Diastasis Recti- Is it all about the gap?
What about the “The Gap”? Is always a commonly asked question during pregnancy and in the post-natal period.
I thought it would be good to look at what is normal and what is involved in assessment and treatment.
Diastasis Recti is the thinning and widening of the Linea Alba - the connective tissue between your rectus abdominis (your 6 pack muscles) and the laxity of your anterior wall and the loss of strength and tone of your muscles within your abdominal wall.
This means that Diastasis Recti is more than "the gap" between your abdominals but encompasses the entire abdominal wall.
The anterior abdominal wall consists of your deep abdominals - Transversus Abdominis, obliques - internal and external and your rectus abdominis.
What is normal?
Many people think that the presence of any gap between the muscles means they have a diastasis. This is not the case. The Linea Alba is the connective tissue that joins the 2 rectal walls together. We have a gap between these muscles for many reasons - the obvious one is pregnancy - allowing room for the baby to grow. The abdominal wall also needs to be able to expand for eating and breathing - so we need the gap!
During pregnancy 100% of women will develop some level of diastasis from 35 weeks gestation onwards. This allows the baby to grow. Research shows that 1/3 of women will require input postnatally for Diastasis.
The gap becomes an issue when the integrity of the underlying tissue changes. This can mean that there is increasing laxity, loss of muscle and strength of the abdominal wall.
How do I know if I have one?
You may notice an increase in the gap between your six pack muscles, which was more than what you had prior to pregnancy. You may also notice a coning or doming of the abdominal wall with movement, down the middle of the tummy or the tissue dropping down between the 6 pack muscles.
How do we assess it?
When looking at Diastasis, we have to look at the entire body and how it is moving (not just the abdominals) as this all has an effect on how the abdominal wall functions.
We look at your posture, how you are sitting, standing and moving. How you are breathing.
We look at how you recruit your abdominals, and pelvic floor.
We also want to look at the tension and depth of the connective tissue between the muscle bellies.
Having good tissue tension is far more important than the size of the “gap”
How do we treat it?
To bring change to the muscles and connective tissue we need to load it! Exercise is really important.
We will teach you how your breathing is super important with the connection of your abdominals and pelvic floor and we will show you how to incorporate this not only into your exercises but all day to day activities.
We will provide an exercise plan that focuses on your needs. We want you to achieve your goals so we will build your rehab around want you want to do and modify and progress exercises to help you to achieve this.
It is important to remember that what is safe and appropriate for you initially will change over time. No matter what your movement goals are, there is no such thing as a bad exercise, it might just not be the best exercise for you right now!
If you have any concerns regarding your abdominals or pelvic floor post birth, feel free to call us for more information, or to book your Womens Health Physiotherapy consult on 07 5337 9853.