What Is It?
Diastasis recti is the separation of the abdominal muscles that can occur during pregnancy due to the increasing size of the uterus. When this happens, only a thin layer of connective tissue remains to protect the abdominal organs, which means it is much more likely that bulges or hernias can occur. It also leaves the lumbar and pelvic region with less muscular support, leading to poor core control and contributing to low back pain, as well as constipation and urinary problems. Diastasis recti is much more likely in subsequent pregnancies, multiple pregnancies eg twins, or with large babies, and risk also increases in women over 35.
Do I Have It?
If you’ve recently had a baby, it is highly likely that you do, but in many women it will go unnoticed and recover quietly on its own. However, if you are having ongoing back or pelvic pain, a diastasis recti could be contributing, and your osteopath will assess your abdominal musculature to find out. Separation of the muscles is most common around the belly button, and is measured both for width and length by inserting the fingertips and feeling the borders. You can do this yourself by feeling your tummy whilst lying on your back and gently lifting your head to contract your abdominals. Ultrasound examination may also be performed.
What Do I Do About It?
Firstly, it is important to avoid any activities that can make the problem worse – crunches and situps are the major offenders, along with planks, leg raises, pushups and even some yoga poses. These activities place extra pressure on your already weakened core and can prevent recovery, increasing your chances of back and pelvic pain. It is vitally important to work on strengthening your pelvic floor muscles, ideally before and during pregnancy as well as afterwards. One of the best options is to attend a specifically designed pregnancy or postpartum exercise class, or to see someone who has been trained to prescribe such exercise and can monitor your technique eg your pilates instructor. Some people also find braces and corseting quite helpful as external supports to help bring their separation together and remind them to activate their core muscles, although these are usually only effective in the short term. Unfortunately, in some cases these conservative measures fail, and a rectus separation that is causing symptoms may persist, requiring surgical intervention.