What is Diastasis Recti / Rectus Diastasis?
Diastasis Recti, or more commonly known as Rectus Diastasis, is the separation of the rectus abdominis, commonly known as the 6-packs. This is a common condition seen in pregnancy as the foetus grows in the womb, as high as 2/3 of pregnant ladies may have this condition. Upon delivery, most diastasis recti would gradually recovery within 8 week post-partum. To assess the extent of the diastasis, we would get the patient to do a little sit-up and we would measure the gap between the rectus abdominis, at the level of the belly button. We would take measurement using the width of our finger tips. To have a gap of up to 2cm (approximately about 2 fingers width) post-delivery is considered to be normal. However, about 50% of post-partum ladies would have a gap of more than 2.7cm (about 3 fingers width), which would be of a little concern, even after 3 months.
Possible causes of Diastasis Recti
- Abdominal muscles being stretched during pregnancy
- Growing uterus pressure
- Hormonal changes
- Multiple pregnancies
- Rapid weight gain
- Insufficient core support
- Poor posture
- Genetic predisposition
- Improper lifting
- Intense abdominal exercises
- Weak connective tissue
Why is it a concern?
There is a high co-relation between the extent of the
diastasis and the incidence of low back pain post-partum. The degree of
separation is link to weakness of the core muscles. Besides affecting the
mother’s ability to return to exercise or sports after delivery, the presence
of Diastasis Recti might even affect the mother’s ability to care for their
babies. Carrying of heavy loads, like even carrying their child as they grow,
would increase the intra-abdominal pressure, which might lead to further
separation of the diastasis. In severe cases, the separation has been known to
allow the abdominal contents to herniate out, which may end up requiring
surgery to repair the diastasis. With the core muscles working in tandem with
the pelvic floor muscles, weakness in the core muscles might also lead to poor
pelvic floor control, which may lead to incontinence or even uterine prolapse.
How can Physiotherapy help?
Exercises is most commonly known to be used as a treatment for Diastasis Recti. It is highly recommended that rehab exercises should start about 6-8 weeks post-partum. For a start, when you enter our clinic, we would assess how wide is the separation. If the separation is wider than 4-finger width, we highly recommend that you get an abdominal binder to aid in your recovery. After the assessment and knowing how far on you are post-partum, we would explain your condition to you as best as we can and plan your rehab accordingly. We may start first with very basic pelvic floor stabilization exercises followed by gentle progression to Transverses Abdominis activation while lying on your back. As the diaphragm forms the roof of your core, proper breathing techniques would also be taught. Depending on the activities that you plan to return to, your exercise program will be tailored to suit your needs. You would expect the rehabilitation program to last anywhere between 3 to 6 months, depending on your progress.
How can you help yourself and prevent Diastisis Recti?
While some degree of separation of the Rectus Abdominis is common, there are proactive steps you can take to minimize its severity and prevent complications.
- Maintaining a proper posture
- Engage in safe and gentle exercises
- Be mindful when lifting objects
- Ensure adequate nutrition and hydration
Diastasis Recti is a natural part of pregnancy, proactive steps can help you prevent excessive separation and promote better postpartum recovery.