What is Diastasis Recti?
Diastasis means separation
Recti refers to the Rectus Abdominus muscle. This is a pair of muscles running vertically along the midline of the body. It extends up from the area of the pubic crest in the pelvis to the base of the sternum and ribs 5-7. The muscles are joined by a band of connective tissue called Linea Alba.
Diastasis Recti refers to the separation of the right and left sides of the Rectus Abdominus muscles along the Linea Alba.
What is the job of the Rectus Abdominus?
The Rectus Adbominus has three meaningful jobs. (This image shows the Rectus Abdominus without Diastasis Recti, where the muscle is connected to the Linea Alba)
1) Important postural muscle
It is responsible for lumbar flexion
bringing the ribs toward the pelvis = moving from lying on your back to sitting up
bringing the pelvis toward the ribs =pelvic lift
2) Assists with breathing
particularly during a forced exhale
heavier breathing after exercise
3) Assist in keeping organs in tact through intra-abdominal pressure
when lifting heavy objects
50% of pregnant women
develop Diastasis Recti
and 50% of those women,
do not recovery spontaneously.
muscle weakness and imblanace
throughout the core with
increased risk for injuries
in the back and pelvis (1) (2)
How does Diastasis Recti happen?
During pregnancy the growing uterus stretches the muscles in the abdomen. This stretching increases particularly during the third trimester and the Linea Abla also expands to accommodate the is growth. This can cause a separation of the Rectus Abdominus muscles along the Linea Abla.
The separation is common, naturally occurring, painless, and can recovery on its own.
For some women the separation is larger (greater than 2cm = 2 finger tips); this is what is referred to as Diastasis Recti.
The research is unclear as to why the larger separation happens in some mothers and not others.
Some factors may include:
* births closer together
* mother over age 35
* carrying a large baby to term with a smaller body frame
Diastasis Recti is not painful and many mothers don't often realize they have this condition until related symptoms occur:
* chronic back pain: upper or lower
* pelvic floor weakness
* urine leakage
* gastro-intestinal issues like constipation or irritable bowl syndrome
What movements and exercises should I avoid?
* forward flexion of the torso (ex: sits ups, crunches, going from lying on your back to sitting up)
* significant arching of the torso (ex: backbends, upward dog in yoga)
* twisting upper torso while reaching with the arm (ex: handing something to your child in the car from the front seat while they are in their carseat behind you)
* activities with quick rotation of the torso (ex: racket sports, baseball, boxing)
* any action that causes the stomach to bulge or push forward. This puts too much pressure on the Linea Alba and may cause diastis recti to increase
Can Diastasis Recti be mended?
Can Diastasis Recti be mended without surgery?
Yes! This is a matter of healing the connective tissues first while focusing on the Transverse Abdominus, the deepest core muscle, and the pelvic floor.
What if it has been 1+ years since I gave birth? Can Pilates still help?
Yes! (see my personal experience below)
How can Pilates help?
Pilates focuses on comprehensive core development, with attention to connective tissues and neuro-muscular development. Specific attention is given to the Transverse Abdominus, the deepest core muscle, and engagement of the pelvic floor. This is critical for post-birth Mamas.
After birth, it can be difficult for Mamas to feel their abdominal muscles. Additional emotional layers of trauma may be present as a result the birth or post-birth experiences.
Pilates helps Mamas to safely reconnect and purposefully engage all the layers of their core, including the Transverse Abdominus and pelvic floor. Mamas with Diastasis Recti need additional attention on how to heal the connective tissue so the muscles of the Rectus Abdominus can draw together, with the support of the whole core.
At Elevate Pilates we provide Mamas with step-by-step strategies for quality core engagement and redeveloping important neuro-muscular connections that changed as a result of birthing.
It is important for post-birth Mamas, particularly when breastfeeding, to work within a small range of motion, due to the hormone Relaxin which loosens the joints. At Elevate Pilates all of our Post-Birth Pilates exercises work within a purposeful and smaller range of motion.
These exercises are not your "typical Pilates exercises" that you would find in a fitness club because a post-birth body with Diastasis Recti needs a different approach.
See our Post-Birth Mama page for details.
Personal Experience: Mending Diastasis Recti with Pilates
Soon after the birth of my first child, I experienced severe Diastasis Recti. It measured 8 fingers wide, 8 fingers long, and I literally could not feel a "back wall" when gently pressing my fingers into the separation. It was considered a hole.
Due to my child landing in the Neonatal Intensive Care Unit after birth and eventually coming home with the support of Palliative Care and a long list of complex medical needs, I as Mama didn't have the ability to begin to think about my Diastasis Reci recovery until my child was 18 months old.
Having had a 20 year professional dance career, I knew first hand the benefits of Pilates as a method for developing core strength. I knew if I were to ever perform dance again, I needed to find a way to heal my abdominal hole. As a mother of a child with medical complexities, the last thing I needed was to endure abdominal surgery.
I sought out the help of a Certified Pilates trainer with specialized Pilates training in working with post-birth Mamas. We scheduled a long series of private sessions, each of which resulted in a detailed home program. My Diastasis Recti was severe and I knew it would take time and a commitment on my part to complete my home program in order for by body to heal.
And heal it did!!
The results have been incredible!
* no back pain
* no surgery
* no incontinence
* return to professionally dancing in less than 1 year
* 2nd pregnancy & birth the following year without Diastasis Recti
In the years following I have since become a Certified Pilates trainer and invested in additional post-birth Pilates training with the Trainer who helped me personally recover.
Layered into my work as a Certified Pilates trainer is a BFA in Dance, 20 year professional dance career, and the real-life experience of motherhood: with both a child with medical complexities and a neuro-typical child.
In my role as a Certified Pilates trainer I am known for helping Mamas access the body-mind benefits of Pilates while supporting soulful resilience.
I am passionate about helping Mamas experience the same quality of life benefits I have experienced as a result of healing my severe Diastasis Recti through Pilates.
At Elevate Pilates, our Post-Birth Recovery Program, draws directly from the wisdom of Joe Pilates and the work that has been done in recent decades for Post-Birth Mamas, within his Classic approach to Pilates.
To learn more about our Post-Birth Recovery Program with supportive Home Program, check out our Post-Birth Mamas page and reach out to me at Dannell@ElevatePilatesMN.com
Helping you recover while you mother,
Please note, I am not a doctor. All Post-Birth Mamas need provider permission before starting a Pilates program. This article is for purposes of information, not intended to be medical advice. It is my personal recommendation Post-Birth Mamas complete any Recovery Program while also regularly seeing their primary provider and a Chiropractor who is trained to work with the needs of Post-Birth Mamas.
1. Boxer et al 1997; Toranto 1990; Oneal et al 2011; Spitznagle et al 2007. 2. Spitznagle TM, Leong FC, Van Dillen LR. Prevalence of diastasis recti abdominis in urogynecological patient population. Uroggynecolo J Pelvic Floor Dysfunct. 2007; 18:321-8. via http://www.corerestorephysio.com/the-core/