Mamas, after giving birth, our main focus is on loving on our new baby, breastfeeding, and resting during the first couple months postpartum. All of our energy goes towards healing our body, but at some point the desire to return to our “pre-baby body shape” may creep in. That feeling is totally normal, but sometimes we struggle in to do with the new found “pooch” in the lower abdomen. I know I did for the first eighteen months after having my first baby. If you have distention in your lower belly, it may mean you have diastasis recti, a condition where the two bellies of the six-pack abdominal muscles separate from each other, causing the bulge, or “pooch.”

Here’s a simple explanation of the anatomy: Diastasis means separation, and recti is the abdominal muscles, or the rectus abdominis. Diastasis recti can cause your stomach to stick out more because your muscles have widened and separated, to make space for the baby during pregnancy. Even at rest, it may be noticeable. Bottom line: The abdominus muscles separate from the linea alba, which is the connective tissue in your stomach.

With the right approach and exercises, you can help the diastasis recti separation come back together. Well Spine Family Chiropractic is here to help. We’ve seen mothers with a diastasis two years after having their baby and we’ve seen mamas get adjusted, do our exercises and close their diastasis 8 weeks after delivery.  There are certain factors that make all the difference.

Who gets Diastasis Recti?

Millions of women experience diastasis recti each year, most of them are postpartum. You may feel like you are suffering silently but it’s much more common than you think as about two-thirds of pregnant women struggle with abdominal separation. It tends to happen in women who deliver a large baby or have a second or third baby.

After a mom has lost the baby weight, her stomach may not appear back to pre-baby shape. It’s important to know that studies have shown about 60% of mothers have diastasis recti at six-weeks postpartum and nearly a third have it after a year.

But abdominal separation can happen to anyone, including men. For them, it can come from doing too many sit-ups or weightlifting with incorrect form.

There are several underlying causes which lead to separation, including pregnancy, sudden weight gain, a C-section, abdominal surgery like appendix or gallbladder surgery, weightlifting, or holding more weight around your abdomen. 

At Well Spine Family Chiropractic, we see diastasis recti in women who struggle with a weak deep intrinsic core (transverse abdominis, internal abdominal obliques, diaphragm, and pelvic floor muscles) or have a habit of chest breathing. Both of these can lead to low back pain and incontinence also known as urine leakage and may make it harder to move properly.

The linea alba, which holds the abdominal muscles on the front side, loses its ability to stabilize the abdomen. Other abdominal muscles meet at the linea alba, causing a compromise in several muscles, including your rectus abdominus, your transverse abdominis, and your internal and external oblique muscles.

There are ways to minimize the symptoms and effects of diastasis recti to make it much more manageable and less noticeable, especially with doing the proper exercises.

Who diagnoses Diastasis Recti?

If you suspect you may have abdominal separation, visit one of our chiropractors at Well Spine Family Chiropractic. We’ll be able to identify if you have diastasis recti and share ways to minimize its effects. We also highly recommend pelvic floor physical therapy during the postpartum period, they are a wealth of knowledge as well!

How do you know if you have abdominal separation?

Diastasis recti typically presents with several other symptoms besides just the belly pooch. You may have lower back pain, suffer from constipation, or have pain with sex. In serious cases, a hernia or doming of the abdomen may occur.

During pregnancy, there is a huge amount of pressure put on your abdominal muscles, especially during the third trimester. You may feel a lack of core strength, experience urine leakage with coughing or laughing, or notice doming in your stomach muscles when you lie on your back.

At Well Spine Family Chiropractic, we find certain conditions make you more susceptible to develop diastasis recti. This includes belly button rings, abdominal scars from past surgeries, especially from appendectomy and gallbladder removal, a history of poor breathing mechanics and rib flare, or an excessive low back sway, which is called lordosis.

Is it important to have Diastasis Recti checked?

A lot of cases of diastasis recti go unchecked until the pooch is noticeable. Why does this matter? Diastasis recti can lead to pelvic floor dysfunction, back pain, bloating, and hernias, so it’s important to get it managed as quickly as possible.

Diastasis recti becomes a serious condition when there’s a hernia associated with the separation, because the intestines can get caught and strangled in the herniation–which can lead to emergency surgery in severe cases

If you want to do a self-check, lie on the floor and place two fingers horizontally just above your belly button. Lift your head and shoulders as if you’re doing a crunch and feel the area. If you’re feeling a gap wider than the width of one and half of your fingers, you may have an abdominal separation. Your doctor will perform the same evaluation to check for width and depth.

Just a heads up: Checking too frequently 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 chiropractor for a definitive diagnosis.

How can you heal Diastasis Recti?

Completely healing diastasis recti is possible with exercises and preventative measures to minimize symptoms and side effects. The goal is to focus on spinal alignment and strengthening of the core.

Postpartum exercises to restore functional movement are helpful as well as dynamic exercise slings and braces. These provide support with sleeping, making your body more comfortable and helping to train the muscles back into place. Tools like splints and braces aren’t healing your muscles but simply taking the load off and helping support the muscles, not necessarily providing long-term results. They are great for short term therapy but long term they don’t allow for a full belly breath and limit good core stability which are both essential for healing abdominal separation.

How we help heal Diastasis Recti – Well Spine Family Chiropractic approach:

At Well Spine Family Chiropractic, we use a thorough assessment to determine which muscles are overcompensating. This helps us get to the root cause of muscle pain and weakness.

We often find overactive tight muscles compensating for other muscles used for breathing out or exhaling. This is especially common today with stress causing the breath to be short and shallow, which exacerbates diastasis recti.

We find that muscles commonly inhibited to be transverse abdominis, internal obliques, and multifidus muscles, which lack the full ability to help protect the rectus position and exacerbate diastasis recti.

Tupler Technique: Is it worth it?

The Tupler technique is a common method for healing diastasis recti. A Tupler therapist uses a splint to take the pressure off of your connective tissue, allowing it to heal better.

The goal is to focus on preventing diastasis recti from flaring up by building up strength in the transverse abdominis. This is achieved by drawing the stomach up and in. As the weakened tissue becomes stronger, the muscles come back together.

However, the Tupler technique doesn’t access the deeper core muscles, which means the rectus abdominis muscles will most likely eventually separate again, which we’ve seen frequently with our patients.

What not to do with Diastasis Recti:

One of the worst exercises for diastasis recti are movements like crunches, planks, or forward folds, especially too soon after giving birth. These exercises can actually create more abdominal separation and widen the gap.

Focus on the exercises that don’t really feel like exercise at all, such as deep breathing and getting your spine aligned with chiropractic adjustments. Breathe deep from your diaphragm with 360-degree expansion around your abdomen, waistline, and low back. There will be an eccentric contraction of the transverse abdominis deep down into your lower core and pelvic floor as you simply breathe.

When your Diastasis Recti is more serious:

Surgery for diastasis recti may be an option for more severe cases with three or more fingers width of separation and especially those with hernias and strangulated intestines.

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 Well Spine Family Chiropractic, we see neck and back pain down the road with our tummy tuck patients, because abdominal surgery comes with its own risks and side effects.

In general the best relief from diastasis recti comes from building up the deep intrinsic abdominal strength again through exercise and breath work.

We can help! Contact us today about Diastasis Recti. Call us at (720) 403-8255 or email us at info@wellspinefamilychiropractic.com. We’re here for you!

 

XO, the Well Spine Team