Diastasis Recti – serious problem no one talks about.

Does your belly still appear pregnant months after childbirth? If so, you could be suffering from a postpartum abdominal condition known as diastasis recti. It's a common condition which in our view receives far too little attention, given how many women it affects. 

What is diastasis recti?

It's the partial or total separation of your right and left abdominal wall muscles, also known as the "rectus abdominis" 

In women, the separation may occur during pregnancy as a result of stretched out and weakened abdominal muscles. As your uterus expands to accommodate the growing fetus, the layer of joining tissue linking the rectus abdominis muscles stretches out and weakens. As a result, the abdominal contents bulge out causing your belly to form a pooch. 

Image source: myPhysioSA

The condition is quite common both during and post-pregnancy, affecting approximately 65% of pre and postpartum women. 

If you are surprised by how common this is, don't be, as lack of accurate diagnosis is one of the leading reasons.  

But isn't a postnatal belly something normal?

Absolutely yes, it's a question of whether your abdomen is returning to its normal pre-pregnancy state. The postpartum period lasts usually between three to six weeks. It is only after that initial recovery period you can start looking closely into how well your belly is returning to shape.

Although the separation can be quite bothersome and uncomfortable, it normally reduces a few months post-delivery. In most cases, however, the condition may prevail if left untreated. It is good practice to seek consultation with a trained physiotherapist to check on how well your muscles are recovering after the initial recovery. Consultation on allowed exercises is essential as if you perform abdominal exercises excessively or without any safety precautions, you are likely to suffer from the condition.

Who is most likely to develop diastasis recti?

The condition is most common among petite women. However, other factors make you prone to diastasis recti. These include:

• Carrying multiple babies simultaneously

• Having repeat pregnancies

• Getting pregnant in your later years

• Having poorly toned muscles

• Having a swayback posture

Your medical history is crucial as well. If you’ve previously suffered from the condition, it will likely develop in your later pregnancies too. Similarly, if you have a history of pelvic instability and ventral or umbilical hernia, you are at a higher risk of developing the condition.

Image source : Brace Ability

Is diastasis recti preventable?

Properly taking care of yourself and protecting your abdominal muscles can keep you safe from diastasis recti. It is advisable to use the log roll manoeuvre during pregnancy when getting out of bed or up from the floor or couch. This technique instructs you to roll over to your side with your head and torso aligned, then support your weight with your arms to help yourself up to a sitting position.

Besides the log roll manoeuvre, there are several exercises designed specifically to help you strengthen your abdominal muscles during pregnancy. The Dia Method designed by Leah Keller, for example, is a great way to strengthen your pregnant abdominals and improve your general body fitness in preparation for labour. It also helps in post-delivery recovery to ensure an easy and smooth recuperation process.

What are the symptoms of diastasis recti?

The lead symptom of diastasis recti has to be the pooch belly, which is normally a bulge in your stomach. It is most apparent when you strain your abdominal muscles or contract them. Other symptoms include:

• Bloating

• Lower back pain

• Constipation

• Poor posture

If you have these symptoms you may suffer from diastasis recti. 

How can I check if I have it?

The surest way is always to consult a professional physiotherapist, however, there's an initial self-test to determine if you could have the condition. To do that, lie on your back in a mini-crunch position. Bend your knees and place your feet on the floor. With one hand on your belly, position your fingers on your midline at your belly button and press them down gently as you slightly pull your head upward. Resist moving your shoulders from the floor. Feel the sides of your “six-pack” muscles to see the distance between them. Use your fingers to measure the separation, for example, one, two or three fingers’ separation.

Any permanent separation of over 1.5cm - 2cm most likely will qualify you for treatment. It is vital to start treatment immediately as treatment through exercise is possible only for a specific time after which surgical intervention may become necessary.

Exercise is a great way to initiate the recovery process, and you would like to apply it as your first approach to healing. Ensure to seek your doctor’s approval postpartum to avoid making it worse. The MuTu system by Wendy Powell, a mom and trainer based in the U.K., is a great workout program for core strengthening. It is especially effective because it avoids workouts, such as crunches, that exacerbate the problem. You can also engage in physical therapy to repair the separation. If severe, seek medical attention. Your physician can surgically correct the condition with a tummy tuck procedure. However, this should come as a last resort.

If you feel overwhelmed by all those things, take a deep breath and relax as you can easily get treatment and once detected early enough, most of the time it's an easy fix.

Finally please be advised not to take the information contained in this article as a substitute for professional medical consultation

Sources

https://www.hse.ie/eng/services/list/3/acutehospitals/hospitals/portiuncula/physiotherapy-post-natal-exercise-and-advice-booklet.pdf

https://www.scbp.ca/assets/documents/2_1_Abdominal_muscles.pdf

https://www.ouh.nhs.uk/patient-guide/leaflets/files/11749Precti.pdf

https://www.bartshealth.nhs.uk/download.cfm?doc=docm93jijm4n5725.pdf&ver=8867