assess why the distancing remains for each individual.

Is your neck jutted forward or tucked reading your screen?

Make sure your ribs and pelvis are positioned properly. These postural changes you can begin from day one postpartum. If you are reading this and do not have diastasis recti, work on your posture anyway!

posture

If your ribcage is up and forward there is an increased pull on the linea alba. If the pelvis is positioned out of “neutral” there can also be an unnecessary tug on the linea alba. Katy Bowman compares the linea albas resilience to stretching a pair of socks. You can stretch socks back and forth and they return to form until held too long, too often, and in the wrong direction causing them to be tossed. Too much stress on the linea alba and there is a breaking point where deformation occurs and the stretch and release back to the original form is not longer possible.

Posture is key. How are you sitting right now? Is your ribcage up? Is your neck jutted forward or tucked reading your screen? Is your back slouching or with an increased curve? Pay attention, these sustained positions over time have a huge effect on our core. Diastasis recti is a core problem, and will remain with improper posture, and if incorrect exercises performed.

Why Should You Care?

Making steps to decrease the distance of your diastasis recti is important because the body requires a fully functioning core for proper movement. As stated above, the core is considered a cylinder, which is required to resist forces in all directions. If one of those walls is not able to resist these forces due to the unnatural distancing, the core cannot function the way it needs to and can cause pain in another region of the body. Nearly every movement we do as humans, will have some form of core activation, and as one might be able to conclude, if everything we do involves the core and it is not working as it should be, problems can and will arise.

You can find more information about Dr. Nichelle Gurule, a postpartum chiropractor and personal trainer, at gaiawomenshealth.com.

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References   [ + ]

1.Bowman, Katy. Diastasis Recti: A Whole-Body Solution to Abdominal Weakness and Separation. Propriometrics Press, 2016. Print.
2.Beer, G.M., Schuster, A., Seifert , B., Manestar,M. Mihic-Probst, D., & Weber, S. A. (2009). The normal width of the linea alba in nulliparous women. Clinical Anatomy, 22(6), 706-711. <http://www.ncbi.nlm.nih.gov/pubmed/19637295>
3.Byrne, Helene. Exercise After Pregnancy: How to look and feel your best. 2001.Print.
4.Kuhland, Jeff. Breaking Muscle. Do you know what your core really is and what is does? <http://breakingmuscle.com/mobility-recovery/do-you-know-what-your-core-really-is-and-what-it-does>.