For many readers, this condition might never be a problem, but considering around 1 in 3 women will suffer from it during pregnancy it is important to understand what is going on and have a plan to fix it. Diastasis recti refers to a separation of the rectus abdominous muscle at the midpoint (linea Alba), causing a protrusion of the anterior uterus wall. This happens to 30% of pregnant females generally at around the 16th week of pregnancy, but it can happen at an earlier, or later, stage too. You might be able to see it as a long ridge (varying in width) when the abdominals are contracted, or as some call it “the Toblerone tummy”
Despite this being a common condition that can be caused by pregnancy and postpartum, some woman do not even realise that they suffer from it. There is however a simple self test that can help show you how the right and left halves of your abdominal muscles spread apart at the body’s midline. In laymen terms, the line, which splits your ‘six pack’, is being pulled apart and is no longer connected. This can occur as early as 16 weeks of pregnancy and in some cases over 4 fingers (6cm) width can appear at full term. This condition occurs because of the widening and thinning of the midline tissue in response to the force of the uterus pushing against the abdominal wall, in conjunction with pregnancy hormones that soften connective tissue.
A small amount of widening of the mid line happens in all pregnancies and is absolutely normal. However, anything over 1 finger (1.5cm) needs to be addressed postpartum. If the connective tissue does not reconnect within a year, it is unlikely to ever reform. This can result in back pain, herniation and weak core muscles, with the only solution being surgery.
What are the implications for exercise?
It is important to try to identify diastasis recti if you are continuing to exercise during pregnancy, so that you can stop doing exercises that might exacerbate the condition. You should ask your midwife or obstetrician to check your abdominal muscles periodically, which they may do as a matter of course whilst checking the position of your baby and uterus. It is also possible for you to test your abdominal muscles yourself during and after pregnancy and if you detect that your abdominals are splitting you should take the following into account.
- Avoid excessive abdominal work
- Avoid heavy lifting
- Focus on training the TVA/ core to help with possible back pain
- Stop doing any crunches after 16 weeks, although most mums will be to uncomfortable to do crunches by this stage.
- Medical braces are often considered post natal to help bring back the separation.
- Avoid standing rotation work
Below is an example of the self-test:
- Lie on your back with one knee bent, and other straight out on the floor
- Place one hand behind your head, and the other hand on your abdomen, with your fingertips 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
- Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis
Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominis muscle. Test for separation both above and below your belly button
Here are a couple of exercises to help with diastasis recti.
Seated SB twists
- Start by sitting up straight and tall on the stability ball
- Bring both arms together straight out in-front of your torso at shoulder height.
- Ensure you keep your core encaged and shoulders relaxed
- Slowly begin to twist your upper body to your right side. Ensure your arms and head continue to twist with the rest of your body.
- Once you have reached the end of your twist, pause and slowly return to the start position.
- Repeat with your left side, and continue to alternate for 24 repetitions.
Horse Stance level 2
- Position yourself on all fours, with the knees in line with the hips and the hands underneath the shoulders.
- Gently pull in with the belly button and contract the pelvic floor.
- Breath in and as you then exhale, raise right leg and the left arm.
- As you return bring the right knee and left elbow to touch underneath your belly button.
- Repeat for 10 repetitions
- Now repeat on opposite side