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7 Seven Things You Need to Know About Diastasis Recti: Mummy Tummy

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Struggling to regain your core strength after your pregnancy, mama? Seeing that dreaded ‘mummy tummy’ bulging? It is time to enlist some help from a pelvic floor physiotherapist! 

Diastasis Rectus Abdominis (DRA) is a long term for a common problem, and the misinformation surrounding this can create a lot of fear and anxiety during pregnancy and postpartum. At InvigoPhysio, we take a holistic and evidence-based approach to managing DRA.

We are here to share some reliable facts that can help you understand DRA: 

What is diastasis rectus abdominis? 

This long word is not as complicated as you think! While you are pregnant, your abdominal wall is weakened as your uterus expands to hold your baby. 

While your baby grows inside of you, your rectus abdominis muscles pull away from each other. This leads to thinning of your linea alba, a collagen-rich connective tissue which houses your ab muscles. Thinner linea alba means a decrease in your body’s ability to resist against the added pressure of your pregnancy (this is called intra-abdominal pressure) as well as the optimal contraction of all your abdominal muscles (obliques and rectus). The widening and thinning effect of the linea alba beyond the norms is called diastasis rectus abdominis. 

DRA can lead to ‘mom pooch’ but also some more severe symptoms including: 

  • Lower back pain
  • Abdominal pain
  • Pelvic floor pain
  • Incontinence issues
  • Pelvic floor disorders

When can diastasis recti happen?

During your pregnancy, you’ll probably learn a lot of different words for issues you didn’t know about before. Diastasis rectus abdominis is one that, while many women may know about it, few talk about! Even though 3 out of 10 women will experience at least a mild form of diastasis after their first pregnancy, most women don’t talk about it, and often don’t go to seek treatment. 

A widening of your linea alba is expected during your pregnancy, however, it can lead to compromised function in other surrounding muscles that work with the abdominal wall. These other muscles that depend on your abdominal wall include your:

  • pelvic floor, 
  • multifidus, 
  • diaphragm, and 
  • back muscles. 

Therefore, it is important to see a pelvic physiotherapist to help you address the imbalance around this midsection. A pelvic floor physiotherapy will work with you so that you may continue moving well throughout your pregnancy, limit future issues, and be prepared for your unique birth experience.

How can you help me manage my DRA during pregnancy?

At InvigoPhysio, we use a holistic approach when it comes to managing DRA during pregnancy. We understand the importance of maintaining a balanced lifestyle incorporating regular physical activity, good sleeping habits, and effective stress management. There is a lot of fear, anxiety, and misinformation surrounding exercising during pregnancy. We will help you navigate with the latest evidence-based information so that you can continue to build your muscular strength, maintain optimal posture and keep your pelvic floor happy. 

Is there anything I can do on my own to manage DRA during pregnancy?

Some actions you can take to maintain core strength include: 

  • Lifting with good technique. Even lifting common household things like a full laundry bin inappropriately can strain your abdominal muscles. 
  • Sit up straight. Practicing good posture makes your muscles work harder and keep them in top shape. Slouching can happen with working at your desk for long hours but hard work requires discipline, and it will pay off.
  • Keep moving! Yes, staying active can help with blood flow, maintaining muscle strength and flexibility. You can continue with your current level of fitness but listen to your body’s signals so that you know when to modify your activities. If you’re worried about diastasis recti, talk to your pelvic floor physiotherapist. 
  • When you are getting in and out of the bed, couch or up from the floor, try this tip “blow as you go”. This means breathing out and engaging your abdominal muscles first, and then moving gently with support from your arms. You should not see any abdominal bulging with these activities. 

What can be done to help me with my postpartum recovery?

Postpartum is the time for the body to heal the tissue and readjust its hormone level. The changes are gradual and can take up to 12 months to get to the new “normal”. The most critical period is the fourth trimester where new moms can feel overwhelmed and without proper support, they are vulnerable to develop anxiety and depression and that can greatly affect the recovery. 

There are also certain conditions that will not get resolved by themselves without attention and help such as pelvic floor problems. It is reported that if you experience stress urinary incontinence at 3 months postpartum, there is a 92% chance that you will still experience it at 5 years postpartum. 

At InvigoPhysio, we will meet you wherever you are in your healing journey and help you get to where you want to be. Our holistic and evidence-based approach to DRA rehabilitation strongly focuses on both your emotional and physical wellbeing.

What are the consequences of having DRA?

Because DRA affects the function of the entire abdominal wall, it can lead to impairment of other surrounding muscles. There is a possible connection between having a DRA and experiencing

  • Lower back and pelvic pain 
  • Pain in your abdominal area when coughing, sneezing or pushing
  • Incontinence when coughing, sneezing or pushing
  • Pelvic organ prolapse
  • Poor posture
  • Appearance of pregnant belly months after delivery (mummy tummy)

Exercises or movements to avoid with diastasis rectus abdominis:

Your pelvic floor physiotherapist will help you figure out the appropriate exercises for your DRA rehabilitation. Here are a few tips to support your recovery:  

  • Avoid movements where you can see bulging or doming at the abdominals. It can be very individual so you need to pay attention to your body. 
  • If you experience incontinence issues, you should avoid exercises or movements that trigger the incontinence.
  • If you’re used to doing abs exercises that have you flexing your upper spine off of the floor such as crunches, rolls ups, roll downs, or oblique curls, now is the time to take a break from them.
  • Maintaining good posture when carrying and lifting your growing baby.

Even though DRA is expected during pregnancy, there are many things that your pelvic physiotherapist can help you with for a strong pregnancy and smooth postpartum recovery. It is important to talk about it and to get professional guidance so that you can continue doing the exercises which you love. 

At InvigoPhysio, we’re here in Toronto for you. At your pace, and with your personal health goals in mind, we will support you through your pregnancy, birth preparation, and postpartum recovery. 

Reach out today!

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