09 Sep Diastasis Recti and The Pelvic Floor Connection
There is a lot of talk about ‘mummy tummy’ lately. What to do about diastasis recti, why it happens, and why healing it matters. For many it doesn’t matter to them why it happens, or even why it needs to be healed – they just want it gone! Well girls – it is important to know why it happens and why healing it matters and knowing this information will actually help you get rid of it too!
Mummy Tummy is a name used to describe a medical condition known as diastasis rectus abdominus (DRA) which means separation of the rectus muscles from the midline. In layman’s terms, it means that there is a gap between your two 6-pack muscles and the connective tissue has weakened.
Why diastasis recti happens?
Diastasis recti happens for many reasons, one of them being pregnancy and birth. The forward pressure on the abdomen contributes to increased and continuous stretch and pressure on the connective tissue that can cause the rectus muscles to lose their ‘alignment’. There are also postural and hormonal changes that occur in pregnancy that may contribute to the gap as well.
Why healing diastasis recti matters?
Women don’t like the gap or the ‘pooch’ that remains after pregnancy and they will try all sorts of diets, exercise programs and products in an attempt to get rid of it. These tactics are used to address the cosmetic side which is the main motivator but it is important to know that diastasis recti is about MORE than aesthetics.
The two 6-pack muscles (the recti) attach from the sternum to the pubic symphysis (pubic bone). Because of their attachment points on the pelvis, a gap in between them and weakness in the connective tissue, directly affects the pelvis and pelvic floor. In fact 52% of women with pelvic floor dysfunction have diastasis recti.
Research tell us that 100% of pregnant women will get DRA in their third trimester as measured by an enlarged inter recti distance (Mota et al 2014). Research also shows that some women also stretch through the abdominal muscles (Brauman 2008) and we know that muscles that are lengthened beyond optimal loose contractile strength as seen on the length tension curve as their maximum force generated decreases (Gordon 1966). So it stands to reason that many women trying to get rid of their mummy tummy need to pay attention to their pelvis as well.
In the pelvis, the shape of the bones provides what is called ‘form closure’ while the surrounding muscles, ligaments and connective tissue contribute to what is called ‘force closure’.
During pregnancy biomechanical changes occur which can reduce the effectiveness of both form and force closure such as;
- Altered alignment and load bearing
- Altered muscle length in the pelvic floor and abdomen (both longer and shorter) which results in reduced ability for muscle force production
- Diastasis recti – a distortion in the abdominal wall that impairs function of the muscles including their role in pelvic stability
- The abdominal muscles are stretched to allow space for the enlarging uterus which can lead to loss of muscle tone and strength in the abdominal region and a compromised ability to produce tension in the thoracolumbar fascia, resulting in reduced force closure in the pelvis
- Changes to muscular co-ordination (reduced)
- Hormones – The role of relaxin and progesterone is to increase the extensibility of the ligaments and smooth muscle to allow the pelvis to expand more readily for the delivery of the baby – when the ligaments are lax it affects the force closure
Healing a diastasis recti is important because if left untreated it can contribute to back pain, constipation and as we have said, pelvic floor dysfunction. The good news is that it is never too late to work on healing your DRA or improving the function but the sooner you address it, the better the outcome.
After giving birth body with diastasis recti. Photography by Jade Beall http://www.abeautifulbodyproject.org/
How to heal diastasis recti?
Spontaneus healing of diastasis recti only occurs in the first 8 weeks post partum, beyond that intervention is needed (Coldron et al 2008). Intervention in the form of posture and alignment work, breath work and exercises such as those found in the Bwom app are what is needed to heal a DRA and the corresponding pelvic floor dysfunction.
Using an abdominal wrap in the first 8 weeks postpartum is a great way to support the abdomen and pelvis and it helps provide temporary form closure while restorative exercise helps rebuild the ability of the muscles and tissues to provide force closure.
For those who are past the 8 weeks postpartum timeframe, wrapping may still be helpful for some but not all. It is best to have your abdomen and pelvic floor assessed by a women’s health physiotherapist who specializes in the pelvis and pelvic floor.
While they are often considered independently, the abdomen and pelvic floor are intimately connected and they deserve more attention than they get. Book an appointment with a pelvic health physiotherapist today.
About Kim Vopni
The Fitness Doula. Author of Prepare To Push™ – What Your Pelvic Floor and Abdomen Want You To Know About Pregnancy And Birth, Owner of Pelvienne Wellness Inc, and Co-Founder of Bellies Inc.
Kim is a mom of 2 boys and is a Certified fitness professional who also trained as a doula. She combines the support aspect of a doula with the principles of fitness to help her pregnant clients ‘Prepare To Push’ while postpartum she helps her clients optimize healing and regain their core confidence for motherhood. In 2009 she created a women’s health event called Kegels and Cocktails designed to empower and educate women on the importance of pelvic health.
You can find her on-line at www.pelviennewellness.com and www.belliesinc.com, on Facebook @PelvienneWellness and @BelliesInc and on twitter @FitnessDoula and @BelliesInc.
Inés MelladoPosted at 17:30h, 09 September
Por favor quisiera información ya que en mi caso sufrí de una evisceración de la cúpula vaginal y son muchas las dudas que tengo.
Abigail medinaPosted at 18:03h, 10 September
me fue de mucha ayuda, gracias 🙂
evaPosted at 22:38h, 10 September
diana tellezPosted at 03:00h, 18 September
gracias por la informacion. no tenia ni idea. con razon me ha sido tan dificil volver a adelgazar la barriga… cuando estuve embarazada aumente 28 kg y mi bebe (en octubre cumple 3 aos era grande 57 cm y peso 3.700 kg. comprend que mi abdomen se estir demasiado.
claudia milena castilloPosted at 23:56h, 20 September
excelente informacin si las mujeres tuviramos el conocimiento suiendo sobre este tema tendriamos mejor Nuestras salud del piso pelvico y abdominal
nelaPosted at 04:43h, 22 September
NelidaPosted at 12:58h, 28 September
yo no tengo hijos pero tengo probelmas con mi sobrepeso
ClaudiaPosted at 12:01h, 30 September
No lo saba!! Peri manos a la obra
Belen ParraPosted at 11:12h, 05 October
Hace 6 semanas que he sido madre y ninguna comadrona y ni la ginecologa me han recomendado la faja abdominal, me parece muy extrao que aqui se mencione en las 8 primeras semanas.
Veronica TorrasPosted at 08:35h, 07 October
Hola Belén, algunas comadronas y fisioterapeutas son partidarias del uso de la faja abdominal como ayuda temporal a la musculatura abdominal, y otros no lo son porque de este modo la musculatura no trabaja tanto. Ten en cuenta que en este post estamos hablando de la diástasis abdominal (una disfunción de la musculatura abdominal) y en estos casos, la autora del post recomienda el uso de la faja para no acentuar el problema en las primeras semanas, antes de poder ejercitar y rehabilitar la zona. Un saludo!
MariaPosted at 06:07h, 09 October
cual seria la solucin para este problema despus de haber ya pasado muchos aos de haber dado a luz y el estomago quedo distendido?
Alba MonteroPosted at 09:42h, 21 October
Hola María, te recomendamos que consultes con un especialista en fistioterapia del suelo pélvico para que te haga una exploración física. También puedes empezar realizando diariamente ejercicios hipopresivos y con la aplicación de aceite de rosa mosqueta. En Bwom encontrarás ejercicios de Gimnasia Hipopresiva, te recomendamos nuestro plan “Vientre firme”.
AliciaPosted at 02:13h, 14 October
muy buena explicacin
CatiPosted at 07:49h, 16 October
Hola , mi nombre es Cati , tengo 52 aos , hace un ao con menopausia , hago ejercicio regularmente, intento cuidar mi alimentacin.
Alba MonteroPosted at 09:36h, 21 October
Hola Cati, gracias por tu mensaje! Próximamente publicaremos un post sobre Menopausia y Suelo pélvico. Enhorabuena por cuidar de tu salud, tu cuerpo te lo agradecerá 🙂
Ana Cecilia Gonzalez CazaresPosted at 04:51h, 16 October
Hola cuando yo tuve mi segundo hijo tuve problemas en el periné y suelo pelvis o pero los doctores no me dijeron que debía ejercitar mis músculos. Ahora después de dos años creo tener diastesis abdominal también. Aun puedo recuperarme con ejercicios? Tengo una barriga de embarazada y siento que no tengo fuerza en el abdomen. Ayuda por favor!!!