The Truth about Diastasis Recti
Diastais Recti sometimes wrongly referred to as mommy tummy is a condition that we tend to associated with pregnancy and motherhood. However, Diastasis Recti is found on the bodies of more than just moms. Men, children and women who have never given birth can all have a Diastasis Recti. In actuality if you take the literal translation of Diastais Recti it means Separation (Diastasis) and Rectus Abdominis muscles (Recti), than everyone has a Diastais Recti. Yes, we all have an abdominal separation. The two sides of our Rectus Abdominis muscles are never fused together, and what is a “normal” gap will vary from person to person.
In pregnancy, 100% of women will have an increased separation between their left and right Rectus Abdominis muscles by their third trimester. Meaning, if before pregnancy a woman had a 1.5 centimetre gap, it may become 3, 4, or 5 centimetre gap by the third trimester. This separation may even be larger if a woman is carrying multiples, has a shorter torso or for many other reasons. This increased separation is the body’s natural, healthy and protective response, allowing room for baby to grow and thrive while safely managing the increased intra-abdominal pressure and therefore protecting the body of the mom. This increased abdominal separation is likely to be present for the first several weeks postpartum and sometimes longer. Often times the abdominals never return to their pre-pregnancy positioning, meaning the woman who went into pregnancy with a 1.5 centimetre separation, may live the rest of her life with a 2, 3, or 4 centimetre gap.
It is not all about the gap!
I think the term Diastasis Recti can be a bit confusing. I mean, like stated above the term actually means, separation of the Rectus Abdominis muscles. I think the terminology is misleading and unfortunately creates a lot of misinformation or unnecessary fears regarding the function of our core. I have spoken to several women who are terrified to return to exercises they once loved or who are considering treatments, sometimes surgical because they discovered they have a 2 centimetre gap (sometimes even 1 centimetre, and sometimes in the first few weeks postpartum). This discovery is often made when following directions from a friend or from Google on how to perform the basic head lift Diastasis Recti test. Like I stated above there is always a space between the right and left Rectus Abdominis muscles and discovering that you can fit 1 or 2 fingers between your abs is not immediate cause for concern. In general, a space up to 3 centimetres is within normal range and don't be surprised if the separation is a bit bigger and maybe slightly "mushier" around the belly button. This is normal. If you can fit more than 3 fingers between your Rectus muscles when doing a head lift Diastasis Recti check, you still don’t need to panic. When assessing Diastasis Recti, we actually want to asses more than the IRD (Inter-recti distance). This is the fancy way of saying the gap, separation or space between your abdominals. We want to asses the integrity of the core. This is why listening to Dr. Google, as much as I love Dr. Google, may not always be the best approach. Sure, you can definitely perform your own assessment at home, but if you have any questions or concerns, please go and see a qualified pelvic health practitioner, for a much more thorough assessment. This assessment should include breathing, alignment and how your core responds to different loads, movements and cues. Yes you can have a 4 centimetre gap and a very strong and functional core. Again it is about more than the gap.
What does it mean if my core is not responding optimally to loads and movements?
Ok, so you have gone to an appropriate pelvic health practitioner and they have determined that yes, you do in fact have a Diastasis Recti that is effecting the integrity and function of your core system. You may be asking yourself, “how did this happen?”, “why me?”, “what did I do wrong?”, “can I ever go back to CrossFit?” “Is it safe to run?”, “Do I need surgery?” and a whole host of other questions. PLEASE DON’T FREAK OUT! The term Diastasis Recti can create a lot of fear, uncertainty, and anxiety, but in most cases the integrity of your core can be restored without any surgical interventions. You may even find that with the proper treatment you may feel stronger than ever. COME ON CROSSFIT! Ok, you definitely don’t have to take your amazingly strong core to CrossFit, you will never see me at a CrossFit gym, but you can take it to do whatever activities you want, with a newly found sense of confidence and ability.
How can I achieve this amazingly strong and functional core? Is there anything I should be avoiding?
You may have heard about “Diastasis safe” and “Diastasis unsafe” exercises. The truth is, there is no such thing as a safe or unsafe exercise when it comes to Diastasis as a general condition. However, when it comes to your particular Diastasis and the function and integrity of your Core system, then yes, there are appropriate and inappropriate exercises. What makes an exercise inappropriate or less safe? A exercise that requires loading the body in a way that our bodies are not able to manage safely. These exercises will require an amount of intra-abdominal pressure that our core system is unable to accommodate. This will present as leakage, pain, abdominal bulging or doming, abdominal bracing, bearing down and breath holding. It might also present as instability. If you can do a movement with a sense of ease and feel completely in control during the movement with no lingering discomforts afterwards than it is likely a “Diastasis Safe” exercise for you.
When looking to restore the integrity of the core we need to look at many things including; breathing mechanics, alignment, how we engage our core, toileting habits, diet and hydration, stress, daily activities and much more. Diastasis Recti is much more than a core or abdominal issue. It is an entire body issue and when working to rehabilitate the core we must rehabilitate and strengthen the entire body. Working with a Pelvic Health Physiotherapist and/or a qualified health and fitness professional will give you the best chance of restoring your core and feeling stronger and more confident. And remember, you may never decrease the distance between your left and right Rectus Abdominis muscles, but you can still have a strong core. And yes, you can have an ab gap and still have abdominals that are toned and make you feel confident and sexy. However, beautiful and sexy abs have many looks and learning to embrace a little extra fat, a little extra skin or stretch marks can make you not only sexy, but strong, beautiful and an inspiration to others.