Diastasis Recti // What is it and what can you do to support your recovery?

Diastasis Recti is yet another important consideration for women during postpartum recovery. This separation of the abdominal muscles is normal during the third trimester of pregnancy, however for many women it remains a problem 8 weeks after giving birth, and even worse if left untreated remains unchanged at 1 year postpartum [1,2]. Believe it or not, but 66% of women with diastasis recti experience some level of pelvic floor dysfunction [3], which is exactly why I asked Candice to make sure to cover this topic in addition to her two blogposts (you can read them here, and here) on the pelvic floor. In today’s post, she explains what exactly diastasis is and includes some practical tips that will support recovery both during and after pregnancy.


Rectus Abdominis Diastasis (RAD) or diastasis recti is a normal separation of your abdominal muscles that occurs during pregnancy as your body makes room for your growing baby. This separation occurs along the line of the linea alba as your tissues stretch and thin (not tear) and your rectus abdominis muscles move apart. During pregnancy it is common to notice a bulge/tenting/doming down the front of your belly during certain activities. In the postpartum period, your RAD may resolve spontaneously over a couple of months or you may experience a soft and hollow sensation down the middle of your belly or doming during exercising that does not resolve on its own.

This physical presence of a ‘mummy tummy’ is often a cause for great concern for women as society pressures us into ‘bouncing back’ after pregnancy or achieving that unattainable Instagram bod. The truth is that a RAD is normal during pregnancy and postpartum there are many factors that may impact your recovery. I always recommend a physiotherapy check-up to ensure that your personal needs and goals are met and that you are taking a holistic approach to recovery.

 
Image from  here

Image from here

Image from  here

Image from here

 

Tips for recovery

General (During Pregnancy and Postpartum)

  • Avoid or adapt activities that exacerbate or cause RAD (planking, sitting up, lifting, straining)

  • Breathe - think exhale on exertion, do not hold your breath

  • Avoid a sit up manoeuvre - rather roll first to get out of bed, then exhale as you push yourself up using your arms

  • Gently activate your pelvic floor (and breathe) as you sit up from the sofa, get out the bath, or pick up a toddler

Pregnancy

  • Seek the help of a qualified physiotherapist if you are concerned about your RAD or have any symptoms relating to your pelvic floor

  • Perform safe and appropriate exercises during pregnancy, including those for your pelvic floor

  • Maintain good general fitness (adapted as your body allows)

  • Be mindful of your posture 

 

Postpartum 

  • Be gentle and patient with yourself in the weeks following delivery and consider the ‘fourth trimester’ as a time of rest and recovery

  • Find a pelvic floor physiotherapist and go for a 6 week postpartum check-up (or earlier if you have any pressing concerns)

  • Only consider binders and strapping once assessed and discussed with a professional

  • Start with deep breathing exercises and gentle core/pelvic floor activations in a comfortable resting position

  • Progressively increase gentle exercise as your body allows (i.e. walking)

  • Consult with a pelvic floor physio prior to returning to you normal exercise regime

  • Avoid jumping into a rigorous sit up regime in an attempt to resolve your RAD - you may be doing more harm than good

  • Progress to a strong and dynamic transversus abdominis (TrA) and pelvic floor (PF)

  • Integrate TrA and PF exercises into your training regime

  • Maintain a healthy overall lifestyle (diet, hydration, exercise, relaxation), as these factors impact the ability of your ‘functional unit’ to work as it should (as discussed in previous posts)


unnamed.jpg

Candice is a Physiotherapist based in Durban with a special interest in Women's Health and Pelvic Health, a relatively new and growing field of Physiotherapy. In an effort to improve awareness of Pelvic Physio as well as educate and empower women with pelvic health concerns, Candice is known for addressing many of the taboo topics in this area. Rather than ‘brushing it under the rug’ or giggling over pelvic floor symptoms in conversation, she highlights that there are professionals trained in conservative treatment. She has an Instagram page @umhlangaphysioforwomen and ran a series of ‘Wonderful Women’ Events in 2018 which aimed to normalise conversations and address pelvic floor dysfunction in an empowering and engaging setting. These platforms allow women to interact with herself as well as other professionals within the field. When Candice isn't dancing around in front of a crowd explaining the ins and outs of a pelvis she is based at a Physiotherapy practice in Umhlanga, Durban, South Africa. This is where she assesses and treats any patients that may come her way with concerns relating to the pelvis.

You can keep in touch with her work on: