fbpx

The Core Recovery: Diastasis Recti in Women

Have you ever wanted to get rid of your mummy tummy? While there’s no magic pill for that, there may be something better. Read on to find out more.

Abdominal muscle separation, also known as diastasis rectus abdominis (DRA) and mummy tummy, can cause anxiety or insecurity. Fear not, Preet, our resident women’s health physiotherapist, answers some of your questions about DRA in women.

WHAT IS A DIASTASIS RECTI?

Diasis recti occurs when the connective tissue (linea alba) between two muscle bellies of the rectus abdominis—what you may know as the ‘six-pack’—stretches and weakens. Although it is usually painless, diastasis recti can make your ab-muscles look and feel separated.

WHY DOES DIASTASIS RECTI HAPPEN?

Diastasis recti can happen for many reasons, but it is usually due to the following:

  • Intense intra-abdominal pressure
  • Poor posture or alignment
  • Poor technique when performing abdominal exercises
  • Pregnancy

Take note that this condition can affect babies and men, too.

WHAT ARE THE SYMPTOMS OF DIASTASIS RECTI?

One of the tell-tale signs of having DRA is a doming or tenting through the middle of your tummy. You can notice this separation between your muscles upon sitting up from the floor or getting out of bed. In some cases where the separation is large and thin, internal organs like the bowel can be seen or palpated.

It is a common notion that diastasis is the cause of some symptoms such as back or pelvic pain and incontinence. However, there is not enough present evidence to support this.

HOW DO I ASSESS THIS?

Performing a self-assessment is not always easy and might make you feel agitated. It is best to book an appointment with a women’s health physiotherapist to get an accurate assessment. Physiotherapists will examine the extent of your DRA, study the factors that may contribute to it, and give a prognosis. Of course, they will also prescribe a treatment plan and guide you throughout your healing process.

If you want to do a self-assessment before talking to a physiotherapist, follow these steps:

  1. Lie on your back with your legs straight and arms by your side.
  2. Lift your head off the floor and crunch, so that your shoulder blades lift off the ground.
  3. Begin moving one hand over your xiphoid process (tip of the breast bone) and run your fingers along the middle of the two rectus abdominis muscles. If present, move your fingers over the linea nigra, sometimes called the pregnancy line, all the way to your belly button and pubic bone.
  4. Feel for the two firm edges of your rectus abdominis muscles and the softness between them (check for ‘depth’— whether it is soft, mild, or firm). Then, measure it using finger widths. When examining it, think of it as the skin between your knuckles, where the knuckles are the muscle.

I’VE JUST HAD A SIX-WEEK CHECKUP WITH MY OBSTETRICIAN/GYNAECOLOGIST AND I GOT THE GREEN LIGHT TO EXERCISE AGAIN. WITH DRA, WHAT ARE SOME SAFE FORMS OF EXERCISE?

Remember that your body is still recovering six weeks postpartum. Though bringing life into this world is miraculous, childbirth is one of the most traumatic experiences your body will undergo. Mums, let me remind you that you should not immediately go back to pre-pregnancy-level workouts, such as boot camp and CrossFit, at this point in your postpartum journey.

Although you may not be experiencing any pain at the moment, if you just had a caesarean birth, we know for sure that your c-section scar will not be healed within six weeks. By then, your abdominal muscles will only have regained about 50% of their original tensile strength. By six to seven months, only 73 to 93% of the original tensile strength is regained (Ceydeli et al., 2005).

 

 

Current studies actually recommend that women do not consider running until three months post-delivery if their labour is uncomplicated. It’s better to be safe, mums!

The saying ‘You can’t fire a cannon from a boat’ is actually applicable in this situation. Before returning to your exercise or strenuous workouts, make sure your core and floor muscles are in good shape and that you do not have any childbirth injuries that require attention.

If you haven’t already started activating your core and pelvic floor muscles, then that’s where we start your physiotherapy. Aside from this, I also encourage you to do other light exercises, like walking and swimming. You can also try postnatal classes and low-intensity gym workouts that engage your deep abdominals. Make sure to emphasise your posture, breathing, and strengthening your core. Read here to learn more about helping DRA for further recovery.

WHEN SHOULD I SEEK FURTHER ADVICE?

Keep in mind that in 60% of women, the mummy ‘pooch’ or the abdominal separation usually goes away on its own two months after giving birth. It does not mean you have to ignore it, though!

WHAT TO DO NEXT?

If you are seeing the signs of diastasis recti and would like to be assessed, please call or WhatsApp us at 9780 7274, or email us at help@embracephysio.sg.

Feel free to look through our website, where you can learn about other women’s health conditions we treat. This is a safe space where we can discuss how we can help you with physiotherapy.

Note: While I am a physiotherapist, I am not your personal physiotherapist. The contents of this website are for informational purposes only and are not intended to serve as personal medical advice.

References:

  1. Goom T; Donnelly G; – Brockwell E. Returning to running postnatal – guidelines for medical, health and fitness professionals managing this population March 2019.
  2. https://pubmed.ncbi.nlm.nih.gov/15796944/
  3. https://absolute.physio/wp-content/uploads/2019/09/returning-to-running-postnatal-guidelines.pdf
  4. https://www.embracephysio.sg/how-to-help-your-diastasis-recti-recover/#content
  5. https://www.embracephysio.sg/returning-to-exercise-post-c-section-recovery/#content
5 Star Google Reviews
Embrace Physiotherapy is committed to 5 star client satisfaction.

My experience with Embrace Physiotherapy has been very good. A very professional approach from the staff, right from the first call I made to seek appointments till the end of the therapy. A special note about my interaction with Alex, my consulting physiotherapist: Alex is very good at her work. She listens to her patients patiently to understand the issues being faced before exploring the solutions. She made me feel very comfortable and helped me to work with her to find the right solution to my needs. Her interactions have always been nice and with an added human touch, enabled me to feel comfortable working with her. She doesn't rush the treatment procedure and has helped me explore more than one solution keeping my condition and the history of complications in mind. She also keeps track of the progress and provides alternate solutions if the current approach isn't yielding the desired results. She is much more than a physiotherapist as she gave some great suggestions about lifestyle which helped me avoid the recurrence of issues.

Sowmya Krishnan Avatar Sowmya Krishnan
September 10, 2022

Always love coming to embrace. Both preet and brenda have been nothing but really encouraging and supportive on my journey to solve my lower back pain. Feels really comfortable going to them, knowing that it is a journey and they will recommend me suitable exercises to do at home as well. Special mention to the receptionist who assisted me one time when i had sharp pain in my back and had to urgently drop by for a visit! highly recommended!

sherry lu Avatar sherry lu
May 11, 2023

Professional, Knowledgeable, Patient and Caring - highly recommended! I’ve completed 8 sessions with Preet to prepare for birth and a follow up post birth and was impressed at her level of care. She does a thorough assessment while keeping you comfortable and relaxed. I would highly recommend Preet

Leanne Avatar Leanne
September 30, 2021

Embrace life. Embrace Physiotherapy.

Looking to make an appointment? We are here to help! Booking an appointment online with Embrace Physiotherapy is the most confidential, convenient way to lock in the practitioner & time you want.