Diastasis Recti: 5 Things You Should Know So It Doesn’t Happen to You

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Yep, that’s me and my three kids.

Two on the outside and one still in my uterus. And no, I don’t have Diastasis recti anymore. I just have a small umbilical hernia that made my “inny” turn to an “outy” for about nine and a half months. No band-aid in the world was going to hold that back. I had Diastasis during my pregnancy, but I don’t have it now, 2 years later.

How did I get rid of Diastasis Recti? Let’s get right into it.justyn-warner-532058 small

First, if you don’t know me by now, I love to run the numbers. If you could hear how many of my patients are asking about Diastasis lately, you would think that it affects 100% of pregnant women. It doesn’t, at least not longterm. And while we are on the subject, let’s practice saying it so that you can ask about it with confidence.

DIE-UH-STAY-SIS. You got it. (You know how I feel about the pronunciation of medical terms.)

Diastasis recti (the full name is actually Diastasis recti abdominis or DRA) is around a 2-centimeter separation of the rectus abdominis muscles. The rectus muscles are the “abs”. Pictured below, they are the ones that give you the “pack” that you have, or in my case, want.

Rectus_abdominis mod

As the uterus grows in pregnancy, those muscles can separate. At 35-weeks pregnant, the prevalence of this degree of muscle separation is 100%. By the 6-month post-delivery mark, only about 39% or women have it. That number isn’t small, but it isn’t the majority.

So what do the 39% do to get their abs back? Well first, what is the problem with Diastasis? Some may get uncomfortable hernias that result from this separation. Some are even born with it and need surgical correction to keep the abdominal contents contained. The problem is often cosmetic though. 18424159_10209329163812249_2213968896285513287_n

Some may experience core weakness after childbirth and if not corrected, can find themselves having difficulty lifting objects and having back pain. In that case, the problem isn’t necessarily the Diastasis. The core weakness is the problem. It is VERY NECESSARY to do proper exercises to not worsen the separation, but still strengthen the abs.

If you suspect that you have persistent Diastasis after about the 8-week mark after having your baby, first do this: Lie flat on your back and do a half crunch. If you can fit 2 fingerbreadths between your abs, you may have it. The actual process for diagnosis is more technical than that, but this works for at-home use. Those most likely to be affected are women who carried twins or other multiples, women who have larger babies, women who are over 35 years old,

Here are my 5 Must-Knows.

  1. Pregnancy does not irreparably damage your abs. Even women who have c-sections can come back to flat mid-section. We do not cut the ab muscles during c-sections either. That is a common misconception. Your glory days can come again.

    lq-n5xbg1rs-marcos-moraes

    There is no treatment during pregnancy. Wait until at least 6 weeks postpartum to try any of these exercises.

  2. Don’t do crunches. They can worsen the separation. Do these exercises if you think you have Diastasis recti:
    1. Core contraction – In a seated position, place both hands on abdominal muscles. Take small controlled breaths. Slowly contract the abdominal muscles, pulling them straight back towards the spine. Hold the contraction for 30 seconds, while maintaining the controlled breathing. Complete 10 repetitions.[9]
    2. Seated squeeze – Again in a seated position, place one hand above the belly button, and the other below the belly button. With controlled breaths, with a mid-way starting point, pull the abdominals back toward the spine, hold for 2 seconds and return to the mid-way point. Complete 100 repetitions.[9]
    3. Head lift – In a lying down position, knees bent at 90° angle, feet flat, slowly lift the head, chin toward your chest, (concentrate on isolation of the abdominals to prevent hip-flexors from being engaged),[6] slowly contract abdominals toward floor, hold for two seconds, lower head to starting position for 2 seconds. Complete 10 repetitions.[9]
    4. Upright push-up – A stand-up push-up against the wall, with feet together arms-length away from wall, place hands flat against the wall, contract abdominal muscles toward spine, lean body towards wall, with elbows bent downward close to body, pull abdominal muscles in further, with controlled breathing. Release muscles as you push back to starting position. Complete 20 repetitions.[9]
    5. Squat against the wall – Also known as a seated squat, stand with back against the wall, feet out in front of body, slowly lower body to a seated position so knees are bent at a 90° angle, contracting abs toward spine as you raise body back to standing position. Optionally, this exercise can also be done using an exercise ball placed against the wall and the lower back. Complete 20 repetitions.[9]
    6. Squat with squeeze – A variation to the “squat against the wall” is to place a small resistance ball between the knees, and squeeze the ball while lowering the body to the seated position. Complete 20 repetitions.[9]
  3. Don’t make the mistake of making the call too soon. If you don’t have pain and you are still trying to lose the baby bump, give it time. Your mid-section took 9 months to get to that size. The 6-week snapback is not a realistic expectation for many, no matter what Instagram and Pinterest say. lol

    Planks

    Planks are good, and we do Sculpsure in my office- laser fat removal. loopobgyn.com

  4. Keep your bowels moving well. Constipation may not worsen Diastasis, but it won’t make it better either. Excessive regular bearing down for bowel movements has other health implications that are worth avoiding. (Check out my post about that too.)
  5. If you are worried that it isn’t improving, ask your doctor about it. Physical therapy may be an option, and in extreme circumstances, surgery. Don’t be afraid to ask.

At the end of the day, know that your abs will go through changes due to pregnancy.  Stay optimistic that you can be beach-ready again if you so desire.

giphy

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Photo by Justyn Warner on Unsplash; Photo by Form on Unsplash

References: https://www.ncbi.nlm.nih.gov/pubmed/25282439 https://www.ncbi.nlm.nih.gov/pubmed/2968609

 

Dr. Wendy Goodall McDonald is a board certified OBGYN. She began practicing medicine in 2007 and now uses her extensive knowledge and growing following to increase health awareness in a fun and viral way. She is the founder of The Gyneco-blogic and an author of numerous books for adult and childhood health education and social growth. For more, check me, I mean her out at dreverywoman.com

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