Let’s chat for just a second about what happens to your body post-partum or if you inappropriately train your abdominal muscles with exercise. When you have a baby, your body goes through many physical and emotional changes, and this is NORMAL. We are just getting to a point where we talk about them more openly, and this is FANTASTIC. When we grow a baby, our hips widen, muscles weaken and tighten, and our rectus abdominis (“6 pack abdominal muscle”) thins. Let me give you a visual…take your child's play dough and pull it apart, right to the point of it breaking. That thinning in the center of the ball is what happens to your abdominal muscles without the proper strengthening exercises during pregnancy and is called a Diastasis Recti. For some women the muscles do not automatically come back together and you may need some hands on work and retraining of the muscle to improve strength.
Now we all know, Dr. Google gives us a TON of information about Diastasis Recti; however, it is important to be evaluated by a Pelvic Floor or Women’s Health Physical Therapist to know what muscles are tight, which are weak, and which are uncoordinated from growing and delivering a baby. Well known Physical Therapist, Diane Lee describes our body as a “canister” –the top is the diaphragm, the bottom is the pelvic floor, the front is the transverse abdominis, and the back is the multifidus. All four of these muscle groups must be round and full to have normal bowel, bladder, and sexual function; however, it is COMMON for them to become shifted during pregnancy and labor and delivery.
Do you want to know what it would look like for a pelvic floor Physical Therapist to check for a Diastasis Recti? Or check for one yourself? Here are the quick steps to do so.
Lying on your back, your PT will place two fingers on your tummy at the level of the umbilicus.
She will then ask you to lift your head and neck off of the bed as she feels for any separation in your muscle
She will check above and below the umbilicus as these are two common sites of separation
Now that we know if there is a separation, what can we do about it?
Depending on the cause of the separation, some manual therapy or “hands on” work of the torso including the lumbar spine, hips, pelvic floor, and abdomen (from “nipple to knee”) may be necessary as all of these components are connected. Once all of these muscles are loosened and ready for strengthening, your Transverse Abdominis (TA) will be the target for many exercise. How to do a TA contraction? Give 50% effort and pull your belly button towards your spine without using your compensatory muscles…it’s harder than it sounds! The coordination of the TA with hip and core stabilization exercises is what will get you back to your “new normal”. I can tell you from experience, as a momma of one, you will have a “new normal”, but those little ones are SO worth it.
Brittany Wilmoth, PT, DPT
Benjamin DR et al. 2014. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: A systematic review. Physiotherapy 100:1-8. http://www.physiotherapyjournal.com/article/S0031-9406(13)00083-7/pdf [Accessed July 2018]
Fernandes da Mota PG et al. 2015. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy 20(1):200-205. https://www.ncbi.nlm.nih.gov/pubmed/25282439 [Accessed July 2018]
Lee. Diastsis rectus abdominis & postpartum health. http://dianelee.ca/article-diastasis-rectus-abdominis.php [Accessed July 2018]
Nahas FX et al. 2004. An efficient way to correct recurrent rectus diastasis. Aesthetic Plastic Surgery 28(4):189-196.
https://www.ncbi.nlm.nih.gov/pubmed/15599529 [Accessed July 2018]
Picture location: Equinox Great Neck