Understanding Diastasis Recti and Pregnancy
During pregnancy, the growing uterus stretches the muscles in the abdomen and the connective tissue (the linea alba) to make more room for the baby.
The linea alba softens during pregnancy and the two rectus abdominus muscles migrate away from the midline of the abdominal wall to accommodate the growing belly. The resulting gap or separation of the 2 rectus muscles is called Diastasis recti.
Here are a few questions women ask you may find helpful.
Is it normal to have diastasis recti while pregnant?
Diastasis recti is common and considered a normal adaptation to pregnancy. One study found that 100 percent of women experience diastasis recti by the third trimester.
What does diastasis recti feel like while pregnant?
Even though the muscles are moving and stretching, very few people actually 'feel' diastasis. You may see it more than feel it. Look at your abdomen when you sit up from a reclined position and you may notice a ridge along the midline that some refer to like a 'loaf of bread'. This is a result of the rectus muscles engaging while further apart and the increase in intra-abdominal pressure is evident by the bulging in between the 2 rectus as in the image below.
Can diastasis recti cause problems in pregnancy?
Diastasis used to be an unknown and about 10 years ago started to get some press. The internet went a little hysterical and because we didn't have a lot of research or experience with the condition, there was a lot of misinformation spread. It used to be thought that the separation could lead to impairments with pushing but there is no evidence to support that. The overall stretch and accommodation of the abdominal wall, along with diastasis recti, can hinder overall core control and stability but there is a lot we can do to minimize this. Diastasis is not bad or something to be worried about. There is a lot you can do while pregnant and in the early weeks postpartum to reduce long term challenges.
Diastasis Recti-Kim Vopni
How can I prevent diastasis recti from getting worse during pregnancy?
There is not really anything we can do to 100% prevent the condition but we can take steps to try and minimize it. Posture is a key element to be aware of. Ensuring the buttocks are strong, that the upper back is strong, the chest is supple and that the rib cage is stacked over the pelvis is considered optimal. While there is no evidence to suggest that front loaded positions are bad, many professionals do recommend to avoid static front loaded positions like planks and bird dogs due to the resulting influence of gravity on an already stretched and compromised abdominal wall. Working with a pelvic floor physiotherapist is a top recommendation to help keep the pelvic floor in check and the overall core able to manage pressure well.
Whole body movement that encourages lengthening exercises (like yoga) and shortening exercises (like resistance training) is helpful.
If you are already expecting try pregnancy-safe exercises (as long as you have your practitioner’s okay). A great book is Pregnancy Fitness by Human Kinetics. Exercises such as pelvic tilts engage the deeper transversus abdominis muscles along with the pelvic floor to really work the core. In the third trimester, if your baby bump is particularly big and your abs feel loose or strained, you may want to consider wearing a belly band for a bit of extra support. It is recommended to wear the band around your pelvis and under your belly as opposed to over the belly.
The Ab Wrap from Bellies Inc is a great option as it can be used in the postpartum recovery phase as well.
Honor the need to recover adn embrace the philosophies of mother warming. Start gentle pelvic floor initiated movement such as pelvic tilts and clams and bridges in the 2nd week postpartum. See a pelvic floor physiotherapist at 8 weeks postpartum and gradually return to more intense activities. Let your core control be the indicator of readiness as opposed to a set time. We all heal differently and it can take upwards of a year to heal postpartum. Keep in mind that the gap size is not an indicator of function. The integrity of the connective tissue and your ability to generate and maintain tension in the midline is the true indicator.
Are Crunches off limits?
It used to be recommended to avoid flexion activities including crunches but we are now realizing that was not the best advice. We need whole body movement and flexion is a part of our movement library. Gradually loading the abdominal wall in a variety of ways is ideal. Lean backs are a great place to start after the initial 8 week recovery period is over.
We are Here to Help!
If you have any questions about pregnancy, diastasis recti, and exercise programs through pregnancy and beyond, fill out the form below/in the sidebar to speak with one of our Pelvic Floor Professionals and get clarity on all the options available to you.