Mamas! Do you know what to do about Diastasis Recti? Hey, Mamas! Do you have a belly you wish would go away? Or maybe low back pain when you lift your baby and pressure that builds from the inside almost like you feel bloated. Don’t worry. You’re not alone, All of these can be signs of diastasis recti, a separation of the abdominal muscles that happens when the two bellies of the six-pack abdominal muscles separate from each other. And no wonder. I mean, your belly was just expanded out to hold a human being! I can’t emphasize this enough: Diastasis recti happens to a lot of new moms. It can cause back pain and make it difficult to lift your baby. It can even lead to sciatica. What’s more, you don’t have to have a baby to have diastasis recti; even men can get it. Sometimes, your daily habits can even make it worse. At Urban Wellness Clinic, we have seen diastasis recti close right on our table when we use our therapeutic approaches, including breathing techniques and exercises designed to help the two sets of ab muscles come back together. What is diastasis recti and who gets it? Diastasis means separation, and recti is the abdominal muscles, or the rectus abdominus. Diastasis recti can cause your stomach to stick out more — that pooch — because your muscles have widened and separated. Even at rest, it may be noticeable. Bottom line: The ab muscles separate from the linea alba, which is the connective tissue in your stomach. Why does this matter? The pooch isn’t the only symptom of diastasis recti. It can lead to lower back pain and urine leakage and may make it harder to breathe and move properly. Even after a mom has lost the baby weight, her stomach may not appear as flat or toned as she’d like. If that’s you, you’re not alone. Studies have shown that 60 percent of mothers have diastasis recti at six-weeks postpartum and nearly a third have it after a year. You may think you’re supposed to heal right back up after giving birth, but that’s often not the case. Now is the time to have compassion for your body and all it has been through. Other causes of diastasis recti include: sudden weight gain weightlifting or doing sit-ups with incorrect form previous C-section delivery previous abdominal surgery, including appendectomy, gallbladder removal, and “tummy tuck” naval piercings a history of liposuction carrying more weight around your abdomen weak deep intrinsic core chest breathing The 5 Daily Habits that Can Lead to Diastasis Recti Wearing high heels: Wearing heels affects posture by tilting your pelvis, think of a bucket dumping out forward. This puts pressure on the linea alba—that lining connected to the ab muscles—which can be weakened by pregnancy. This also makes for a really weak core. Poor Posture: I can’t emphasize this enough: Poor posture is the root of a lot of problems, including diastasis recti. If you stand or sit wrong for long periods of time, it can affect your abdominal muscles. For instance, standing with excess swayback (arched lower back), your hips get pushed forward, placing the pelvis in front of your center of gravity. This leads to overstretching of the abs muscles and poor stability of the deep intrinsic core. Overstretched hamstrings: The hamstrings are attached to the ischial tuberosities of your pelvis, or SIT bones. If you overstretch them, it can lead to nothing to anchor down the pelvis, which in turn, causes your abdominal muscles to weaken. Chest breathing: When you breathe only in your chest, you trigger cortisol, the hormone responsible for a flight or fight stimulus. Too much cortisol can cause the body to hold on to more belly fat. Shallow chest breathing also creates the perfect environment for a weak core. I tell our patients, you take 25,000 breaths a day minimum, so you have 25,000 opportunities to create a strong core a day. Repeatedly holding a baby on the same hip: If you’re always putting your baby on the same hip, your lower body is forced to shift in the same direction, over and over, while carrying a load. This can keep the abdominal muscles from rejoining. How is diastasis recti diagnosed? I can’t emphasize this enough: A lot of cases of diastasis recti go unchecked until the pooch is noticeable. Why does this matter? Diastasis recti can cause pelvic floor dysfunction, back pain, bloating, and hernias, so it’s important to get it managed as quickly as possible. It’s not just about the pooch! Diastasis recti becomes a really serious condition when there is a hernia associated with the separation because the intestines can get caught and strangled in the herniation–a cause for emergency surgery. If you suspect you may have abdominal separation, visit your primary care doctor, your OB/GYN, or your rehabilitation specialist at Urban Wellness Clinic. We’ll be able to tell you for sure if you have diastasis recti and provide ways to minimize its effects. Here’s the deal: Diastasis recti typically presents with several other symptoms besides just the pooch. You may have lower back pain, suffer from constipation, or have pain with sex. You may see vertical coning or tenting, which is a rise in the area in the middle of the abdomen when you’re weightlifting. In serious cases, a hernia may occur. You can check for diagnosis diastasis recti at home with a sit-up test. Lie on your back with your knees bent and feet flat on the floor. Then place two fingers above your belly button, with your fingers pointing down towards your toes, while you lift your head and neck off the floor. Repeat with your fingers below your belly button. If you feel a gap wider than two fingers in the muscles, you likely have diastasis recti. But there’s a catch: If you check this on your own too frequently, you can actually damage the tissue and weaken the muscles, worsening the gap. You may want to check at four to six weeks postpartum and then see a doctor or physical therapist for a definitive diagnosis. Don’t keep checking over and over again obsessively! 5 Moves to Heal Diastasis Recti What’s the real story? You can heal diastasis recti with exercises that focus on alignment and strengthening the core. At Urban Wellness Clinic, we use functional exercises and breathing techniques to train the ab muscles back into place. Face-down belly breathing: Also called diaphragmatic breathing, this type of breathing fully saturates the lungs with oxygen while pushing the belly out. If you lie face down, you can feel the belly expand against the floor while you inhale and relax while you exhale, helping you use correct belly breathing form. You should feel your breath go down into the lower belly, wide into the waist, and fill into the low back. 6-month supine: You lie on your back with your knees bent just above 90 degrees and hip-width apart with your feet almost touching. Next, you breathe in and then when you breathe out, keep your belly full of air by at least 50%. Do not tuck your pelvis to flatten your lower back. 6-month supine under load: Repeat the exercise above, but hold book or light weight towards the ceiling. Isometric oblique sling activation aka hard style roll: Slings are muscle groups that transfer rotational force through your trunk. The anterior oblique sling runs across the front from under the armpit, across the abdomen to the leg, and the posterior oblique sling runs the same way across the back. This activation is what started to close the diastasis recti on a full braced core. Low oblique sit rolls unweighted and weighted: Lie on your back with your arms straight out and legs bent, feet flat on the floor. Cross your arms like you are hugging yourself. Then slowly lift your right shoulder off the floor and bend toward the left. Alternate lifting your shoulders to activate your oblique muscles. You can add weight for additional load. Got diastasis recti? Don’t do this! One of the worst things you can do for diastasis recti are exercises like crunches, planks, or forward folds, especially too soon after giving birth. These exercises harm more than help. Instead, focus on the exercises that don’t really feel like exercise at all, such as deep breathing and moving like a baby. Breathe deep from your diaphragm with 360-degree expansion around your abdomen, waistline, and low back. That’s not all: Tools like splints and braces aren’t healing your muscles. Rather, they’re simply taking the load off and helping support the muscles, not necessarily providing long-term results. So don’t rely on splints and braces to heal diastasis recti. When your diastasis recti is more serious Surgery for diastasis recti may be an option for more serious cases with three or more fingers width of separation and those with hernias, strangulated intestines, or debilitation. But there’s a catch: Insurance companies often determine that surgery for diastasis recti, called abdominoplasty, is a cosmetic procedure unless paired with hernia surgery. That’s because it’s essentially a tummy tuck, where the muscles are sewn back together. If you have an abdominoplasty, beware. At Urban Wellness Clinic, we often times we see neck and back pain down the road with our tummy tuck patients, because they have been tightened down so much. We can help! Generally speaking, the best relief from diastasis recti comes from building up the deep intrinsic abdominal strength again, whether through exercise or breathing work. We are experienced in diagnosing and treating diastasis recti. Contact us today about diastasis recti. Call us at 212-355-0445 or email us at hello@urbanwellnessclinic.com. We’re here for you! Best in health, Dr. Emily Kiberd Share this post