How To Assess Yourself for Diastasis Recti
If your tummy still looks pregnant months after delivery, a postpartum abdominal condition called diastasis recti might be to blame.
I recall when I was first pregnant; I bought The Pregnancy Bible and read it diligently every day to see what was happening to me and my babe.
About three-quarters of the way through the book there was a tiny paragraph about diastasis recti that described it as when the abdominal muscles separate due to the stretching of the connective tissue during pregnancy. Nothing was included about stats, how to check for it, how to prevent it or what to do about it!
It sounded painful! And I thought for sure I would know if I had it. Not so; it took four years to diagnose it in myself. I kept learning (and am still learning) all about it.
Diastasis (DRA) is so far poorly researched, but thankfully the research world is realizing the impact and increased occurrence of this condition, so more studies are in the works.
In short, it's a gap in between your right and left abdominal wall muscles that can result in a rounded, protruding belly. "
The connective tissue referred to as the linea alba is a complex, three-dimensional, highly structured meshwork. It softens during pregnancy to allow the two rectus abdominis bellies to curve around the abdominal wall in order to accommodate the enlarging uterus.
Some of the complaints associated with diastasis are -
- back pain
- pelvic pain
- bulging abdominal wall
In my experience,
- DRA affects about 80-90% of women
- 60-70% of the women have stress urinary incontinence.
- Not everyone with a diastasis has a poochy tummy.
- The poochy tummy is more a result of poor alignment and posture, as well as overuse of the oblique muscles and a tight psoas.
- In some people the separation never returns to ‘normal’ or midline
- If the separation never ‘closes’ but the person is able to generate tension in the linea alba and their internal core is synergized (meaning the timing of the pelvic floor, deep abdominals, breathing and multifidus are all as they need to be) then there is no problem and they would be considered a functional diastasis.
There is still much to be learned about diastasis recti, but what we do know that we need to focus on improving the integrity of the linea alba, and that the first eight weeks postpartum are the most critical.
A Prescription for Diastasis Recti
Prevention during pregnancy, as well as taking advantage of the first eight weeks post-partum are essential.
Ultimately, there is no one prescription. Everyone is different, but I know is that it starts with alignment and posture. Then add in the breath and then movement to regain coordination - the ABC's - Alignment, Breathing, Coordination.
Alignment is key, as well as the posture you choose through the day. Keeping your ribcage over your pelvis is one of the biggies, along with straight feet and a tailbone that is un-tucked.
Everyone is concerned with closing the gap, but it is more important to get the linea alba (the connective tissue) tensioning properly; how you do that is through the pelvic floor (and alignment and breathing).
How Do I Know if I Have It?
It's easy to perform a self-test for diastasis recti.
Here's a video I made showing how to do a self-assessment for diastasis recti:
Core Breathing and Physio
Incorporate core breathing into your daily routine - 30 seconds to one minute. This is especially important if you are pregnant.
Awareness is Key
Awareness is key and can help minimize DRA. The first eight weeks postpartum are critical for healing.
It is helpful to see a pelvic floor physiotherapist who can help you connect with your pelvic floor – the pelvic floor is key in your inner core function and in healing a Diastasis. Pelvic floor physiotherapists have additional training in the pelvic floor muscles and are licensed to go beyond the labia. It will also help you with the ABC’s – Alignment, Breathing and Coordination (or Core-ordination as I like to call it!).