Diastasis recti refers to a midline gapping of the abdominal muscles as a result of stretching and thinning of the linear alba- the aponeurosis where the deep and superficial core muscles connect.
Diastasis results in loss of integrity through the abdominal wall and ineffective load transfer. Low back and sacro iliac joint dysfunction are often a consequence.
Diastasis affects everyone to a varying degree in pregnancy, especially in the third trimester. The extent of gapping increases with multiple pregnancies, pregnancies in quick succession and carrying large babies. Non-exercising Mums are also at increased risk. However, it is not just ante and post natal ladies that suffer from diastasis- men suffer from it too. This is due to overuse of the abdominal muscles against resistance.
So whilst aesthetically the goal is often to regain a nice flat tummy post pregnancy, it is more important to restore the integrity of this system- enabling optimal recruitment and load transfer. This is required for movements such as getting on and off the floor, lifting your baby and returning to previous exercise regimes.
This is not achieved by way of sit ups and planks (these exercises put a lot of load through the superficial core musculature and can make diastasis worse)!! Rather an individualized, multi modal treatment program focusing on increasing fascial tension and reinstating appropriate motor control patterns.
This may include:
- Optimizing posture and pelvic position to promote length tension relationship of muscles
- Improving breathing patterns
- Avoiding abdominal bracing strategies ie when lifting
- Promoting thoracic mobility
- Learning to load the core correctly- this may start with isometric contractions- before progressing to retraining outer core muscles through range and then in a functional format
- Integrating and balancing muscle recruitment through the core
Consequently diastasis is a coordination and functional issue that affects the whole body. This needs to be the focus of treatment rather than closure of the diastasis gap- though this often an incidental consequence!
Book an appointment at embrace therapies (embracetherapies.co.uk) for a full assessment and advise on treatment with an ante and post natal trained physio