This is the sixth post (Week 15 in the series "What you don't expect when you're expecting".
First off, what is diastasis recti?
DR (I’m gonna be like all the cool researchers and abbreviate, because diastasis recti is a lot to type) is the widening and thinning of the connective tissue around and between (the linea alba) your 6-pack. It can occur for a number of reasons, but most notably, it happens during pregnancy.
TIP: Click any of the following Myths to read more about them!
The widening and thinning of the linea alba is a normal process in pregnancy. Otherwise, where would the baby go? Your rectus abdominis (6-pack) can only stretch so much, but the linea alba? It’s perfect for stretching and spreading, due to its tensile properties.
DR is now believed to occur in 100% of women at the time of delivery (1). It should NOT be considered abnormal or pathological. But a DR that overstays its welcome? Possible problem.
Approximately 1 in 3 women will have a lingering, dysfunctional DR at 6 months postpartum (1). So how can you tell if you are that ONE?
The best way is to visit a physical therapist or exercise specialist (oh, hello, that’s ME!) who is trained in DR recovery. These professionals can tell the difference between a DR that’s functional and one that is not. Check out Myth #3 for an example.
You can also check yourself. A quick “diastasis recti check” search in YouTube will give you a ton of videos.
I’m not just speaking to those 6 months postpartum. I’m speaking to YOU, mama. Yeah, you with both kids in elementary school. You who just became an empty nester. Yes, even you who has welcomed your first grandbaby into the world.
It is not too late to address the movement and postural habits that are keeping you from feeling like the best version of yourself. The trained eyes of a health or fitness professional will give you what your body needs to get on the road to recovery.
“Old School” DR thinking was all about measuring the width of the linea alba. If you found a DR check video on YouTube, you probably noticed that three locations were checked: above, at, and below the belly button. While there is no international consensus which defines an exact width for DR, common thought is 2 finger widths. It has been suggested that gap bigger than 2 fingers wide can lead to problems such as pelvic or low back pain. But here is the interesting thing: there have been multiple studies looking at the relationship between DR width and low back pain and none of them have found any relation. At 6 months postpartum, women with DR were not more likely to report lumbo-pelvic pain than those without DR (1).
So what gives?
New research suggests it is not the width of the gap but the integrity of the linea alba that is the important factor in “diagnosing” DR (2).
Remember when I suggested seeing a health or fitness professional? Here’s another reason why...
Thelma and Louise are both 6 months postpartum. They are both concerned about DR so they hop over to YouTube and do a self check. They both discover a 2 finger wide gap so they head to their local DR professional. The professional discovers that Thelma’s 2 finger wide gap bulges when she does planks. Louise’s 2 finger wide gap does not because she can create tension in her linea alba. Same width, but one would be considered a pathological DR (Thelma), the other would not (Louise). The DR professional can help lead Thelma through exercises and movement patterns to get her on the road to recovery.
Whoa - slow your roll there, sister!
While yes, this may be the case for some women, I am of the mind that all options should be exhausted prior to surgery. If the gap a postpartum woman is experiencing is a result of less than optimal body mechanics, surgery will only provide a temporary fix. Similar to ACL repair – if the movement patterns aren’t addressed, the problem will come back.
At the risk of sounding like a broken record, reaching out to a health or fitness professional will help you determine a course of action that is right for you.
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Mota, P. G., Pascoal, A. G., Carita, A. I., & Bø, K. (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, 200-205.
Lee, D., & Hodges, P. W. (2016). Behavior of the linea alba during a curl-up task in diastasis rectus abdominis: An observation study. Journal of orthopaedic & Sports Physical Therapy, 46(7), 580-589.