“How’s Cara doing? Has she had her baby yet?” A patient at the chiropractic clinic that I used to work at asked me this question as I was working with her. This was near the end of Cara’s pregnancy with Oliver.
“No, not yet, but she’s more than ready,” I answered.
“It must be so fun getting to do this baby thing together.”
“Yes!,” I said, “It’s great. Being a mom is hard enough on your own, it’s nice to have someone else there understanding your struggles.”
“That’s so nice. So, Cara is due any day now…..when is your baby due?”
“My son was born 4 months ago. I’m not pregnant.”
The patient blushed and quickly changed the subject. It would have been easy for me to get upset or offended. To take it home with me and stew. To look at myself in the mirror and analyze every spot around my belly that bulges out. But, I didn’t. I’ve done a lot of self work over the years to move past worrying about what my body looks like, and focusing on what it can do. And, what it did was have a baby!
Understanding and respecting everything that my body went through to create, sustain and deliver a baby really helped my mindset. I didn’t expect to look any certain way after my son was born. I don’t have any goals to “get my body back.” My body went through many, many changes and I knew different aspects of my body would look different after pregnancy.
At the time of this incident I still had a little pooch where my son took residence for 9 months. Some may have even be thinking to themselves that I still “looked pregnant.” Thankfully, I knew the reason for this, and was able to give myself some grace. The reason is I had diastasis recti.
What is Diastasis Recti?
Diastasis Recti (DR) or Diastasis Recti Abdominis (DRA) is the thinning of the tissue that connects the two sides of the rectus abdominus (your “six pack” muscles). This tissue runs down the center of your rectus abdominus and is called the linea alba.
DR is a common and natural part of the process of pregnancy. A recent study suggests that all women by their 3rd trimester get some degree of DR. As the linea alba softens and widens it creates more room for our growing baby and allows our organs to continue doing their jobs—this is a good thing!
I find it important to note that DR, while the result of the extra intra-abdominal pressure or loading created by the later stages of pregnancy, can also happen to men, women who haven’t been pregnant and even babies! Excessive intra-abdominal pressure can also be caused by excessive weight gain, intense ab work and improper heavy lifting.
What Does Diastasis Recti Look and Feel Like?
Some women see a ‘pooching’ or ‘doming’ of the stomach, especially when coming up from a lying position on their back. (Wendy Powell, MuTu System) This is commonly called the “mummy tummy.”
Sometimes you appear to still be a few months pregnant (or someone tells you that you do, in my case). Other signs include a protruding belly button, back and/or hip pain and urinary incontinence.
In order to have an idea of how severe your DR is, you can do a self diastasis recti assessment. The assessment not only tells you how wide and deep your separation is, it shows you the tension and integrity of the connective tissue, giving you a benchmark for future assessments. We show you exactly how to do a self DR in this video.
What Does This All Mean?
As stated above, DR is a totally normal and common part of pregnancy. It’s how we heal DR postpartum that it’s important.
In postpartum, we want the linea alba to be able to regain its function by being supportive, gaining tension and supporting your body during everyday activities as well as athletic performance. With the connective tissue and muscles being stretched and weakened during pregnancy, labor and delivery, this leaves the front of the abdomen unsupported and unstable.
You’ve probably heard that you can improve and heal diastasis recti by doing breathing and restorative pelvic floor exercises (we’re going over exactly what to do in our upcoming training series that starts on Jan. 3rd), but here are 4 surprising facts about diastasis recti that you maybe didn’t know….
- Breastfeeding affects the healing of diastasis recti.
One of the hormones that affects the laxity of the linea alba during pregnancy is relaxin. Simply put, the production of relaxin increases during pregnancy in order to promote the health of mom and baby.
At childbirth as soon as the placenta is delivered, the increased secretion of relaxin returns to normal, but the effects of relaxin can last up to 5 months and breastfeeding keeps the levels higher than normal until baby has weaned.
Of course this doesn’t mean that you should stop breastfeeding (unless you want to). It just means that you may need to be more vigilant about your posture and restorative exercises, and understand that things may not progress as quickly as you’d like.
2. You don’t have to “close the gap” for optimal function.
Old school thinking is that you had to completely close the separation in order to have a fully functioning core. Latest research says that’s not the case.
According to Diane Lee, PT, some women can restore their core muscular system balance and function with an existing separation. We’re not just looking for the gap to close anymore, we’re also looking at the integrity and support of the connective tissue that allows the ab muscles to do their job.
If you’re wondering if you have healed with a gap, ask yourself a few questions….
- Do I leak?
- Do I have back, hip or knee pain?
- Do I feel supported by my core?
- Do I lack good tension during my self DR assessment?
If you’ve answered “yes” to any of these questions, or if you’re not sure, chances are there is still work to be done and that you should get in contact with your local pelvic floor physical therapist.
It doesn’t matter if your baby is 6 months old or 30+ years old, it is still possible to heal diastasis recti with the right information and care. How long it will take depends upon the severity of your separation and your commitment to not only doing breathing and exercise techniques that heal DR, but avoiding exercises that can make it worse (until you’re absolutely sure you’re ready). Things like…
- Knee tucks
Think about it….if your core and linea alba aren’t supporting you and holding things in place, then doing exercises like these cause your ab muscles to bulge up and/or hang out, and can actually cause you to have even more of a tummy bulge, and I know we don’t want that!
Healing Your Diastasis Recti
When we talk about healing DR, there is so much more to it than just the separation itself. We need to be doing restorative work not only on the separation, but the core and pelvic floor as a unit.
66% of women who have diastasis recti also have at least one related pelvic floor dysfunction, including urinary incontinence, fecal incontinence and/or pelvic organ prolapse. It’s become abundantly clear that we are facing an entire system breakdown.
The first step in healing DR is if you have access to a pelvic floor physical therapist, make an appointment and get checked out! Your pelvic floor PT can help let you know what is going on with your body and what to do about it. You can use this locator tool to find someone in your area.
Next, work on connecting your breath to your pelvic floor muscles. Let this video guide you through it.
What you do next really depends on the individual. At the time that I originally wrote this article, I was nearly 7 months postpartum. I still had a pooch, and I still did my pelvic floor exercises everyday. Every woman heals at different rates, so please don’t compare yourself to other moms that you know! You are unique, as is your healing. If you’re dealing with DR and don’t have a personal trainer who is qualified to work with the pre & postnatal population, we highly recommend finding one. (We happen to know a couple… 😉 )
We want to help you regain confidence in your body. If you’d like more info and tips on how to heal diastasis recti feel free to contact us at firstname.lastname@example.org or connect with us on social media via Facebook, Instagram or Twitter. We’d love to help!