Understanding and improving diastasis recti
After pregnancy, a lot of women notice that their abdomen just doesn't seem right. They may not have the same strength or may notice everything seems to be sticking out a bit more than they remember. The reason is often diastasis recti, a common condition which physiotherapy can greatly improve.
What is diastasis recti?
Diastasis recti is a term that means your outermost abdominal muscles have separated. These muscles are called your rectus abdominis and are the muscles that form that six pack so many people are after. Normally your left and right rectus abdominis muscles lie very close to each other, joined by a strip of connective tissue which is called the linea alba. In diastasis recti, the muscles have been pulled apart, with a gap of greater than 2 centimetres between the left and the right.
How does it occur?
Diastasis recti tend to occur in two groups: newborn babies and women who have been pregnant. In newborn babies it tends to happen due to their abdominal muscles having not completed development, so is more common in those who are born prematurely. In women who are or have been pregnant, it can result due to the abdominal distension that comes with pregnancy. As your baby grows your uterus enlarges, stretching your abdominal muscles. If the pressure on them is so great that connective tissues stretch, separating the left and right sides of the muscle and resulting in diastasis recti. This almost always occurs during pregnancy, however by 6 months postpartum over a third of women still have a separation.
Why is this significant?
Imagine your abdomen is like a rubber band - it's strong but flexible, so it expands when it needs to before snapping back into position when needed. If you have a diastasis recti it's as if part of the rubber band is stretched. You won't be able to control your abdominal muscles as well and it can appear that your belly is protruding or sagging more than it usually would as a result of this weakness, giving you a "mummy tummy". It also means that your other muscles have to work harder, so you can get lower back pain and poor posture. Rarely women can develop a hernia as a result of their diastasis recti.
Physiotherapy for diastasis recti
Physiotherapy involves first assessing your abdominal muscles to see if you do indeed have diastasis recti and how bad it is. To do this your physiotherapist will get you to contract your muscles while they measure to see how big any gap in your rectus abdominis may be.
If you do have a diastasis recti then your physiotherapist will be able to design an exercise program to help you regain core and pelvic floor strength, which will improve any symptoms and may help close the defect in your abdominal muscles. These exercises will be prescribed based on your individual circumstances.
In addition, an abdominal binder or support garment may be suggested. These garments help give you extra support while your diastasis recti improves and may even help to improve it.
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