Diastasis Recti, pelvic health, physical therapy, postpartum, pregnancy, women's health

Splitting Up With Your Diastasis Recti

Are you fed up with Diastasis Recti (abdominal separation)? Good. Here’s some incriminating facts and break-up advice.

Incriminating information

As I mentioned in this blog post, DR can occur in any phase of life due to physical forces causing our rectus abdominis (the six pack muscle) to stretch and separate down the middle – whether that’s due to a very physically demanding job, poor body mechanics during intense exercise, pregnancy, or the like.

There is some research to say that a certain amount of abdominal gap is normal, but I will not default to that sense of normalcy because it’s all about what symptoms you have that may or may not be associated with a DR.

Diastasis Recti can be a major factor when considering the following impairments:

  • Back/SI joint pain or instability
  • Pelvic pain
  • Gastrointestinal issues (constipation/diarrhea)
  • Abdominal discomfort or pain
  • Incontinence (leaking pee, gas, or poo)
  • Hip pain
  • Impaired balance
  • Hernias
  • Pelvic organ prolapse
  • Pain with pregnancy
  • Protruding stomach
  • Other joint pain or instability

This is not a comprehensive list of symptoms, but gives you an idea of how important it is to consider a DR when you are experiencing any of these issues.

I strongly advise you to see a pelvic health physical therapist if you think, or know, you have a DR and/or any of those impairments (up there) going on. They will assess your DR and dive into any other symptoms you may be having, then provide you with an individualized program to address your specific needs and goals!! Also, if you are considering surgery for a DR, please, PLEASE check with a pelvic health PT first. You can locate one in your area by going here.

BUT in the meantime, here are some general guidelines to help prevent a DR from happening or worsening.

Break-up Advice

Breathe normally

During ALL movement and exercise. Never ever hold your breath. Not even to strain and get that last Chick-Fil-A french fry that fell in the abyss that is between the seats of your car.

Why? This places excessive force outward on your abdomen and back and downward on your pelvic floor, potentially worsening a DR and any other abdominal, back or pelvic health issues you may have.

Don’t do the dome

IMG_4111.jpg

This happens with a lack of activation of inner core muscles (transversus abdominis, multifidus and pelvic floor) causing your stomach to protrude into a dome shape, noticeably displaying a DR (if you have one). Doming can happen with transitional movements (getting in/out of bed), during exercise, with lifting – basically any physical activity.

Why? This is poorly activating muscle that’s separating and potentially cause it to separate further.

Let me see that log roll 

Meaning, when you move from sitting to/from lying down, move as one unit (like a log). Keep your knees and feet together, and either lower yourself to your side to lie down or use your arms to push up to a sitting position (from sidelying). It sounds more complicated than it is, so I found a fairly good video of how-to here.

Why? When you sit straight up or lay straight down, this places a great amount of force on your abdominals (and pelvic floor), typically causing the doming effect and worsening or causing a DR.

Exercise considerations

It is best to avoid exercises that are belly down, initially anyway, like planks and push-ups.

Why? It places increased pressure on the DR from the weight of your organs and the abdominal instability you likely have as a result of the DR.

Sit-ups and crunches are best to avoid because it is very difficult to properly stabilize your core even without a DR when performing these exercises. Sit-ups are particularly harsh on your abdomen, back and pelvic floor, so I caution against these for life. (I err on the side of conservative, but not all PT’s feel the same way.)

Learn how to use and engage your pelvic floor and transversus abdominis (a deep abdominal muscle) during exercise while utilizing proper breathing techniques and your diaphragm (exhale on exertion, inhale on return to starting position).

Why? These muscles, combined with your multifidus (back muscle) work together to create a corset affect, providing maximum, and optimal, stabilization of your core! YAY-YEAH!

A good place to start working on your DR is in this blog post. I also have several exercise mentioned throughout my instagram feed or facebook page (@underthewomanhood) that are DR friendly. Working on your hip/thigh/butt muscles is also an excellent and safe go-to (unless that means 3 ft box jumps to you…).

The most important thing is to always listen to your body. If you feel any tugging, pulling, or discomfort at the diastasis, notice you can’t control your movement well, find yourself holding your breath, peeing on yourself, etc… Step away from that exercise, babe. It is not helping you in any way right now, but it might be something you can work back up to doing!

When in doubt about what exercises to perform and not to perform, check with a pelvic health therapist and they will give you exactly what you need.

Bracing

If you are newly postpartum, I do recommend wearing some kind of abdominal binder. Not only to help support your now empty belly and contents, but to help close the DR if there is one present. There are lots of opinions out there about “to brace or not to brace,” but I’m basing this advice off of my experience.

You will want to apply the brace in an upward lifting motion so it’s not just squishing everything out the top and bottom of the brace. I have been recommending this one from Bellies Inc. lately as it was designed by a pelvic health PT and does promote some lifting of the abdomen. However, it does contain latex, which can be an allergen, so you might consider wearing it over a tight fitting shirt to avoid skin irritation.

If you are further out, or can’t stand wearing a brace, you might consider taping your DR. This is less of a takeover than wearing a brace, but will cue your abdominal muscles to activate and stay together. It will also keep you aware of how you’re using your abdominals/body during the day and/or during a work out. If you search on YouTube, you will find several different taping techniques. Do the one that works the best for you. Always do a test strip of the tape on your stomach before you do the actual technique to make sure you won’t have a reaction to the adhesive. (I realize the need for me to make some videos for you all! Putting that on my to-do list.)


 

Alrighty, gal pals. I touched the surface of some of the big DR basics – things that will help minimize the risk of DR development, prevent worsening, and improve the closure. BUT there is so much more to it which really can only be addressed by seeing or talking to a pelvic health therapist. If you can’t see a therapist, please get your online information or “DR program” from a licensed physical therapist. This is not to say that the other professionals out there are giving out the wrong information, but you are more likely going to get safe and effective information from a licensed PT or DPT (doctor of physical therapy).

If you have any questions, please don’t hesitate to contact me!

xo,

Lacey

 

2 thoughts on “Splitting Up With Your Diastasis Recti”

  1. Just stumbled upon this article. I found it very interesting and informative.
    Love those pictures of the little man.

Leave a Reply to Lacey Welch Cancel reply