I come across a lot of mums with diastasis recti (DR). Diastasis can occur as early as the first trimester of pregnancy, or may not occur until postnatally.
Risk factors for diastasis recti
- having a belly button piercing
- past abdominal surgeries
- history of umbilical or inguinal hernias
- a previous Diastasis
- having an anterior pelvic tilt, when the pelvis is pushed forward and no longer in neutral. Neutral pelvis is important for the internal pelvic organs
How does it occur?
The condition occurs when the anterior wall of the abdomen expands in conditions such as:
- Abdominal weight gain
There are also other common factors amongst mums who have diastasis recti
It is more prevalent in woman who are hypermobile due to general laxicity of joints and tissues
Diastasis will often be paired with pelvic floor issues, again which more frequently presents with hypermobility
Women who have historically done a lot of intense crunches and oblique work, giving rise to heightened tonicity in the abdominal muscles are also at increased risk of DR. When intra-abdominal pressure increases during pregnancy, these pull on the weakened linea alba causing the rectus abdominus muscles to separate.
And another possible cause I have observed is women who have done a lot of running prenatally.
Today I saw a lady who was cycling 20km per day and the DR had got worse since taking up the cycling. Why is this an issue? Because the hip flexors are in a shortened position, so creating a downward pull on the abdominal wall. For the same reason that the tight obliques create a sideways pull.
There are many things that can be done to help a DR heal.
Simple ‘good housekeeping’, such as turning onto the side to get up from a lying position and not ‘crunching’ up.
Avoid slouching whenever possible.
Proper breathing patterns to activate the pelvic floor properly. Ensure that the ribs are being used to correctly breathe and that the breath on exhalation is kept slow and steady rather than rushed through! Always exhale on exertion.
Taught well, appropriate floor exercises can be useful in training the abdominal muscles to fire up and create synergistic function of the pelvic floor and abdominal muscles.
However sit ups, or some pilates moves can often make the problem worse. Without proper use of the correct support muscles, these exercises often pull outwards on the linea alba which either increases the separation, or keeps it from knitting back together.
The benefits of massage
A combination of massage and physical therapy can speed up the healing process considerably.
Massage can help to reduce tension in the tight tissues that are pulling on the linea alba, keeping the physical therapy exercises from working.
The synergy between the two modalities is worth more than the two separate parts. Hands on massage strategies such as STR are highly effective for freeing ‘stuck’ tissues at the intercostals, rib surface, diaphragm border and iliac crest.
Rachel Law is a personal fitness trainer based in New Malden, Surrey. Qualifications: ActivIQ Level 3 Personal Training; Burrell Education Pregnancy Exercise Prescription; Burrell Education Advanced Pregnancy Wellness Practitioner; Burrell Education Advanced Post Natal Exercise Prescription; Burrell Education 3rd Age Women Optimal Health and Nutrition; Burrell Education Peri Natal Athlete; Burrell Education Pelvic Flow and Freedom; Olympic Weight Lifting; Premier Global Kettlebells; FIE Level Assessment and Mentoring