I've written a few blog posts in the past about diastasis recti, but like all science and information, recommendations change over time. I'm constantly reading articles and attending classes to learn the latest research and recommendations in order to help my clients in the best possible way, which is why I figured it is time to write an updated blog about diastasis recti.
This topic has been so popular in the past few years. Unfortunately I think a lot of that comes from body image and fear that our culture preys on. Especially living in Southern California moms tell me all the time the pressure they feel to "get their body" back after having a baby. Living in an environment that is warm with beach and pool weather nearly year round adds to this pressure.
Social media, television, movies and celebrities have also fed into this fear and pressure. Most people don't have access to 24 hour caregivers, cooks and trainers like many celebrities do in order to "get their pre-baby body back." Also, this isn't healthy! It took 10 months to grow and birth a baby, it takes time for the uterus to shrink, the muscles to return to their pre-pregnancy state and for strength to return. As long as breastmilk is being produced, hormone levels are going to be altered and have an effect on tissue healing. Give yourself time!
Diastasis recti is defined as the separation of the rectus abdominus, or six pack muscles. These muscles have two sides that meet in the middle of the abdomen and are connected via connective tissue, which is what gets stretched in diastasis recti. It isn't a hole in the muscle, that is called a hernia. Diastsis recti is a thinning of the connective tissue holding the two sides of the muscle together.
First of all it is 100% normal and expected to have a diastasis recti during pregnancy. The body was designed this way. The abdomen has no bones between the ribs and the pelvis so that it can stretch to accommodate a full term baby. It adapts to this by the abdominal skin and muscles stretching, and creating a separation in the muscles in order to make room for the baby. It is normal and expected. There is nothing you can do to prevent diastasis recti during pregnancy. Don't let anyone tell you otherwise. How much the abdominal muscles separate will depend on the size of the pregnant person's torso length, how much weight is gained, and how large the baby is. Most of these factors are uncontrollable. Thankfully the body is made to adapt!
There are things one can do during pregnancy to prevent the diastasis recti from increasing more than is going to happen naturally.
First, it is ok to exercise during pregnancy. There are no off limits exercise, however a pregnant person needs to pay attention to what that exercise is doing to their body. I saw it once described as pregnancy is not the time to increase core strength but to maintain. That being stated, core and abdominal exercises may need to be altered, modified or put on hold during pregnancy. A pregnancy and postpartum athleticism coach or a pelvic floor physical therapist can help guide you in safe exercises.
If you are exercising you want to make sure you aren't creating doming/coning/tenting in the middle of the abdomen, as seen in the video above. If you see this you will know. One client described it to me as it looked like an alien popping through her belly. This is the thinning and separation of the connective tissue of the abdominal muscles and whatever exercise you are doing is putting too much pressure on the abdominal muscles creating the doming. Try to avoid this. You can do this by: decreasing the intensity of the exercise, make sure you are breathing and not holding your breath during exercise or activity, maybe change the position you are exercising in.
This doming or tenting mostly occurs with exercise, but can also occur with every day activities, like getting up out of bed or picking up a toddler. Apply the same principles if you see this in every day activities: make sure you are breathing, try to change your strategy or position in how you do these activities.
The bottom line is diastasis recti is NORMAL and expected during pregnancy. You didn't do anything wrong to create this. Don't let anyone sell you some program that claims to prevent diastasis recti.
You can make sure to avoid straining and activities that create more pressure and make it worse.
You can also consult with a pelvic physical therapist or a certified pregnancy and postpartum athleticism coach who can help you figure out which exercises are safe for you to do throughout your pregnancy.
We offer in person and virtual consults to help pregnant people (and others). You can book via the page on our website. You can also set up a free phone call if you aren't sure what you need and want some guidance before booking something.