Diastasis Recti and the Pelvic Floor Connection
As pregnancy progresses, the belly grows and the connective tissue between the rectus abdominis thins and stretches contributing to Diastasis Recti.
What is Diastasis Recti?
Diastasis recti by definition means separation of the rectus abdominis muscles, however the term is a bit misleading because there is always a gap (known as the inter-recti distance, or IRD) between the two muscles along the midline of the abdomen. There has also never been consensus on what is considered 'normal' IRD.
In pregnancy, as the uterus and belly expand to accommodate the growing baby, the connective tissue between the rectus abdominis thins and stretches and the two straps of the rectus move away from the midline. This is a normal response to pregnancy but challenges like back pain, pelvic pain, and incontinence can result when the connective tissue loses its ability to generate and maintain tension in the core.
For many years, the focus of diastasis recti was on the size of the gap - the inter-recti distance - but newer evidence is suggesting that the gap is not the main concern but rather the connective tissue integrity and its influence on core function. Terms like 'closing the gap' and 'fixing a diastasis' are used regularly but are perhaps a bit misguided. We prefer terms like healing and core re-training.
Until recently, most women were unaware of this condition. The internet and social media have contributed to a rise in awareness about diastasis recti, however it has also contributed to a bit of hysteria around it as well. Women are now obsessing about trying to prevent it or are afraid to move in certain ways in fear of making things worse.
While full prevention may not be possible, the good news is that diastasis recti can be minimized during pregnancy—and with an optimal recovery plan, function can be restored postpartum! Varied movement is essential as is awareness of the importance of the role of the pelvic floor in core function.
Diastasis and The Pelvic Floor
The pelvic floor is a collection of muscles, nerves, tendons, blood vessels, ligaments and connective tissue that are interwoven within the pelvis. The muscles of the pelvic floor connect to the pubic bone in front, to the tailbone in the back and to the sitz bones.
These muscles provide support and stability to your spine and pelvis, help keep the pelvic organs in place, play a key role in sexual health and help maintain your continence.
The rectus muscles originate at the pubis and when there is weakness in the connective tissue and if the muscles are out of alignment, as happens with diastasis recti, it can directly affect the pelvis and pelvic floor. When the pelvic floor muscles contract there is a co-contraction of the transversus abdominis that generates tension in the abdominal wall. Ensuring an optimal functioning pelvic floor is essential to healing the abdominal wall and diastasis recti.
In our experience, women who prepared specifically for birth, who honoured the need to recover and chose to rest and wrap, and those who used appropriate exercise to restore their core had better outcomes.
Our mission is to educate and empower women with knowledge so they can make informed choices in their pregnancy, birth and postpartum recovery. While it is never too late to heal a diastasis, it is our hope that it becomes the norm for women to know what to do in pregnancy and the early weeks postpartum.