My Journey With Diastasis Recti & What I’ve Learned

September 9, 2016

Hi ladies! I have another special guest blogger on today talking about her major case of Diastasis Recti and how she conquered it naturally! She is so inspiring and I hope you all enjoy her as much as I do~

5 years ago I had never even heard the words “diastasis recti”. After having my second son I saw the changes in stomach but I assumed they were normal. Nobody had ever really told me what to expect from my body during or after pregnancy. I assumed the protrusion in my abdomen was due to 9 months of pregnancy, which wasn’t untrue, but at the time I didn’t know there was much more going on. It was not until I started speaking to other mothers about their postpartum bodies that I realized maybe everything I was seeing and feeling from mine wasn’t normal. I remember searching for ways to lose the belly fat. I remember trying all the traditional ab exercises I could think of; I did 50 sit-ups every morning, followed by 50 crunches. I did oblique twists, I planked. I was obsessed with getting lean again so I did high intensity interval training 5 days a week, and focused on large amounts of cardio. The appearance of my stomach didn’t improve. Nor did it relieve my back pain or increase my physical strength. Then one day I posted a photo of myself planking to a social media group. I was exposing my midriff and my stomach sank down between my abs. A group member commented on the photo and asked if I had “diastasis recti”. Not knowing what it was I googled it. Then I saw it; google images flooded with all these photos of bellies, bellies that looked just like mine.

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What is diastasis recti?

Diastasis recti (commonly known as abdominal separation) is defined as a gap of greater than 2cm between the right and left halves of the rectus abdominis (abdominal muscles shown on lean people as a six pack). It can appear as a protrusion or indentation along the midline of the stomach (the linea alba) and is associated with a distended belly. Diastasis recti is a result of weakened core muscles and is also associated with a weakened pelvic floor. It can cause lower back pain, and a weak pelvic floor can cause urine to leak out during activities of everyday life. Untreated in can lead to pelvic organ prolapse.

What causes diastasis recti?

Diastasis recti (DR) is a result of the stretching and weakening of the abdominal connective tissue, the linea alba, which can happen as a result of sudden weight excessive weight gain, overtraining, or most often in women, as a result of pregnancy.

How to test for DR

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  • Lie flat on your back with your legs bent at the knees but soles of feet planted on the ground
  • Place one hand behind your head, and the other hand on your abdomen with your fingers across your midline, parallel with your waistline, at the level of your belly button
  • With your abdominal wall relaxed, gently press your fingertips into your abdomen
  • Slowly raise your head lifting your shoulder off the ground so your ribcage moves closer to your pelvis (in a crunch-like movement)
  • Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominis muscle. Test for separation at, above, and below the belly button.

DR separation is measured according to the number of fingers you can fit between the gap. Also pay attention to the depth. There was a time I could fit my entire fist between my rectus abdominis.

Once I discovered I had diastasis recti, I wanted to know how I could fix it. The initial responses I received were discouraging. Many people believed, and advised surgery as the only solution. Having already suffered through a failed abdominal surgery as a child (to repair an umbilical hernia) I was not fond of the idea and wanted to avoid that route if at all possible. I did however want to keep all my options open so I booked an appointment with a Nurse Practitioner (NP). The NP examined by body, confirmed I did have DR (a large gap of 6 fingers) and referred me to the General Surgeon. She told me because of his schedule that the appointment would not be for 6 months. I didn’t want surgery. I knew that. So I decided I had 6 months to see if there was another route, and I started researching.

Diastasis recti is due in part to a weakness in the core. People often use the words core and abs interchangeably leading to the belief that they are the same thing when in fact they are not. The core refers to all the muscles surrounding and supporting the middle of the body and so includes the muscles of the back as well as the muscles of the abs. Another problem in thinking is that when many people talk about abs they are often only talking about one set of muscles, the rectus abdominis, whereas the abs actually consist of 4 different muscles: the rectus abdominis and external oblique’s, beneath that the internal oblique’s, and beneath that the transverse abdominis (TVA). What is special about the TVA is that it wraps around the entire core like a belt. It is known as the body’s internal corset. This muscle is not visible from the outside but it important because a weak TVA means a weak inner belt and thus a protruding stomach. The role of the TVA is also to support and stabilize the spine so a weak TVA and an unsupported lower back will lead to lower back pain. Muscles in the body work together in synergy. Weak back muscles put more pressure and load on the abdominal muscles and weak abdominal muscles put more pressure and load on the back muscles, and the entire core suffers as a result.

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Understanding my core was my key to understanding how to improve its strength and appearance. Diastasis recti is not a superficial ab problem and so doing superficial abdominal exercises will not help improve it. Exercises such as crunches, sit-ups, and v-sits mainly target the external core muscles, the rectus abdominis and external oblique’s. These may help define your six pack when you’re lean enough to see it but they won’t address the core weakness.

There are some major mistakes I made when I first began training with DR:

  • I did sit-ups, crunches, v-sits, oblique twists and frontal planks. These exercises (and other similar ones) increase intraabdominal pressure which forces your internal organs to push against the weakened and stretched connective tissue (linea alba) weakening it further.
  • I did HIIT workouts and I ran sprints. These exercises were too high intensity and put too much stress on weak muscles that could not support my core.

Misconceptions about relating to fitness with DR

  • DR is permanent
  • Surgery is the only option
  • Crunches and sit-ups are the best core exercises
  • HIIT is the best way to lose weight
  • Those with DR will never be able to lift weights

DR affects the core and movement and movement affects DR and the core. Healing DR goes beyond the gym and involves changing every day practices. Something I began to do was to start avoiding daily movements that increased internal pressure and exasperated DR. So you know not to do crunches or sit-ups during your workout but it is also important to avoid crunch or sit-up like movements during daily living. The average person may only spend 30 to 40 minutes daily exercising but will spend 12 to 14 hours awake and in this time poor health practices (such as poor posture or doing sit-ups to get up) would undo the work done at the gym. Something as simple as getting out of bed may be an activity you have to reassess and change how you perform it. Women with DR should always raise their bodies from a supine position (on your back) by using the log role.

*Log roll: with your torso and head aligned, roll over unto your side then use your arm to push yourself up to a sitting position

Tips for healing DR

  • Start with low intensity exercises and focus on your deep core muscles. A simple exercise to help you learn how to engage your core muscles to strengthen them (and which can safely be done prior to 6 weeks postpartum) is the Ab Hold. The Ab Hold is an abdominal exercise that targets your body’s inner belt, the TVA.

    How to do an Ab Hold:
    – Sit on a stool or stability ball with your back straight. Ensure you are sitting on your sit-bone (you can do this by spreading your butt cheeks as you sit).

    – Maintain good posture by drawing your shoulder back, and raising your chest up. Keep a slight, natural curve in your lumbar spine (lower back).

    – Inhale fully. As you exhale draw your belly button in towards your spine. Imagine you are trying to touch your belly button to the back of your spine. Fully exhale as you do this. You should feel a tightening around your waist. At the same time as you draw in your belly button, slowly raise your pelvic floor (try imagining that you’re trying to draw a marble up into you). Begin by holding this contraction for 5 seconds while breathing naturally. Relax your core muscles after 5 seconds. Each week, incrementally add time to the ab hold maxing out at a 20 second hold. The weaker your abdominal muscles, the more difficult this exercise will be.

    An ab hold is a simple, low intensity exercise that targets the TVA. It is important to know how to engage your core as you will need to consciously engage it during other movements such as when lifting a load (including your child) or when doing a hip flexion (bending over). Engaging your core when lifting (an ab hold) helps reduce and support the build-up of internal pressure.

  • Begin with exercises where you are in the supine position and do not raise your head or shoulders off the floor, such as lying heel slides, toe taps, lying alternating leg raises, and glute bridges.
  • Do not continue an exercise if you notice your stomach bulging out along the linea alba as you perform it.
  • Squats are one of the best exercises for DR. Squats are important because it is a functional movement of life and works most muscle groups. It is an important core exercise because it engages all the muscles of the abs and the back. During a squat, always exhale as you’re bringing your body up from the bottom of the squat (when your body is bearing the most load.
  • Do exercises that target your back muscles. Most women are so focused on their abs postpartum their neglect their back. Your back muscles are part of your core musculature and work together with your abdominal muscles. A strong back will reduces the lower back ache often associated with DR by strengthening the muscles surrounding the lumbar spine.
  • Initially avoid front loading exercises such as frontal planks or push-ups, but reverse planks and side planks are a safe exercise.
  • There is some debate on this next tip, but I’ve personally found abdominal binding to be my best friend. I wear a waist cincher during exercise to help support by back and abs when lifting. I began 3 years ago by wearing it daily for 10 to 14 hours and have reduced the length of time I wear it over the years as my core has strengthened. The benefits of abdominal binding postpartum is that it gives support to a weakened core by imitating the role of the TVA, the body’s internal corset and physically pushes the separated abdominal muscles closer together so they can heal together. You must take precautions though not to over-constrict to the point of discomfort and not to rely on the binder. This means binder or no binder you should still exercise, do ab holds and consciously engage your core when bearing a load. The binder itself does nothing but in association with the proper exercises I’ve found it helps. On a vanity level, it help with confidence as you’re healing (nobody wants to be asked if they are pregnant when they are not).
  • Nutrition is an important aspect of healing. Your body rebuilds itself from the nutrients it gets from your meals, so having a healthy, natural, nutrient dense diet is important. Dark leafy greens, such as kale and spinach are shown to encourage collagen production in the body which helps strengthen the linea alba. It’s also important to keep hydrated by drinking water

6 months after my diagnosis I had my appointment with the General Surgeon. I had been exercising for 6 months, binding for 6 months and eating a healthier diet for 6 months. I was lifting weights (gradually and incrementally adding to the load I lifted) and maintaining walking or a steady jog for my cardio (not sprints). The surgeon examined my stomach and confirmed that I had a 3 finger gap (3 fingers less than 6 months prior). He said that although it was clear there was a separation he viewed it as only aesthetic as he said my core muscles were strong and the linea alba showed good tension. He said he would not recommend surgery for me. Those words were music to my ears. Without putting one foot unto that surgical table my DR improved. Naturally.

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I’ve been on this DR journey for 3 years and have learnt a lot in that time. Most importantly is that surgery is not the only option, the body has the capability to heal itself if you know how to assist it, and that DR takes time to heal. Most decent DR programs on the market are 12 week programs. These programs are designed to build a safe foundation of exercises and an understanding of DR but complete heaking can take months or even years. It’s not a sprint, it’s a marathon, but your body is worth the effort.

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For more tip on DR and safe workout options please visit my blog Facebook.com/MummyFitness where you can message directly.

 

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PLEASE NOTE: Following and/or participating in my blog, daily workouts, meal plans, and any tips or advice is solely your decision. I recommend checking with your physician prior to following any of the workouts or meal plans that I share. I am very open in sharing that I am not a health care professional, personal trainer, nutritionist, or counselor. I provide the workouts, meals, and tips that have worked for me based on my personal experiences.

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