• Gabrielle Babineau

Diastasis Recti In Pregnancy & Postpartum


What is Diastasis recti [Di-asta-sis rec-ti]?

A woman’s body goes through many physical and physiological transformations during pregnancy. An important region that is very much affected during this gestation period is the abdominal muscles. More specifically, the rectus abdominis muscles, or what we all refer to as the “six-pack.” There are two bellies that construct this muscle that are connected together by a fascia tendon which is called the linea alba.


Pregnancy commonly, causes diastasis recti (DR). Diastasis recti is the separation of these two bellies along the linea alba. It occurs due to hormonal elastic changes of the connective tissue caused by the relaxin hormone, the growing fetus, and the displacement of the abdominal organs. As the baby grows, the bellies of the rectus abdominis muscles elongate and curve round as the abdominal wall expands leaving a separation between the two bellies. DR is very common and affects over 60 percent of pregnant women.


Studies also show that 60% of postpartum women

have some degree of abdominal separation months after delivery.


What’s the problem with diastasis recti?

It’s important to know that DR doesn’t spontaneously resolve for many postpartum women and may even persist for many years if not properly rehabilitated. Since the abdominal muscles play an important role in trunk control and function, the presence of DR can diminish its functions and present discomfort such as lower back pain. Posture, trunk stability, respiration, trunk flexion and rotation, and pelvic stability are all affected by DR, leaving the lumbar spine and pelvis vulnerable to injury. It also increases the difficulty in engaging the rectus abdominis muscles leaving the abdomen region weak. Lastly, DR ranges from mild to severe, depending on the width and length of the abdominal separation.

Prevention and rehabilitation

The exciting news is that exercise has been revealed as an important tool in diastasis recti prevention and rehabilitation. Try to include abdominal muscle activity in your exercise routine during pregnancy and postpartum, specifically the transverse abdominis (TA) muscle (deep abdominal wall), while avoiding exercises that engage the rectus abdominis (i.e. crunches). Pelvic floor exercises are also very beneficial exercises that help with diastasis recti closure, alignment and urinary incontinence. Simple yet effective TA exercises are crucial to DR prevention and rehabilitation in both the prenatal and postnatal phase.

How do I know if I have diastasis recti ?

If you suspect that you have an abdominal separation, we recommend that you speak with your family physician, a specialized physiotherapist, or a postpartum exercise specialist. They will be able to evaluate your diastasis recti and guide you towards an individualized rehabilitative program. All diastasis rectis are not identical and should be treated according to the severity of the separation and to the individual’s strengths and weaknesses.

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Exercises to avoid until you’ve been assessed by a professional:

  • ​Crunches, forward planks, push-ups, and twisting torso exercises.

You can contact us if you have any questions during or after your pregnancy! Martine can help you optimize your health and exercise routine!

References:

Benjamin, D. R., van de Water, A. T. M., & Peiris, C. L. (2014). Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy, 100(1), 1–8.

Chiarello, C. M., Falzone, L. A., McCaslin, K. E., Patel, M. N., & Ulery, K. R. (2005). The Effects of an Exercise Program on Diastasis Recti Abdominis in Pregnant Women. ResearchGate, 29(1), 11–16.

FitzGerald, M. P., & Kotarinos, R. (2003). Rehabilitation of the short pelvic floor. II: Treatment of the patient with the short pelvic floor. International Urogynecology Journal, 14(4), 269–275.

Hickey, F., Finch, J. G., & Khanna, A. (2011). A systematic review on the outcomes of correction of diastasis of the recti. Hernia, 15(6), 607–614.

Keeler, J., Albrecht, M., Eberhardt, L., Horn, L., Donnelly, C., & Lowe, D. (2012). Diastasis Recti Abdominis: A Survey of Womenʼs Health Specialists for Current Physical Therapy Clinical Practice for Postpartum Women. Journal of Womenʼs Health Physical Therapy, 36(3), 131–142.

Mota, P. G. F. da, Pascoal, A. G. B. A., Carita, A. I. A. D., & Bø, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy, 20(1), 200–205.

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