Diastasis Recti! What is that huge gap in my belly?

 In Motherhood, Pregnancy

Diastasis Recti, (DRAM or DR) is when the connective tissue in the midline of the abdominal wall stretches and thins. It’s actually something that happens to all pregnant bellies and to some non pregnant bellies, to a more or lesser degree. DRAM looks like a ‘doming’ or ‘coning’ of the abdominal muscles when under load during pregnancy. And after birth it can look and feel like a gap you can sink your fingers into inside your midline between the six pack abdominal muscles.

Diastasis recti develops during pregnancy to accommodate your growing baby, and in many cases (not all!) the abdominals return to normal within six months after birth. People get really worried about the width of the gap. But a two finger width or 2 cm wide gap is considered fairly normal. What seems to be more important is the depth of the gap and the squishiness of the midline tissue.

If there’s a wide gap, like four or more fingers wide and the tissue feels spongy and soft and you feel like your insides might just fall out the front, well that’s not very pleasant and is a really great time to get support from a women’s health physio, and to do some movement retraining with a postpartum corrective exercise specialist. You don’t have to struggle alone. If you don’t feel quite right, then please get help. 

So, is it possible to prevent a diastasis from developing during pregnancy?

Well no, it looks like you can’t prevent DRAM during pregnancy. There’s some recent research that shows that by the end of pregnancy, all women have some stretching and thinning of the midline of their abdominal wall. This is good! It’s allowing space in there for your baby to grow. 

The thing I’m really interested in, is whether it’s possible to prevent a diastasis from becoming the sort of ‘gap’ that doesn’t recover very well after giving birth. 

I wonder, can we keep your diastasis within a healthy and normal, healable range?

The answer is… maybe. 

No one really knows exactly what causes some abdominal midlines to stretch out sooooo much more than others. 

Perhaps it’s a combination between

  • nutrition
  • body proportions
  • movement habits
  • genetics
  • how a woman works with her abdominals during pregnancy,
  • how well she’s supported to prioritise healing in the postpartum period.
  • And sometimes things just happen. 

But bodies are malleable and adaptable. They respond to how we move them, feed them, and nurture them. I think that if we cared better for bodies during pregnancy and afterwards then it might just be possible to decrease the number and severity of injuries sustained by the bodies that birth our children. 

Taking preventative care of your pregnant body doesn’t mean getting weak and unfit. It means being smart and getting strong, safely. 

So what can you do to care for your mama body to help prevent, care for, and rehabilitate a DR?

  1. Feed it well – keep it hydrated, and really well nourished. 
  2. Let it rest – growing, birthing and feeding a baby takes huge reserves of energy. So rest. Let your body restore itself. 
  3. Move it safely – some movements will challenge your abdominals more than others. Learn what your belly looks like when it’s ‘doming’ or ‘coning’ which looks like a sort of triangle shape popping out of your midline and avoid movements that make this happen. 
  4. Give it bodywork – massage your belly muscles gently to help them release and to off load the stretch on your midline. 
  5. Talk to it with love – your body is amazing. Speak to it gently with kindness and reverence. It’s doing the best it can! 

And what happens if you have Diastasis Recti?

Many cases of Diastasis Recti will heal well on their own given plenty of time for rest and recovery, nurturing bodywork, and provided good care is taken to not overload the abdominals too much, too soon. So hold off on the sit ups!

This is not to say that some women don’t have a wider gap which may need special care and rehabilitation, perhaps even surgery. But not all!

Often it’s the coordination, synergy and responsiveness of the ‘core’ muscles under load – so how the muscles work together during movement, that is much more important than the width of the ‘gap’.

Over the last week I’ve checked four lots of abdominal walls for Diastasis Recti.

  • One mama was three weeks postpartum.
  • One mama was eight months postpartum.
  • One mama was three years postpartum.
  • One mama was five years postpartum.

All these women were really concerned that they had a ‘gap’ and that they might make it worse doing the ‘wrong’ sort of exercise. And do you know what? When I checked, all these abdominals were actually fine.

Some of them had a little gap, about one finger wide, and some of them had no gap at all.

The thing is that it’s not really about the gap anyway!! It’s about how the muscles and fascia all organise themselves. How do they coordinate? And a gap of up to two fingers wide is considered normal anyway. So these mamas were all in the range of a ‘normal’ DR gap. Whew!

Buuuut, they all had other symptoms!

One mama had pelvic organ prolapse, one had a sore low back and a tight hip, one had leaking, and one expressed deep sadness over the shape of her low belly. They each had symptoms that caused them concern and that may indicate the coordination through their core muscles could be better.

So, whilst their ‘gap’ measured ‘normal’ these women still had symptoms, which suggests to me that there’s still room for healing, recovery and rehabilitation.

It seems to me that some complaints commonly blamed on Diastasis Recti, may in fact be caused by the deep core muscles just not being quite recovered yet.

For those who do need help to recover, there are many womens health practitioners like physio’s, osteo’s, occupational therapist’s, and movement professionals trained in working with the mother body who can help you. And I’m one of them! I’m a pilates teacher with training as a pregnancy and postpartum corrective exercise specialist.

I’m particularly interested in how it may very well be possible to protect and nurture your body during pregnancy and birth, and how to care for and restore it afterwards.

Taking care of your body is really not that hard to do. But it does take viewing the huge changes your body goes through at this time, with deep awe and unwavering respect.

Recovery and rehabilitation after giving birth are not luxuries, they’re essentials.

So look after yourself mama. Prioritise your needs for healing and recovery. And if you’re worried about your body, then get some help! There are loads of women’s health practitioners who would love to support you. And I’m one of them! Please feel so very welcome to get in touch. X 💛

Interested in finding out how I can support your body to heal after giving birth? Learn about my in home support offerings here.

If you want to learn more about supporting your body to heal really well after giving birth then download my free ‘postpartum body recovery guide’ here!

If you’re interested in 👉keeping strong through pregnancy 👉preparing your body for birth 👉preventing common injuries related to pregnancy, birth and early motherhood. Join the waitlist for my next Motherbody Postnatal: Pelvic Floor and Core recovery online course.

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