You’ve probably noticed (either on yourself or someone else!) that the body needs to adapt to a growing baby during pregnancy. One of the ways it does this is by stretching the band of connective tissue between the rectus abdominus muscles (your 6 pack muscles). Research has shown that by the end of the 3rd trimester, 100% of women will have this separation, which is called diastasis rectus abdominus, or DRA. So we know that this separation is a totally normal part of pregnancy. In an ideal world, everyone’s linea alba (that’s the band of connective tissue) would return back to how it was before pregnancy, but this isn’t always the case and that’s when a DRA can be problematic.
This is when I would love to give advice about things to do or avoid in order to prevent a post-partum DRA but sadly there is still a lot we don’t understand about it. All the things you would think would increase your likelihood of having a DRA (big baby, multiples, poor abdominal strength before pregnancy, weight gain, etc)… research has shown that there is absolutely no correlation. The thought now is that it is probably more related to genetic factors, like your body’s ability to repair stretched tissues, or collagen or things like that. Which means that unfortunately there isn’t anything we can do to prevent DRA. On the plus side, it also means that if you develop a DRA, you don’t have to beat yourself up for things you may have done or not done to have caused it!
How do you know if you have a diastasis? To answer that, you first need to know the difference between a problematic diastasis and a functional diastasis. If you were to lay down on your back (you can put a pillow under your knees if your lower back tends to complain in this position), you can actually test yourself! In the midline of your torso, place the fingers of one hand on your LA. If you apply a bit of pressure, do things feel tense or do your fingers sink right in? How many fingers can sink in, and how deep do they sink (to which knuckle)? You can repeat this in 3 different areas – midway between your breast bone (sternum) and belly button, at your belly button and then 1-2cm below your belly button. Next, you are going to test what happens when you do a little curl up, lifting your head, neck and shoulders off the ground – assess the same things as when you were laying still and note any differences. Maybe your stomach bulges or domes in certain places. Maybe everything gets nice and tense. Maybe your fingers sink in more.
Once you have that information, you can determine 1- if you have a diastasis at all and 2- if it is problematic or functional. It is generally accepted that you have a diastasis if the separation is more than 2 fingers widths or if fingers sink in or the abdomen bulges during the curl up test. A functional diastasis will show signs of separation at rest but tense up nicely during the curl up test (or other abdominal exercises). A problematic DRA is one that causes symptoms such as urine leakage or pain.
The good news is, a women’s health physio can help retrain the abdominal muscles to help make them more functional. Of course, there is the occasional severe case that requires surgery to repair, but most women do very well with proper exercise prescription.
Want to learn more about diastasis and how to treat it successfully? Natasha is hosting a FREE virtual workshop on Saturday, February 27th at 11:30 am – just click the link to register!
by Natasha Tétreault - Physiotherapist
Follow me on Facebook here