DIASTASIS RECTI…. AKA ABDOMINAL SEPARATION
So Midwives, Physios and PTs are all telling you about abdominal separation in pregnancy and post birth. I harp on about it a hell of a lot. It is ridiculously important when returning to exercise. Or even carrying your baby around daily! So here are all the facts worth knowing.
WHAT IS DIASTASIS RECTI?
During your pregnancy your abdominal muscles are stretched and weakened. The midline of your abdominal wall (lineament alba) in particular is stretched and the muscles give way to allow the uterus to expand and grow. The RELAXIN hormone released by your body in pregnancy allows this to happen. Your abdominal wall is made up of muscle, connective tissues, fascia, and collagen fibres.
Your line alba runs from the bottom of the sternum (middle of your ribcage) to the top of your pubic bone. It is commonly around 1cm in diameter. When further separation of the abdominal muscles occurs along this line alba it is known as a DIASTASIS.
After you birth your baby and the relaxin hormone begins to leave your body the collagen fibres will begin to regain their normal tension. But often the connective tissue will not return to normal after being stretched so much. Remember your uterus grows to 500 times its normal size. So the linea alba remains stretched and the abdominal muscles remain in two halves and you are left with a gap. This is known as DIASTASIS RECTI (Recti referring to the abdominal muscles).
The rectus abdominal muscles make up a part of the core along with other abdominal muscles. We often talk about the ‘core’ but do you know what it actually consists of? The core is quite literally the centre of your body which makes all movement possible. Your core is made up of:
- The diaphragm
- The abdominal muscles
- The back muscles
- The pelvic floor
Imagine these muscles all form a corset that hold in your internal organs and support your entire body. They keep you upright and stable. Your core is always engaged no matter what your activity. Be it running 5K, yoga, picking up your little one or folding that pram and lifting it in to the car. So when you are pregnant and post birth this stability and strength is compromised. And if 1 part of your core is weakened then entire core is weakened. In pregnancy we find that the abdominal muscles, pelvic floor and back muscles are compromised.
So it makes sense that nearly all women suffer from Diastasis Recti following their pregnancy. However the severity of the separation and the rate of recovery depends on the individual ciircumstances surrounding your pregnancy, delivery and rehabilitation choices.
RISK FACTORS FOR DIASTASIS
The following are known risk factors for diastasis recti:
- Having been pregnant before
- Caesarean section
- Prolonged increased abdominal pressure (I.e. prolonged pushing in labour)
- Multiple pregnancy
- A large baby or polyhydramnious (more amniotic fluid than normal)
- Incorrect and non scaled training in pregnancy
- Incorrect type of training after pregnancy
DIASTASIS AFTER DELIVERY
Following the birth of your baby you will have a diastasis. You will not only have the abdominal separation but the other core muscles will be weakened and as a result your other muscle groups may have to overcompensate if you do not rehab your core, over do your daily activities or return to fitness too soon. This is often the most common cause for postnatal lower back pain, pelvic floor weakness, incontinence or even more serious injuries like an abdominal hernia (basically where your insides are coming out).
It can take up to 6 months minimum for your core to return to its pre-pregnancy state. Although it may never feel quite the same again it is an opportunity for you to strengthen and build that core stability and strength. Anything much as heavy weightlifting or running should not be attempted until around 4 months post delivery when the relaxin has all but left your system. If you want to commence these things sooner then consult a physiotherapist!
DO YOU HAVE A DIASTASIS?
There is an easy and simple way to check if you have a diastasis. You can self check at home if you do not have access to a Midwife or Physio. Some personal trainers are trained to check too but ensure they have the correct qualifications (having their own kids is not a qualification - I mean an accredited course and good experience). Here is how to check at home:
1. Lie on your back with your knees bent and feet about hip distance apart. Do the assessment on your bare stomach as it will be easier to feel than through your clothes.
2. Place your index and middle fingers on your stomach and walk them down on your midline from under your ribs ribs to around 2cm above your belly button.
3. Push down firmly and then lift your head off the bed. You should feel the abdominal muscles closing around your fingers. Or underneath them. If you do not feel anything then try adding another finger.
4. Now place the same two fingers underneath the bellybutton and around 2cm above your pubic bone. Do the same firm push down and lift your head.
5. You are feeling for a gap that your fingers fit in to. In between the abdominal muscles. Take note of what you are feeling.
6. Remember that 1 finger is roughly 1cm. Repeat above and below 2-3 times to be sure of what you are feeling.
This is a great video for some guidance... https://www.youtube.com/watch?v=Ulp3YQ_P92Q
4 TYPES OF DIASTASIS:
There are 4 types of diastasis. As shown on the video. By self checking you may be able to identify what kind of diastasis you have but if there is any doubt please seek professional advice.
1. Diastasis open above the belly button
2. Diastasis open below the belly button
3. Open diastasis
4. Completely open diastasis
So there you have it! A complete run down of Diastasis Recti. All you need to know and how to check if you have it or not. Stay tuned for a core workout series coming your way to help with your rehabilitation and return to fitness!