Diastasis recti could be why you have a stubborn mummy tummy!

Are you tired of people asking you if you’re pregnant long after you’ve given birth? Have you tried everything from dieting to working out religiously and yet just can’t seem to get rid of that mummy tummy? Well, it might not be stubborn fats after all. Ever heard of diastasis recti?

What is diastasis recti?

Diastasis means separation. Recti refers to a pair of long, flat muscles that run vertically down either side of your abdomen. These muscles play an important role in stabilising your core and keeping your internal organs held in.

Diastasis recti is when the rectus abdominis muscles in your abdomen separate during pregnancy, and leave a gap that causes your belly to pooch out. Simply put, it is when the space between your left and right belly muscles widens and you end up with that stubborn mummy tummy!

Why does diastasis recti occur?

As we all know, pregnancy stretches everything in our body. As such, the connective tissue stretches, and in turn causes the rectus abdominis to stretch and separate in the middle.

Pregnancy hormones are a contributing factor as well. The hormones relax the connective tissue and make it easier to stretch to make space for your baby.

Diastasis recti is the result of excessive pressure in the abdomen. Pregnancy puts such great pressure on the belly that at times, the muscles in front are unable to keep their shape.

After delivery, you would expect this tissue to heal, hormones to go back to pre-pregnancy levels and of course, for your muscles to return to their normal state and for that gap to close.

Unfortunately, about 40% of women end up with a gap that doesn’t close on its own and have a diastasis well after 6 months postpartum.

How does it look?

Imagine this – a loaf of bread, or a ridge sticking out of your tummy. Yes, that’s what a diastasis recti looks like. Some describe it as a ‘pooching’ or ‘doming’ of your stomach.

And it’s more obvious when you strain the muscles, for example, when you are coming up from a lying position on your back, or when you sit up. It is less obvious when you lie down and relax the muscles.

Singapore mummy Justina Tan laments, 

After my second child I had a diastasis recti. I had no idea and thought I was just fat. I did so many exercises and tried all kinds of diets but to no avail. I started feeling really depressed and lousy about myself. I gave up hope that I would ever look good and started wearing loose, oversized clothes.

Then one day I came across an infographic that explained this condition and how to test for it. I was so happy to know that it wasn’t just fats that I couldn’t get rid of. With a lot of therapy and exercise, I finally saw progress. I am still working on it but I’m confident that soon my stomach won’t look so terrible! 

Testing for diastasis recti

You don’t have to visit the doctor to get this diagnosed. You can perform a simple test in this manner:

• Lie on your back, knees bent, feet flat on the floor
• Relax your head and shoulders
• Place your fingers above your belly button (your palm should be facing inwards)
• Slowly lift your head and neck off the floor
• Press your belly with your fingertips
• If all is good, you should feel the muscles closing in
• If there is a gap that is wider than 1 – 2 fingers’ width, that’s likely to be a diastasis

You should repeat this test in two other places – directly over the belly button and a few inches below the belly button.

Apart from the gap, it is in fact more important that you look out for the tension, or lack of tension in the linea alba (your midline).

When you use your fingers and gently apply pressure to the midline, you should feel some tension and resistance from the contracting muscles. If you don’t feel this, then it’s probably a diastasis recti!

What happens if you have a diastasis recti?

In case you’re wondering, it’s definitely more than just a cosmetic concern. A diastasis can cause other complications such as :

• Urinary Incontinence
• Painful sex
• Pelvic and hip pain
• Chronic lower back pain
• Constipation
• Difficulty breathing
• Difficult moving normally

When the ab muscles separate, the uterus, bowels, and other organs, are left with only a thin band of connective tissue to hold them together. This is why such conditions occur as a result of a diastasis.

In more extreme cases, the tissue may tear and cause organs to stick out of the opening. This is called a hernia.

What do I do about it?

It is important that you identify and seek appropriate treatment for diastasis recti. If you assume that it is just tummy fat, and try to do core exercises to get rid of it, you might end up exacerbating the condition.

Using abdominal binders and girdles don’t solve the problem either. These pull your sides together but don’t actually help in healing the muscles or keeping them there.

It’s best to seek guidance from a professional physical therapist. There are specific exercises to help get the muscles back where they should be and with the right guidance, you can start doing these exercises.

Typically, you need to connect with the deep core muscles, correct the alignment of your muscles, engage your transverse abdominis and pelvic floor muscles (in the right manner) and then strengthen your transverse abdominis muscles.

If the diastasis is really bad, surgery might be the last option. Surgery helps to correct the diastasis by stitching back the abdominal wall muscles together along the midline.

At times, the surgery can be done laparasopically. This involves using a small camera that is inserted through small incisions. This is less invasive than a conventional surgery. But this can’t be done for severe cases that require a bigger incision.

If the diastasis is severe enough, you need a open abdomen surgery. Insurance does not cover this as it is classified as a cosmetic surgery.

What you shouldn’t be doing

• Don’t go to your gynaecologist if you are have a diastasis. What you need is a physical therapist.
• Don’t put further strain on your abdomen – constipation, lifting of heavy things (even your kids) and too much standing up and sitting down (because you are using body weight)
• Don’t do crunches, sit ups, and front planks & certain yoga poses – these make the diastasis worse

There you go mums, pretty much all that you need to know about diastasis recti. The good news is that it’s never too late to correct this! Even if it has been years since you delivered, with the right care, treatment and exercise, you can close the gap.

Also, prevention is better than cure so if you are planning to get pregnant, work on strengthening your core. It is only effective if the strengthening is done prior to getting pregnant.

Source: Babycenter, WebMD

Republished with permission from: theAsianParent Singapore