Diastasis recti: All you need to know about this postpartum condition

Do you still ‘look pregnant’ months after your delivery? You might have what is called a Diastasis recti.

It is an extended flab (instead of abs) that is formed when there is extra space between your left and right belly muscles. Although this ‘pouch’ is usually harmless, it is fairly undesirable.

It’s most commonly seen in pregnant women and sometimes even newborns. But it usually goes away after a while in both cases. You may also notice it in women who give birth to more than one child or have twins or get pregnant post the age of 35.

Each of us have rectus abdominis, which are long and flat muscles that run down vertically on either side of our abdomen. These are crucial because they provide core strength to our body and also hold in the internal organs.

Now when you are pregnant, the rectus abdominis muscles expand and separate vertically down the middle so as to make room for the baby. In addition, your pregnancy hormones enable the tissues to relax and expand.

Usually, rectus abdominis heal on their own four or six months postpartum. In other words, they come back into the same pre-pregnancy vertical position. However, in many cases there is a possibility that these muscles do not come back to their original position.

In such a scenario, you end up with a ‘pouch’ that looks like a pregnant belly. Sometimes, you may need surgical intervention.

Diastasis recti occurs when the rectus abdominis muscles expand and separate vertically down the middle to make room for the baby during pregnancy

Sometimes, it may also look like an unsightly ridge protruding from your tummy and may look prominent when you cough. But not every type of belly fat is Diastasis recti.

There is a simple home test that can check if the flab you have is actually Diastasis recti or just fat!

Simply lie on your back, keeping your knees bent and your feet firmly on the floor. Now bring your hand gently over the navel. Make sure that it is palm down and your fingers are pointing towards the toes.

Lift your head and bring it towards your chest, this causes the rectus abdominis to contract.

If you feel a gap of two or more fingers between the two sides of your abdomen, it means you have Diastasis recti. But worry not, it is not harmful in any way. However, you may need medical intervention to get rid of it.

While a Diastasis recti mainly affects the abdomen and may be harmless in most cases, sometimes it can also have implications on functioning of other organs and body parts.

• Chronic back ache: Women with Diastasis recti may suffer from chronic back pain (because of excess flab in the front that refuses to go).
• Urinary incontinence: They may also have urinary incontinence, which occurs when loose muscles are unable to keep urine in control and prevent leak.
• Postpartum constipation: In some cases women may also suffer from postpartum constipation. It may take a few days for you to pass stool and you feel bloated most of the time.
• Pain during sex: Another problem that Diastasis recti causes is painful sex. You may have pelvic pain during sex and clubbed with urinary incontinence, intercourse can be difficult initially.

The bad news is that once the connective tissues of the rectus abdominis muscles stretch out, it is difficult to put them back together. In fact, traditional crunches may also render useless because they may strengthen the stretched tissues in the same position. So the gap still remains.

The good news is that an abdominal rehabilitation can help you get rid of Diastasis recti.

In an abdominal rehab you essentially work with a physical therapist who suggests specific type of exercises to strengthen as well as tone weak abdominal muscles.

Here’s what you can expect in an abdominal rehab:

• Strengthen rectus abdominis: You may have to perform mini crunches while wearing a belt or a sheet that is tightly wrapped around your waist. This will strengthen your abdominal connective tissues and prevent them from stretching further.
• Strengthen transverse abdominis: You may also be taught to work on strengthening your transverse abdominis. This is a part of the abdomen that acts as a corset and protects and provide strength to the core. When you say ‘shhh’ out loud, you’ll be able to feel your transverse abdominis. You may also be recommended the Tupler Technique for this purpose.
• Daily activity exercises: Your therapist may show you how to use abdominal exercises and ways so that you can incorporate them in your daily activities such as getting up from the bed, sitting on a chair, picking up objects from the floor among others.

Based on your therapist’s guidance you may have to perform mini crunches to recover from a severe Diastasis recti

To start the abdominal rehab you’ll have to wait a minimum of six weeks in case of normal delivery and eight to weeks in case of a caesarean section.

The other thing to remember is that if your Diastasis recti is severe (if you can feel a gap of three or more fingers between your right and left abdomen), then surgery may be the next best option. This is especially true if you do not plan to get pregnant again.

In a Diastasis recti surgery, your abdominal wall muscles are stitched back together down the middle of the abdomen. While this is a more common method, in certain cases a laparoscopical procedure can also be performed.

Here, a small camera is inserted in the abdomen through tiny incisions and the stitch is made.

In case of severe Diastasis recti, doctors may even perform an open abdominal surgery (abdominoplasty). This usually involves a larger incision in the belly. However, remember that the latter is a cosmetic surgery so you may have to discuss with your insurance provider if this can be covered in your plan.

But there is always a 50-50 percent chance for all this to actually work.

Each body is different and its requirements and healing process, therefore, also differ. So while a few weeks in abdominal rehab may work for some women, others may need a surgery to recover from a severe Diastasis recti.

In addition, you may also want to lose the pregnancy weight and so it may take time for your entire body to get back into its previous shape and size. The important thing is to take it slow, trust your body and do not over exert.

Take a look at this video to get a better understanding of postnatal abdominal exercise.

Sources: wedmd, healthline, wellnessmama

Also read: How soon can you start your postpartum exercise regime?

(All images courtesy: Shutterstock, Pixabay)