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The Postpartum Condition Every Woman Should Know About: Diastasis Recti Explained

 

The Postpartum Condition Every Woman Should Know About: Diastasis Recti ExplainedHands firmly planted on the floor, shoulder-width apart? Check.

Core engaged, legs and back strong?  Check.

I felt great!  

I was excited to be back at the gym, challenging my body and working up a sweat again after 6 weeks of “taking it easy” after giving birth to my beautiful baby girl.  

In a surprising twist of events, I was even enjoying holding a plank. Gasp!

When I glanced down and saw the dreaded “coning” of my abdominal muscles I was crushed.

As a certified therapeutic exercise specialist, this was something I had been aware of, watched out for throughout my pregnancy, and had actively worked to avoid.  Yet there it was, an undeniable Diastasis Rectus Abdominis (DRA).

Diastasis Recti Explained

Diastasis Rectus Abdominis is when the left and right sides of your abdominal muscles separate, creating a gap of varying width and depth.  In some women, this may appear as a protruding lower belly, aka “mommy pooch.”

DRA is common, in fact, some research indicates the percentage of pregnant women that develop DRA to be 100%. 

The Postpartum Condition Every Woman Should Know About: Diastasis Recti Explained

It’s important to note that the female body is doing exactly what it was designed to do, giving the developing baby space to grow in utero. However, abdominal separation should not be the postpartum norm. With proper awareness and treatment, women can close this gap and regain essential core strength.

Local mama and Women’s Health Physical Therapist (WHPT), Dr. Amy Moore of MommyPT has dedicated her life to helping women prepare and repair their bodies before, during and after pregnancy. (For those mamas who attended Bloom 2018: An Event for New & Expecting Mom you probably had a chance to stop by the MommyPT booth.) 

According to Dr. Moore,

While DRA is a normal physiological occurrence, it is important to be mindful of what our bodies are doing (aka “strategies”) with exercise and daily activities like getting out of bed, lifting children or items, etc. during pregnancy and postpartum. Some DRA’s return to their normal state after pregnancy without intervention while others remain present. Regardless of whether or not yours returns to its pre-pregnancy state, you should still be evaluated by a Women’s Health Physical Therapist, postpartum. Current research indicates the focus should not just be on “the gap” and rather, what is happening within the gap.

Dr. Moore treats women with DRA and related symptoms such as urinary leakage, low back pain, pelvic pain and /or pelvic organ prolapse.  She notes that it is essential to treat the body holistically in order to discover and treat the cause of a condition and not just the symptoms.

Why should you care?

Many of the exercises a woman turns to in order to help flatten her stomach post-birth such as crunches and planks can, in fact, worsen DRA.  

When working with my own personal training clients I always teach them to be aware of “coning” of their abdominals when doing an exercise such as a crunch or plank.  This indicates that you are putting too much pressure on your abdominals and are no longer able to control the muscles of your core.

The Postpartum Condition Every Woman Should Know About: Diastasis Recti Explained

It is important to note that one woman with a DRA may be able to do one exercise while another woman may not. You may also be able to do an exercise at one point of your workout, but not later as the muscle is fatigued.

When exercising, it is essential for every woman to learn proper breathing techniques, form and modifications when indicated.

The body has an amazing way of adapting to complete whatever move we ask of it.  

For example, if you are performing a plank and the muscles involved aren’t strong enough, your body will activate different muscles to compensate. This can be very damaging to the body.

What you should do:

Self-Test for DRA:

  1. Lay flat on the floor in a basic crunch position, feet firmly planted on the floor and knees bent.
  2. Place fingers along the midline to test for width and depth of the gap between the left and right sides of your rectus abdominis.
  3. Fingers should be pointed lengthwise, downward toward your pubic bone.
  4. Test for a gap in three locations – at the belly button, 2.5 inches above, and 2.5 inches below the belly button.
  5. At each measurement site, barely lift your head up and down a few times as you feel for the width and depth of the gap. If you lift too much the muscles will seem to pull together and you will get a false reading.
  6. In general, a width of 2 fingers or more is considered DRA.

Visit your Local WHPT:

If you feel a gap down the center of your abdominals while completing this test, notice any coning of your abdominals while doing crunches, planks, or any other activities of daily living or experience urinary leakage or low back pain you should seek professional advice from your local WHPT.  

Dr. Moore states, “you stand, breathe, and move differently after pregnancy – this needs to be addressed.  Just because you do not have symptoms, does not mean you do not need to be evaluated. The human body is amazing and will find a way to make motion happen despite weaknesses and imbalances.”  

It is vital that a woman knows if her body is making any of these compensations.

While DRA is incredibly common, it does not have to be the norm.  Treatment is available and has a very high success rate.

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