Author -Helen Keeble. Women’s Health Physio in Sport.
Diastasis Recti (or separation of the abdominals) is fast becoming the newest hot topic in the pre- and post- natal world. Over the last few years more and more women are being made aware of this, but, very few are told the scientific home truths. There is a great deal of ‘fear factor’ created around this topic, and many, many women suffer without ever knowing how to rectify it.
NB: Diastasis is simply the medical term given for when the middle part of your tummy muscles stretches wider.
Diastasis Recti has been demonised in recent years, so let’s first rectify that…
There is NO EVIDENCE that diastasis during pregnancy can be, or even should be prevented. A diastasis is a crucial process to allow your body to safely accommodate your growing baby. This very normal and natural process has been demonised purely when this stretch to your middle remains after the pregnancy.
The natural recovery and recoil of a diastasis is done by eight weeks post-natal. The same observational ultrasound study found that no further natural recovery takes place beyond this eight week mark.
What this means is that when your baby is eight weeks is the perfect time to get yourself booked in for a post-natal MOT with a women’s health physiotherapist. This is crucial for any woman that has had a baby, even if you have no symptoms, your body has altered quite a bit and a post-natal MOT is a much more in depth check than the one you get at your 6-week check with your HCP.
For all new mums it’s crucial too that within the first eight weeks of delivery, you are not over-doing physical activity as it is thought that this may disrupt your natural healing process. The definition of ‘over-doing’ however is completely relative to you as an individual and will depend on how physically active you have been able to remain during the pregnancy. As a rough guideline; in those first few weeks start by doing pelvic floor squeezes each day (short and long) and begin to build up your walking distance. Also, if you notice any movements that cause your tummy to bulge along the centre, try to avoid these if possible until it stops doing so or until you have been checked by a specially trained physiotherapist. Eating as well as possible (from a nutritional point of view) is also thought to enhance recovery of the diastasis.
When you get your diastasis assessed it is very important that the depth is recorded – this is the indicator of how well it is recovering, not width. Rehabilitation of a persistent diastasis starts with ensuring that your core cylinder is strong and co-ordinated – this often means improving the pelvic floor muscles in the first instance so the stronger and more functional you can make your pelvic floor, the less your diastasis will be.
Once the pelvic floor is optimal, a specialist physiotherapist or exercise instructor can then gradually load/exercise your middle so that you are able to reduce the diastasis. In order for a diastasis to heal, correct movement loading/stressing your tummy in the right way are crucial – rehabilitation should always focus on all the things you can, not what you can’t do. The more you can load/stress the middle, the quicker the collagen in the midline can regenerate and therefore ‘close’ the diastasis.
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ABOUT THE AUTHOR
Helen is an experienced women’s health physiotherapist working to help women with common health problems such as diastasis, low back pain, endometriosis, groin pain, bladder leakage, pelvic pain, buttock pain, prolapse, constipation, abdominal pain, dyspareunia, scar pain. Visit her website: https://helenkeeble.co.uk/