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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.

Really glad to have Alex as my therapist! She helped me tremendously in resolving my pelvic pain issues after delivery. I sought help from a couple of places, but they were of little use. Thankfully, I met Alex who has the experience and patience to accurately diagnose the issue and treat my pain. On top of that, Alex and the staff at Embrace are very friendly, and it was a great experience overall. I would highly recommend anyone who is suffering from postpartum pains to visit Alex at Embrace!

Tash L Avatar Tash L
January 11, 2022

Embrace physiotherapy was my first Physio experience. I had been having issues 3+ years postpartum and I had therapy from both Preet and Brenda. They were both fantastic therapists and helped me with separate issues such as alignment and my constant UTI's. I did my first ever Pilates class in their very well equipped studio in Joo Chiat as well which I loved! Was really pleased with the outcome of my sessions! Learnt some new moves and felt so much better!!

Kara Bensley Avatar Kara Bensley
November 8, 2023

I had a pleasant experience with the team at Embrace. The receptionist Su is very warm and always ready to help! My therapist was Brenda. I went due to pregnancy pains and post partum diastasis recti. Throughout my pregnancy and DR recovery, she recommends tailored exercises and ensures any difficulty that I had are always addressed. She also prepared me for my birth experience and not forgetting the tension releases that felt so good! It was my first time engaging a physiotherapist and it’s worth it. I’ve learnt a lot and I’m more confident of doing the exercises at home now that I’ve been “discharged”

Nur Arinah Avatar Nur Arinah
June 28, 2023

Embrace life. Embrace Physiotherapy.

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