What is “Diastasis recti” in pregnant women?

Do you still look pregnant even months after the pregnancy? This might be due to a condition known as “diastasis recti.”

“Diastasis recti” is one of the most common cases that occur in childbearing women who are above the age of 35 years and those who deliver a high-weight baby or have had multiple pregnancies. About two-thirds of all women have it. This is most noticeable right after the delivery.

It is a condition in which occurs due to the separation of the large abdominal muscles. In this, the rectus abdominis, also known as ‘six-pack muscles,’ stretch sideways, causing damage to the connective tissues in the midline of the stomach. This leads to a protruding stomach or pooch. This is caused due to the bulging of the abdomen forward and overstretching the connective tissue.

When ab muscles move aside, the uterus, bowels, and other organs have only a thin band of connective tissue in front to hold them in place. This condition might cause back pain, pain in the abdomen while coughing, constipation, painful intercourse, inability to control urine, pelvic floor problems, etc. In order to treat this condition, physical treatment is performed. In some cases, even cosmetic surgery is chosen by some women to reduce the appearance of the bulge.

This condition may make it harder to move and breathe normally. In some rare cases, the tissue may even tear, and organs poke out of the opening. This is called a hernia.

The muscles should normally shrink after giving birth, but in some women, these muscles don’t go back to normal ergo diastasis recti.

What causes diastasis recti?

In the gestational period of pregnancy, the connective tissue is known as “linea alba,” which narrows out due to the change in the hormones to accommodate the enlarging uterus. This is crucial as this changes the mother’s body so as to accommodate the baby growing in the uterus.

Upon delivery, the hormone levels return to normal, and the narrowing of the linea alba typically improves. But, in certain women, the tissue gets excessively stretched out, due to which the skin losses its elasticity and is unable to return to its original position.

Who can develop this condition?

Women who have a normal delivery, who is petite, carried multiple babies at a time, have a swayback posture, have poor muscle tone, or had multiple pregnancies have more susceptible to this condition. Any women who have had diastasis recti from pregnancy are most likely to continue to have this condition in the future. Women who have a history of ventral hernia or umbilical and pelvic instability are more susceptible to have this condition. 

What are the symptoms of diastasis recti?

One of the most common symptoms of diastasis recti is a bulge in your stomach, especially under strain or contraction of abdominal muscles. Other than that, a woman experiences lower back pain, constipation, poor posture, and bloating.

What is "Diastasis recti" in pregnant women?

How to self-test diastasis recti?

To self-test diastasis recti, lie on your back with your knees bent and placing your feet on the floor. Place one hand on the belly with the fingers placed on your midline at the navel. Press the fingers down gently and bring your head up while keeping the shoulder down on the floor. Get into a crunch-like position. Next, feel the sides of your rectus abdominis muscles and check how far they are separated. Feel the separation in terms of finger width, for example, two to three fingers’ separation. 

Can you prevent it?

Protecting the abdomen will keep the muscles from separating. During pregnancy, use a log roll manoeuvre when getting out of bed or getting up from the couch or floor. Roll onto one side with your torso and head aligned n push yourself up to a sitting position using your arms. There are a few exercises that a woman can do while being pregnant to strengthen the abdominals and overall body for labour and postpartum recovery.

How Can I Treat Diastasis recti?

You can exercise in order to reduce the gap, but this must be undertaken after consulting your healthcare provider, as some women are advised not to exercise postpartum. You should even consult a health care expert about the type of exercises to follow to type to avoid. Exercises such as crunches are a big no-no when it comes to repairing diastasis recti. Physical therapy is also recommended for repairing diastasis recti. You may choose to correct diastasis recti through surgery, but that should be the last resort. In this, the excess skin is removed, and this procedure must be taken only when a woman has finished family building.

What to do and what to avoid

  • Be cautious about the workout you follow. Some exercises such as crunches, sit-ups, bicycle crunches, reverse crunches, pushups, front planks and press up must be avoided. Some classic yoga moves, such as boat pose, Pilate exercises such as double leg, scissors, etc., could worsen the situation.
  • Don’t strain, as straining will make matters worse. Lifting heavyweights, including your kids and constipation, can put on connective tissue. Standing up and sitting down also comes under heavy lifting.
  • To heal your belly. Physical therapists don’t have a single standard guideline on what will bring the belly muscles back into the previous line. Some research states that Tupler Technique is quite successful in this case. This technique involves performing certain exercises while wearing a belly band, which holds and protects the ab muscles together.
  • Some Pilates or other exercises may help you strengthen and rely more on your transverse (deep core) belly muscles instead of the outer ones when the connective tissue has healed. Not all Pilates or strengthening moves are great during pregnancy, therefore make sure your trainer is aware of what “diastasis recti” is.
  • Holding up baby on one hip when painful
  • Coughing without supporting ab muscles

Exercise-related advice for diastasis recti

  • The best time to begin core strengthening is before getting pregnant, even if you don’t already have abdominal separation.
  • Prior to starting any exercises during or after pregnancy, be sure to ask your doctor what’s OK for you to do and what’s off-limits for now.
  • You can wear a binder for support.
  • Practice good posture
  • Support the lower back when sitting with the help of a towel or pillow by placing it behind you.
  • Bend the knees, roll, and support yourself with your arm while getting out of bed or while standing up
  • During pregnancy, you can continue to strengthen your core but consult a healthcare specialist and know your situation.
  • Don’t do any workouts in which ab muscles are bulging out.

Conclusion

In the majority of cases, diastasis recti are reversible through a therapy of the deep core compressions. This muscle activation serves to protect the abdominal wall at the time of and after pregnancy. This muscle engagement works efficiently to restore strength, function, and form.  A postpartum therapy specialist can recommend exercise to improve the diastasis recti symptoms. If pain from diastasis recti interferes with daily activities, then you may prefer surgery. Talk to your healthcare specialist to know how to improve the condition and what works for you.

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