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diastasis recti and doming of the stomach after pregnancy

A DISCUSSION ON DIASTASIS

diastasis recti and doming after giving birth and how to help it

WHAT IS DIASTASIS? AND WHAT CAN YOU DO ABOUT IT?

We regularly have a lot of women asking about diastasis and worrying about it, so we sat down (via Zoom of course!) to discuss all things diastasis with one of our favourite women’s health experts Sarah Parker

Below is the video of the entire chat if you’d prefer to watch it, otherwise keep reading to understand what diastasis is, how to know if you have it and when to ask for help. Please know that it’s completely normal and nothing to fear. We have another blog post here discussing the best ways to help your body heal. 

WHAT IS DIASTASIS RECTI?

Sarah: First things first – there’s a lot of expectation and pressure on women around having the stomach or body you had pre-pregnancy – the obsession with the gap between the abs has become huge! Basically, diastasis is when your six-pack ab muscles (that are from the bottom of your ribs to your pubic bone) part in the middle to allow for space as your baby grows. The connective tissue in the middle between these muscles – the linea alba – expands. So when you have your baby and your belly shrinks again, this area has lost it’s tension so there is a gap – that’s all it is!

DO MEN GET DIASTASIS?

Sarah: Diastasis is NORMAL in the majority of the population – including in men with big bellies, they can get it too! It’s not just particular to women that have been pregnant, but for some reason we jump on things when it comes to women, particularly around the childbirth years.

You can easily see your belly and the changes it’s going through, so diastasis has really become a sticking point. There are some great people out there trying to blow these myths out the water so that we can actually rehab the body more effectively.  There has been so many “oh you mustn’t do this or that” – massive fear-mongering when it comes to our bodies! 

Lettie: Exactly, you don’t have to be pregnant to have diastasis, I think that’s a really important point. If you look at the six-pack muscles you can see that they are meant to expand – whether that’s from food, gas, laughing, lifting or growing a baby! Our stomachs are meant to move. 

There’s a lot of emphasis put on the postpartum healing stage, because you can visually see this gap down the middle. 

WHEN DO YOU NEED TO START REHABILITATING THE BODY AND CORE POSTPARTUM?

Sarah: Well if it is really really early stages – i.e. during the first six weeks postpartum I’d hope you’re so into your initial mothering period that you’re not even thinking about your body and stomach during this time! It’s a sacred bonding time so make the most of that. Your body has just gone through a massive trauma – the closest-to-death experience that humans have is childbirth! It’s not just that the baby is born – a mother is born too! 

It’s such a massive, epic, phenomenal thing that I just hope that within the first 6 weeks that’s what you’re coming to terms with – not looking at your belly. 

And then at six weeks you can come and get a physio check. By the way, you can go and see a physio at any time, even before your six week checkup they just won’t do an internal exam. Even before that, you can just start with the breathing. Connective breathwork helps the pelvic floor and the core – your diaphragm has been pushed on by a baby for the last trimester, so breathwork helps to reconnect with your body and move it down again. 

If you are seeing doming, see a core specialist or physiotherapist. I’d recommend The Holistic Core Restore specialists, who will often refer you back to a physio to make sure everything is going well with the rehab. As soon as you feel comfortable to be leaving your house and baby, go and get yourself checked if you think there’s a gap there – but honestly I think the whole fearmongering thing has made it bigger than it needs to be! 

Lettie: Women often ask me what can I do about Diastasis and are worried about what to do. I usually recommend that people invest in a women’s health physio – unfortunately it doesn’t get routinely prescribed like it does in France, and if you’re referred to a physio by a GP it can take some time. 

WHAT IS A MUMMY MOT? 

Sarah: I check absolutely everything. A Mummy MOT is a really thorough, comprehensive postnatal check. It’s like a mixture of a pelvic health check and sports physio. The founders of the Mummy MOT have combined their extensive knowledge in order to teach Mummy MOT practitioners to do the best postnatal assessment we can – from both a sports and pelvic health perspective. I will check head to toe – your hips, back and tummy. How are you moving, how are you breathing? There’s an internal examination too to check if the pelvic floor muscles are working, and then rehab starts from there. 

TOP TIPS FOR NEW MUMS: BREATHING AND YOUR FEET

Lettie: Thinking about your posture is a great one, along with breathing. Do you think people can do their breathing from a very early stage postpartum? 

Sarah: Absolutely. Breathing and gentle pelvic floor exercises – to get your brain back down in your fanny! Just starting to reconnect and say “can I lift, can I let go, can I 360 breathe, are my feet working?”

The feet are a really important one as your feet change so much as you approach the end of your pregnancy and they’re really closely connected to your pelvic floor! So while you’re feeding, ask yourself “can I wiggle my toes, can I scrunch my toes?” You can also do really gentle pelvic floor lifts while you’re feeding, just very gently bringing yourself back into yourself, reconnecting with your whole body. 

The soles of the feet are like the wings of the womb

Lettie

Lettie: My pregnancy yoga teacher said to me that “the soles of the feet are like the wings of the womb.” Because of how the fascial system works, they’re all connected together. I just thought it was a lovely way of describing how everything is connected; give TLC to your vagina by giving TLC to your feet! Quite often I ask my newly postpartum ladies to engage with their pelvic floor while they’re feeding. As it’s a time where you’re sitting, bonding and being gentle – and also a nice reminder as it’s a regular occurance where you’re able to get those exercises in. 

Sarah: Absolutely, it’s the perfect time to do it really, you don’t have to have a timer on your phone! While you’re feeding your baby you can use this time to do your toe wiggles and pelvic floor lifts. Imagine it’s like coming back down to earth and into your body after a long savasana – – that’s kind of what this first 6 weeks is – wiggling your toes, stretching and getting back into your body. Although now you’ve got new feet, a new pelvic floor, a new tummy and you’re a new mum!

WHAT IF I’M COMING BACK TO EXERCISE MONTHS AFTER HAVING A BABY? 

Lettie: And for those mums who’ve been taking their time to coming back to doing things for themselves. If they’re 5 or 6 months down the line and still noticing diastasis – is a gap always a problem?

Sarah: No way! If possible, try to measure your gap beforehand during the early stages of pregnancy – you’ll notice there’s already a gap here! Then after birth, how strong is your body after this new kind of experience, what can your body do and how strong can it be now?

It’s so subjective when it comes to the body, there should NEVER be do’s and don’ts with your body, for anything! I’ll throw something at you, can you do it, if you can’t then we’ll change and modify. 

Sarah Parker

All we’re looking for is how well can we load that mid-line between your six-pack and abs. I try not to tell people you can’t do rotations or you can’t do that – the only reason we have these abs and the midline is so that these two sides of the body can communicate – reciprocate, bend, flex and extend. We need to move, and life means that we will be moving all these different ways.

Lettie: You’re going to be doing that in real life, so you should be trying to do that in rehab too!

Sarah: Yes, I’m really trying to come away from any labelling and diagnosing because it doesn’t matter what it’s called or what you have but it’s what can you do with it: how is it showing up for you, how is it presenting in your body and your life and finally how can we overcome those symptoms. That’s all it should be called really. 

Lettie: Ultimately it’s just making sure that your core is doing what it’s supposed to do; transfer energy through the body and support the spine! If your body can do that and it’s not causing any dysfunction then it’s doing as it should. 

WHEN DOES DIASTASIS BECOME DYSFUNCTIONAL? 

Sarah: Your body will usually let you know if there’s a dysfunction – but that’s why it’s so important to have this rehabilitation period so that you don’t get to the point of symptoms. 

Our bodies are magical, they will get you up and keep you going everyday no matter what

Sarah Parker

So it’s best to look holistically at any pain or symptoms in the body (whether that’s hip or back pain or something else) with a specialist, as that might not really be the cause or source of the problem.

Lettie: The body is amazing – it finds the most efficient, effective way of doing something, even if it’s not the right way. It recruits the muscles it needs to get the job done but it’s not thinking long-term! 

Sarah : Exactly, and our brains are made for survival so it’s not concerned with the future, but just trying to get you through right now – however later down the line this can manifest in different ways and various symptoms. Which is why it’s so important to have the rehab and start slow. If you have anything going on with your body see someone about it so you don’t have to unpick it later down the line. 

Lettie: So wherever you are starting in your journey, whether it’s weeks, months of years later, just start slowly and gently. 

Sarah: Yes, but also being aware that the later you start, the more likely it is that some symptoms will arise at some point. 

SURGERY FOR DIASTASIS

Sarah: This really is a last resort that happens when the gap is really large, they might be herniating, and there’s no loading in the world that’s going to get the linea alba recruited and all the abs working as they should be. It doesn’t happen very much in the UK to be honest, I see that it’s more common in the US. 

WHAT ABOUT BINDING OR TAPING THE BELLY? 

Sarah: I don’t do binding or know anything about it really. I would rather get someone to recruit the muscles with their brain.

Lettie: These belts might help short-term with pain, but you need to get the muscles firing and working, and you won’t get them firing up by wrapping them up. In fact you might end up bearing down more, and if the pressure doesn’t go out it’s going to go down!

Sarah: There’s an amazing pelvix health specialist called Anthony Lo, who did a recent podcast good about lumbar supports and weightlifting, saying that unless you’re doing Olympic sports, lifting two or three times your bodyweight, you shouldn’t need a belt, to breath-hold or to brace. 

Your body is AMAZING and can do anything in the right environment! So I think really it’s best to not interrupt the body’s process with external supports like these, but again I can’t say that for every body. It doesn’t need to be held together to come back together, it needs to be loaded so that the tissue can become stronger again – and the only way that you can load is by using it. 

DIASTASIS AND YOUR BODY:

Sarah: The most important thing for me is to not make diastasis an obsession. 100% of women have a diastasis at full term so just know that it’s normal. 

If possible when you’re in the early stages of your pregnancy measure your current gap  – ½ cm to 3 ½ cm is normal! If you know what you’ve got then you can see what you’re working back towards postnatally. Rather than thinking that your abs need to be completely back together, maybe they weren’t in the first place! Give yourself a little linea alba poke! 

Lettie: Don’t panic, as we’ve explained, diastasis is completely normal. Come back slowly, listen to your body, focus on the foundations first: breath, posture, deeper abs, glutes and those feet! 

If you want more help or advice on your journey, give us a shout hello@planet-mama.co.uk