If your belly still looks pregnant months after delivery, a common post partum condition called diastasis recti might be the cause. During pregnancy widening and thinning of the mid line abdominal tissue, or the rectus abdominis, occurs due to force of the uterus pushing against the abdominal wall. Pregnancy also causes changes in the hormones that soften connective tissue, causing a separation between the right and left abdominal muscles resulting in a protruding belly. Diastasis recti can occur anytime while you are pregnant, but it is most common in the third trimester or after pregnancy because this is when the abdominal wall is most lax, and the tissue can no longer provide support. A small widening in the mid line of the abdomen happens in all pregnancies, but a separation of more than 2-2.5 finger widths when the rectus abdominis is contracted can pose problems. What kind of problems can occur? Well, diastasis recti reduces the functional strength of the abdominal wall causing low back pain and pelvic instability. Can you prevent diastasis recti? Yes! Protecting those muscles that are vulnerable to separation can help keep the integrity of the abdominal wall. While you are pregnant, it is important to use the log roll maneuver when getting out of bed, or up from the couch or chair to prevent stressing the rectus abdominis. In other words, roll to one side keeping your head aligned with your torso, then use your arms to help push yourself up to a seated position. The following are other movements to avoid while pregnant to protect your core.
- Exercises that require lying backward over a large exercise ball
- Yoga postures that stretch the abs, like “cow pose,” “up-dog,” and all backbends
- Abdominal exercises that flex the upper spine off the floor or against the force of gravity such as: as crunches, Oblique curls, bicycles
- Lifting and carrying very heavy objects
- Intense coughing without abdominal support
How do you treat diastasis recti? Not everyone needs special attention for diastasis recti because some women will have spontaneous recovery where the connective tissue will come back together. However, if months after you give birth you still notice tummy pouching, back pain and pelvic weakness then there are exercises that a physical therapist can teach to target the deep core muscles and stabilizers, like the transverse abdominis. The pelvic floor muscles are also considered part of the core, so performing kegels is another useful tool for overall strengthening. During pregnancy, significant body changes occur that affect posture, strength and mobility. Having a physical therapist assess these issues like spinal tightness or weakness in the joints and poor postural awareness can all help improve symptoms of post partum diastasis. Before starting an exercise program, schedule an appointment to see a physical therapist that specializes in pelvic floor. They can assess the severity of the diastasis recti and create an appropriate plan of care for your recovery or refer you to suitable medical providers.
References
- George A. What you can do about diastasis rectus abdominis (DRA). Website. http://www.motionmn.com/what-you-can-do-about-diastasis-rectus-abdominis-dra/. Published September 20, 2017. Accessed July 17, 2019.
- Leeder J. Diastasis recti symptoms and how to treat it. Website. https://www.todaysparent.com/baby/postpartum-care/how-to-spot-and-treat-a-diastasis-recti/. Published January 3, 2017. Accessed July 17, 2019.
- Rebelle T. How to prevent diastasis recti with crunches. Website. https://blog.nasm.org/womens-fitness/how-to-prevent-diastasis-recti-with-crunches/. Published June 11, 2018. Accessed July 17, 2018.