Most women accept that pregnancy and childbirth change their bodies. But they don’t realize that these changes can be fixed. The most common fixable change includes a diastasis recti (DR) (translation: the separation of the abdominal muscles), which occurs due to pregnancy.
What is a Diastasis Recti?
Abdominal separation or diastasis recti (DRAM) is a common condition of pregnancy and postpartum when the right and left halves of your abdominal muscles spread apart at the body’s midline.
During pregnancy, separation occurs down the midline as a result of the force of the uterus pushing against the wall of the abdomen coupled with the influx of pregnancy hormones that soften connective tissue
Diastasis recti can occur anytime in the last half of pregnancy, but most commonly occurs after pregnancy when the abdominal wall is lax and the thinner midline tissue no longer provides adequate support for the torso and internal organs.
A small amount of widening of the midline happens in all pregnancies and is normal. In fact, a diastasis recti occurs in about 30% of all pregnancies. Although some women’s midlines spontaneously close to less than a 2 finger-width after labor, for many, the tissue remains too wide. A midline separation of more than 2 to 2.5 finger-widths, or 2 centimeters, is considered problematic.
What’s the Problem with a Diastasis Recti?
A diastasis recti can lead to pelvic instability due to abdominal wall weakness. This instability can create a number of problems. These include:
- Abdominal discomfort with certain movements, such as rolling over in bed, getting in/out of bed, and lifting heavy objects
- Umbilical hernia
- Pubic symphysis pain
- Sacroiliac joint pain
- Low back pain
- Pelvic floor dysfunctions, such as urinary, fecal, and flatulence incontinence and pelvic organ prolapse
Checking for Diastasis Recti
I always check for a DR during a patient’s initial visit. The sooner it is caught, the easier it is to rehab. We typically see both postpartum moms and post-abdominal surgical patients at, or after the six-week mark, which is when physicians clear most patients for therapy
So how common is a DR?
The reality is that about 66% of postpartum women have a widened diastasis immediately after delivery. This is because the tissues at the front of the abdomen are designed to allow the expansion of the belly in order to accommodate a growing baby. However, only 33% of these women will have a diastasis that does not resolve on its own and need intervention.
Diastasis Recti Correction
During the first visit, I assess the length and width of the separation, the strength of the patient’s transverse abdominis muscle, the motor control of the pelvic floor, and the patient’s posture. In addition, I assess hip, back, and sacral stability. Knowing a patient’s overall impairments is important in correcting a DR, because only then can we put together a proper treatment plan. Since every patient is different, treatment plans are specifically tailored for each patient.