During pregnancy, the abdominal muscles stretch to allow the baby’s head to pass through. This is called diastasis recti, which means separating the rectus abdominis muscles, also known as the “six-pack” muscles.
All women have some degree of DR after pregnancy, especially if they carry multiple children or have had a previous C-section. DR is measured by the distance from the uppermost portion of the sternum to the umbilicus (belly button). A woman with a DR greater than two finger-widths has a diastasis, and it may be problematic to some women if their DR measures wider following delivery.
How does Diastasis Recti occur?
Anatomically, a contractile plate called the linea alba (white line) is located between the two rectus abdominal muscles. This plate provides support to these muscles during the movement of the trunk and spine. It also helps facilitate intra-abdominal pressure, which assists with breath support and core stabilization. This white line is avulsed (torn) during pregnancy, which makes the abdominal muscles move apart and stretch far beyond their average length.
The risk factors that contribute to a woman’s DR after pregnancy include: carrying multiple children, having a previous C-section, poor posture, rapid infant weight gain, and heredity.
Each time a woman gives birth, her abdominal muscles are stretched. When the muscle fibers of the linea alba are overstretched, they tear or separate, leaving a gap that cannot be corrected with surgery or exercise.
How does DR show up on an X-Ray?
It is essential to understand that DR doesn’t always present itself on an X-ray. The purpose of DR X-rays is to determine the degree of DR, not if it exists.
The research shows that using an abdominal binder reduces postpartum recovery time and may help diminish or minimize future diastasis for women who wear them correctly after delivery. When worn daily, abdominal binders can reduce maternal mortality due to pregnancy, prevent pelvic organ prolapse, and diminish pain during physical activity.
Several exercises are commonly suggested for Diastasis Recti repair, but which ones are the best?
Current research shows that no single exercise works best to prevent or correct DR after pregnancy. When women perform strength exercises in their postpartum period, they experience increased abdominal muscle activity. Thus, it is recommended that women begin a strengthening program as soon as they start having a bowel movement without pain.
This is the earliest point in the postpartum period to begin exercises for DR repair. It will help prevent or reduce symptoms associated with DR. Some factors should be kept in mind when instructing postpartum women on appropriate abdominal exercises, they include but are not limited to:
- Controlling breathing
- Not overarching the lumbar spine (lower back)
- Avoid activities on the back or all fours
These instructions are meant to ensure that the exercises do not make DR worse by overstretching abdominal muscles during exercise. The best suggested postpartum DR exercises can be done at home or in a clinical setting.
It is recommended that women see their healthcare provider for an individualized exercise program to manage DR symptoms. If they are experiencing any severe abdominal pain, vaginal bleeding, dizziness, severe headache, fevers, loss of appetite, or extreme fatigue, they should seek out medical assistance immediately.
What are some other ways to manage diastasis recti after pregnancy?
A common misconception is that if you have DR, it will get worse. This is not true! The amount of separation of the muscles can vary in size by 10 centimeters or more; however, having no separation at all doesn’t mean you don’t have DR. If you are not physically active, your DR may worsen. Physical activity is the best thing for all women, especially those that are pregnant or postpartum.
Strengthening exercise will help reduce symptoms associated with DR and prevent future diastasis. When doing abdominal strengthening exercises, it is essential to maintain good posture to protect our back muscles from overuse. The abdominal muscles should not be the only muscles used for core stabilization. We need to strengthen our low back and gluteal (butt) muscles as well.
A resistance band is an excellent tool because it can be used at home or the gym, and it may help reduce DR symptoms by increasing muscle tone around the rectus abdominis while promoting good posture.
Sometimes the muscles around the pelvic floor are weak or have been cut during delivery. You may be having urine leakage when you cough, sneeze, laugh or exercise because your pelvic floor muscles cannot support your bladder and bowels as they did before pregnancy. A physical therapist can help women strengthen these muscles. Doing Kegel exercises may be helpful in some cases.
In conclusion, it is essential to continue to exercise during the postpartum period because it will maintain muscle tone, which is essential for reducing or managing DR-related symptoms.
About the Author
Eve Anderson is a quirky, sharp, and meticulous copywriter with a bachelor’s in communications from Washington State University. She loves exploring antique stores, roaming redwood forests, and critiquing the absurdities of modern civilization.