Diastasis Recti

After pregnancy we expect some long term changes to the body. But don't mistake common symptoms for normal symptoms. Like urinary incontinence, abdominal weakness is not something that you have to accept as part of motherhood.

What is Diastasis Recti?

In the first six weeks after giving birth, focus is on healing rather than identifying problems. The abdominal muscles have had to separate in order to make space for the growing baby. Down the centre of the abdomen is a line of tissue that joins the left and right muscles together. This is called the linea alba, and it runs from the bottom of the sternum (breast bone) to the top of the pelvis. It is not muscle, but it can stretch. It does not have the capacity to contract, however, which means it takes time to shrink back down. It may never be as taught as it was before pregnancy, and to a degree this is normal. But if it is significant enough, it may have resulted in a diastasis recti.

Diastasis literally means separation, and recti refers to the two "six-pack" muscles: rectus abdominis. There are no solid guidelines on where to draw the line when diagnosis a diastasis recti, but a separation of more than two fingers width or 2cm depth can be considered one. A diastasis can occur anywhere along the length of the linea alba, but most commonly lies somewhere near the belly button.

You may have noticed abdominal "coning" when sitting up from lying down. This is a visible bulge in the tummy as the abdominal contents pushes against the stretched area.

If your six week postnatal check up did not involve an abdominal examination, or even if you had your baby years ago and still wonder if everything is as it should be, we can diagnose a diastasis. The test is non-invasive and quick:

• Your osteopath will ask you to lay on your back with your knees bent
• They will place a hand on your tummy to feel for a gap
• They will ask you to raise your head off the plinth as if you're going to perform a sit up
• You may need to repeat this a few times as they test different points along the linea alba

Associated Problems

Links between abdominal strength and back pain are inconclusive with research both proving and disproving a connection. It is also worth noting that even with a diastasis, you can have strong abdominal muscles. The separation is not purely a reflection of the muscles, but of the connective tissue between them. In some cases, the only way to fully close the gap is with surgery. In cases where the muscles could be stronger, exercises may help the function and appearance of the abdomen.

Research is also inconclusive in regards to links between pelvic organ prolapse and diastasis. Your osteopath may be able to help you find a suitable specialist osteopath or physiotherapist if you suspect you have a prolapse.

Managing Diastasis Recti

If appropriate, we can devise an exercise plan with you to target any abdominal muscles that may benefit from improved strength. As mentioned above, this may help with function and/or appearance if the muscles are somewhat weak. The outcome may be best if addressed sooner rather than later, but this should always be after the first six weeks post-partum. Even testing for a diagnosis before this point is inappropriate, as almost every new mother will have separation immediately after birth and this needs time to heal.

Your osteopath can also help with any associated problems that may arise as a result of compensation for the area.

If your progress plateaus, and particularly if you have a high demand of the abdomen, you may want to consider surgery. The colloquial name for an abdominoplasty is a tummy tuck, which might have uncomfortable connotations. However, this is not a purely cosmetic procedure, as explained by a post-partum coach who went through it herself.

Click here to make an appointment in Ilminster to assess your diastasis.