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Myth #2: I Should be Better by Now

Updated: May 13, 2021


This is the third post of a 5 part series - 4 Myths about Diastasis Recti. You can read the original post HERE.

 

More often than not, DR corrects itself on its own. There are many factors that can contribute to how quickly this happens: diet, genetics, body mechanics and posture, physical shape before and during pregnancy, and sleep. You remember sleep, right? That thing where you lay down on your bed when it’s dark and don’t get back up for 8 hours? Give new importance to the advice “sleep when the baby sleeps,” amiright?


Looking at this list, I hope you see that while some factors are in your control, other are totally not. So just realize you may be genetically predisposed to a longer recovery - and that’s okay. Another factor that is being looked at is breastfeeding. The pregnancy hormone relaxin can stay in your body up to 4 months after you stop breastfeeding or pumping.

Relaxin, if you recall, softens your connective tissue to assist the pelvis in opening for birth. Since the hormone can’t tell the difference between the ligaments in your pelvis and your linea alba, you may not start seeing significant results in DR resolution until you are done producing milk. Ooof - motherhood really is the ultimate sacrifice!


Alright, back to the data. Let’s check out some studies:


A study of 84 women by Fernandes da Mota et al. found that 100% of women had DR at delivery, 52.4% still had it 4-6 weeks postpartum, and 39% 6 months later (1). Their “definition” of a DR was a separation greater than 1.6 cm, which was concluded by another study after looking at the linea alba of women who had never had babies. But is that comparing apples to oranges? Should we expect the postpartum linea alba to be the same as one whose limits have never been tested? Or should we worry less about the exact numbers and focus on how we look, feel, and function?


Coldron et al. measured the linea alba of 115 postpartum women and 69 age matched women who had never had children (control). While the width and depth of the postpartum linea alba improved, it still did not reach the levels of the control group by the 12 month mark (2). Again, will it ever?


The American College of Obstetricians recommends exercise during pregnancy and logic says if your separation width is smaller to begin with (during pregnancy), your resolution will be quicker. Chiarello et al. looked at the effects of exercise on DR width in pregnant women. The average width for the exercising women was 1.14 cm and 5.95 cm for non-exercising. That’s a big difference! Each group was about 25.5 weeks pregnant on average, so it’s not like they were comparing women in their first trimester to women in their third.


A case study by Collie and Harris looked at a 34-year old woman who was six years postpartum. She had a lingering DR of 4 finger widths along with pain, swelling, and lack of abdominal function. The good news? After 3 months of targeted physical therapy, the pain completely resolved and function was restored (4)! IT’S NEVER TOO LATE!


Moral of the story?

  • The natural resolution of DR is different for everyone

  • It is dependent on factors both in and out of your control

  • In your control? Exercise - specifically modalities which focus on breath and transverse abdominis activation (like Pilates!)

  • Targeted physical therapy can make a big difference

Let’s continue the conversation! Join our Facebook community of mamas and mamas-to-be on our journey to look, feel, and function better.

 

References:

  1. Fernandes da 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.

  2. Coldron, Y., Stokes, M. J., Newham, D. J., & Cook, K. (2006). Postpartum characteristics of rectus abdominis on ultrasound imaging. Manual Therapy, 13, 112-121.

  3. Chiarello, C. M., Falzone, L. A., McCaslin, K. E., Patel, M. N., & Ulery, K. R. (2005). The effects of an exercise program on diastasis recti abdominis in pregnant women. Journal of Women’s Health Physical Therapy, 29(1), 11-16.

  4. Collie, M. E., & Harris, B. A. (2004). Physical therapy treatment for diastasis recti: A case report. Journal of the Section on Women’s Health, 28(2), 11-15.

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