For some, that “four months pregnant” appearance can last for months to years. It is a common question that postpartum moms ask from an aesthetic standpoint, but as a pelvic floor therapist it can indicate the integrity of the abdominal wall. The timing at which this appearance can improve hinges on your genetics, daily posture, the degree of physical changes (and trauma) your body goes through, what your current health, nutrition and fitness levels are like. This blog will not go into how to lose that baby weight or achieve a flat tummy, rather how to rehabilitate the abdominal injury that is diastasis recti (DR).
What is a diastasis recti?
DR occurs when the rectus abdominis, your 6-pack muscles, separate in the front of the body. This commonly occurs during pregnancy affecting over 60% of childbearing women, but can also be found in persons with stomach obesity. As the abdomen increases in size, it stretches the front abdominal wall leaving the linea alba (connective tissue between your abdominal muscles) vulnerable to separation. The degree and severity of DR are unique to each individual and with each pregnancy, however, this can lead to a bulge or “pooch” in the abdomen. This is noticed more so when doing sit ups or crunches.
Why should I care?
Although it is normal having to have degrees of abdominal separation, if it is large enough and does not resolve on its own it can lead to recurring low back pain, pain during sex, constipation, pee leakage and other pelvic floor issues. This can spill over into your workouts, playing with your kids, etc.
How do I check for DR?
You can lay on your back with your knees bent. Place two fingers at your belly button pointing down toward your spine. Lift your head slightly to engage the abdominals like you are initiating a crunch. If more than two fingers can fit in the gap, then you likely have DR. Repeat this check two inches above the navel and 2 inches below.
I have DR - What now?
I would recommend pausing on activities that put undue stress on the abdominal wall like crunches, any plank variation, full push ups, toes to bar and pull ups. That does not mean that you will not be able to do these activities again, rather it will improve your capacity to load your body once the abdomen is working better. If not, the chances of experiencing the above symptoms are great.
Based on your unique presentation, we will go over specific exercises to enhance the function of your entire core (bonus, it may aid in flattening the tummy!), breathing techniques, posture hacks, and ruling out related pelvic floor dysfunctions. We will build a plan together to not only get you to feel your best, but to move your best!
Thanks for reading,
Dr. Krystal Fannin
Dr. Danny and staff's views on performance improvement, injury prevention, and sometimes other random thoughts.