Hi everyone!
Welcome back!
I’ve had a few questions about why I do blog posts and videos (located on social media)- and the answer is really simple.
There are so many people out there who don’t know about their pelvic floor, or about Pelvic Floor Physical Therapy and what we do!
So, I am here to help- even if it is just one person who is helped in some manner by the content I am putting out. I am here for you!
If any of this information has been helping you or you know someone who it has helped- let me know!
Okay! Now for today’s topic- Diastasis Recti!
Unless you have had a baby- you probably have no idea what this is!
Diastasis Recti is condition where the connective tissue that holds the front of your abs together stretches out to a point where you get a kind of dome in the front of the belly. It can get so bad that it can cause a hernia of the abdominal contents through the connective tissue that is no longer strong enough. It’s not super common for the hernia to happen, but it is possible.
Everyone knows what it looks like to have a 6 pack, even if you don’t personally have one right?
Look at the photo below: See how there is a line down the middle pf the muscles on the Normal Belly? That is where the 6-pack muscle- the Rectus Abdominus, connects into and it is called the Linea Alba.
When we have DRA, or Diastasis Recti Abdominus-
The Linea Alba stretches causing the core muscles to have a harder time sustaining the normal look of our abdomen, which results in doming, or a visible separation of the muscles. This lack of natural support of the abdomen can contribute to a variety of symptoms including lower back pain, incontinence, pelvic floor dysfunction, and constipation.
About 99% of pregnant women experience this but men can also experience it too. If you “yo-yo” diet, Diastasis Recti can result from gaining a lot of weight and losing it quickly- resulting in stretching of that connective tissue.
No matter the situation, there is not one specific causation of Diastasis Recti. It generally occurs in thanks to several factors.
If you are or have been pregnant and experience it, your hormones have a lot to do with it. During pregnancy, Estrogen and Relaxin cause your connective tissue to become more relaxed- which means it can stretch further.
Then, not using ALL of your core muscles correctly, poor posture and poor lifting/bracing mechanics lead to increased pressure on this already stretched tissue. Plus, there is the added weight of baby to deal with!
So, what are some ways to avoid DRA during pregnancy?
1. Avoid exercising your “ab” muscles in positions that cause all of your abdominal content to be on the front of your belly; i.e. planking and sit ups. These exercises cause increased abdominal pressure from gravity or muscle contractions on already lax tissue.
a. Many of my Momma’s report feeling “a tear or rip” when performing planking exercises because they didn’t know it wasn’t the best exercise for them.
b. PLEASE SEE A PELVIC FLOOR PT DURING YOUR PREGNANCY. WE CAN AVOID SO MANY ISSUES POSTPARTUM IF WE START DURING PREGNANCY!
2. Avoid doing regular activities that place increased pressure with contraction on the stomach. For example, when you are sitting up out of bed. If you sit straight up- that causes the muscles to have to contract to pull your trunk into a sitting position while stretching the tissue around your belly.
a. Try log rolling instead. This is where you roll onto your side and then press up with your arms and swing your legs over the edge of the bed. This places less stress on your core musculature!
3. No Valsalva Maneuvers during anything!
a. What is The Valsalva Maneuver?
i. It’s generally when you hold your breath and strain (contract your muscles really hard) for some reason. Whether it’s using the restroom, lifting, pushing or pulling.
b. When you hold your breath and then strain, you are stretching your abdomen and activating those ab muscles.
c. Valsalva results in the increased possibility of Diastasis Recti.
4. Practice bracing-
a. This is where you actively contract your core muscles without the added weight in an approved position.
b. I normally start moms on their backs to make sure they can do this right without gravity or weight from there tummies pressing on that tissue!
For Postpartum Women: We suggest seeing a pelvic floor physical therapist after 6-8 weeks if you are still experiencing symptoms.
It is really important to begin bracing activities and strengthening of the core in positions that don’t cause increased stress to the stomach; generally, these exercises start on your back. We stay in that position until you can actively contract and have arm/leg movement without losing the correct core contraction.
If you are early postpartum (less than 3 months):
We are focusing on that safe contraction and restorative exercises. You still have a lot of hormones that are trying to figure out the “new normal” without baby. There is still laxity occurring in your connective tissues and many women don’t know how to appropriately recruit their core or pelvic floor muscles.
Still no activities or exercises that cause Valsalva or increased pressure and weight on the front of the stomach!
The above reasons are why I would prefer to see New Moms 6 weeks after baby for education, exercise, and pain relief. Albeit- there are exercises that I would personally have you doing before then, as well!
For late postpartum (3+ months):
We will begin to progress you as you can facilitate that bracing maneuver and perform other motions correctly. We are still avoiding planking type exercises until you have gone through a bracing/exercise progression. There are certain steps and milestones that have to be hit before jumping back into working out with planks and other exercises!
What are those milestones, you ask? Well, I am not going to give them out because they are different for each and every one of you! What one person needs versus another is very different; no two women, their pregnancies, birth stories or bodies are alike!
A Pelvic Health Physical Therapist will be able to walk you through transitioning from baby all the way to getting your stomach back to normal (or at least close)!
Pelvic Floor Physical Therapists are very good at helping to decrease any separation that you might have or have been living with. I personally have worked with a couple moderate cases of DRA with great success. My mentor has gotten cases where women were considering surgery and no longer needed it. She has taken many moms back from extreme separations to minimal separations within in few short months.
Have hope! It is possible to get back to the body and tummy that you want!
Dr. Paige Hubert, PT, DPT
Owner/Physical Therapist for Recharged Performance Therapy
Paige@RechargedPerformanceTherapy.com
(321) 802-1630