Diastasis Recti 

FYI This topic is also addressed to women and men outside of pregnancy.

Today we will talk about one of the main issues post-partum: Diastasis recti.

So what is this ? How can you check it?  Who is concerned? What’s the main risks ?

How to solve it? The solutions, prevention and recovery.   

1. Definition

This bizarre word sounds for a medical condition which defines: “abdominal separation”. In diastasis refers to separation and recti for rectus abdominis (name of the muscle). There is a distance between the right side and the left side of the rectus abdominis muscle. That creates a gap from 2cm to 10 cm or larger (we even saw 12cm) in between the both sides of the muscle.

This gap creating loose feeling, you might call it a “pooch.” It can happen regular from the top to the bottom of the rectus abdominis or localized: See picture below

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   2- Examination

A diastasis can be easily checked up by physician or even by yourself with simple physical examination.

To check if you have one: self-examination process:

• Lie down on your back, knees bended, feet flat into the floor, legs parallel.
• Lift the head and chest up like you want to do the “classics crunches”
• The belly pops out if you don’t correct much (that’s normal it goes for everybody)
• Keep the head up and palp the center line of the belly from under the breast to the pubic bone.
• If belly is hard under your fingers: the muscle is healthy and normal / if It’s loose and you feel like a “hole”, wide open, a yawning under your fingers: it’s probably diastasis recti.

1. 3- Who’s concerned?

Diastasis recti can be observed on anybody, all gender: men, women and babies are concerned.It’s very common among pregnant women though and we estimate as not less than two-thirds of pregnant women have it.

Newborn babies also can have this belly spread, and it should go away on its own.

Men can get it, possibly from yo-yo dieting,  doing sit-ups, badly executed abdominals exercises, weightlifting, or from other causes.

Women are the more concerned about it and especially pregnant women.

Actually all women have abdominal separation while being pregnant as, for obvious reasons, belly needs to create space for the baby.

But problem happens when diastasis does not resorb naturally after delivery and remains a loose tissue. To be honest it happens quite often, we see it everyday in post-partum recovery. 

Women with repetitive pregnancies, twins, excessive weight loaded, wrong pushing type exercises, or very complicated deliveries, are more subjects to have a severe one.

4- What are the risks?

When the abs muscles move aside like this, the uterus, bowels, and other organs have only a thin band of connective tissue in front to hold them in place. Without the needed muscle support, a vaginal delivery could be more difficult.

The condition also can cause lower back pain, constipation, and urine leaking. It can even make it harder to breathe and to move normally.

It’s rare, but in extreme cases, the tissue may tear, and organs may poke out of the opening :that’s called a hernia.

How long? It all depends about the size of diastasis, like we said, lifestyle habits, and location of the separation, but usually it  takes from few weeks to months and even a year to recover from. In extreme cases (very large ones) surgery is necessary.

1. 5- How to treat it? The solutions

Like we’ve seen diastasis recti is very common, and happens on almost every pregnant woman, especially for second or third pregnancy. But solutions do exist and we can fully recover from diastasis recti. I do it every day with my students into classes and with a team of professional experts. 

So how to do? 

First have a check with your physio or doctor and confirm the diagnosis : how large, where is it located (exercises and treatments will be done accordingly). It might occurs different types, shape and sizes of the diastasis. Please check above for referrals. 

Like I said you can check it by yourself, but the doctor or physio, will give you a more accurate diagnosis and will be able to localize the diastasis (see different diastasis above) and give you the size of it.

One of the most powerful tool for Diastasis recti recovery is

The breathing, shaped breathing – linked to PF (pelvic floor)As simple as that, but don’t be too naïve, breathing is not that simple.

It is a very complex function that has different patterns and when well used, is a super healing tool, but when bladly used can also be the cause of damages. 

Breathing for: 

• Awareness of your deepest abdominals
• Activation of the transverses (deep abs)
• To close diastasis recti. 
• Learn safe ways to move
• To avoid to make it worse

Rehab Pilates method I use with my students, is a combination of Pilates pure method & physio rehab method.

Researches have shown that deep breathing methods called Hypopressive abdominals method (Dr Bernadette De Gasquet for example one of the best method worldwide) are showing the best results regarding diastasis recti recovery.

To treat your diastasis recti, make sure:

• You did a physio / doctor check-up
• Your instructor is trained for diastasis recti. A lot of exercises can make it worse. Ask your teacher if he / she has rehab / post-partum qualifications.
• Be patient: from few centimeters to a larger one: diastasis recti take time to recover from. (Usually from couple of months to one year; 
• Don’t abandon, remain constant in your efforts. Any exercices rehab takes time to give results. Rome hasn’t been built in one day
• Try to fully understand the breathing pattern and listen to what you are instructor is teaching you. In case it’s not clear : ask again. 
• Use shapped breathing as often as possible in your daily life
• Engage PF (pelvic floor) at the same time; it works in link with transversis and helps close diastasis
• Reduce excessive weight, loading weights and unhealthy habits (carrying heavy bags, pushing at toilets, constipation) 

Conclusion:

For better health and prevention: start you core strengthening before pregnancy. Your body will thank you after.

>>>Most damages are done before / during the 1st pregnancy<<<

Most of women / men will be able to close their diastasis with adapted gentle and well executed movements like in the Pilates method. 

Physio, Bernadette de Gasquet method and Rehab Pilates are nowadays the most efficient techniques to recover naturally from diastasis recti. Solutions do exist, but you will need to work and give time and efforts to achieve reconstruction. Exercices including rehab exercices need practice. Give your self enough time to recover. Be consistent in your practice 

Although if, after a year or more, you still have a hole / pooch into your abdominal muscles, you can decide to go for surgery. An operation to correct diastasis may be called “abdominoplasty” or “a tummy tuck.” The surgeon folds and sews together the weak central ridge. It might be possible to get laparoscopy.

Ask your doctor for more medical advices.