Maud is one of our consultants at Make Me Feel, specialising in physiotherapy. Physiotherapy helps to find out why you have trouble with any aspect of body movement.
Maud graduated in physiotherapy in 1998 in Paris. She ran a clinic in Paris for 10 years and she have been living and working in London for several years. Her specialties are women’s health physio, musculo-skeletal, post-operative rehabilitations, back pain, joint and muscles conditions, and bronchiolitis.
She has also completed postgraduate study to manage breast cancer related conditions including manual lymphatic drainage, shoulder exercises, and scar tissue work.
She speaks English and French. She is recognized by: WPA, Bupa international, and all international insurances. Maud gives consultations every Thursday from 2:00pm to 6:00pm.
Today Maud is talking about the diastasis recti, a problem that affect most commonly pregnant women.
THE DIASTASIS RECTI
What is a diastasis recti?
The diastasis recti refers to the separation of your vertical abdominal muscles, the rectus abdominis.
The space between the two muscles may vary from one person to another, and is usually around 2 cm wide. When the distance between these two muscles is beyond 2 ,5 cm, it is pathological. The diastasis can appear between the chest bone and the navel, around the navel, and in severe cases from the chest bone all the way down to the pubic bone.
How does this happen?
Diastasis recti can occur with new born babies, overweight people and men who are overdoing sit ups and similar abdominal exercises. But pregnant women are the most commonly affected.
The vertical connective tissue in between these 2 muscles, called the linea alba gets thinner and stretches during pregnancy. The rectus abdomini muscles become also thinner and longer. This is to allow some space for the baby as she grows in the tummy. Studies have shown that 100% of women have a diastasis at 35 weeks of pregnancy, and 33% at 12 months post-delivery. In most cases, this gap will reduce on its own with time. But, in some cases, the gap remains too wide (>2,5 cm). The linea alba can also rip in some areas during pregnancy, letting the small intestine pop through it : this is called an hernia.
What does contribute to diastasis recti?
- Repeated heavy lifting during pregnancy and after childbirth
- Multiple pregnancies, close pregnancies
- Performing inappropriate abdominal exercises during pregnancy and after childbirth.
How do I know that I may have a diastasis?
- your belly button is sticking out whereas you usually
- have an innie.
- stretch marks around your belly button
- your tummy is doming
- Doming when performing head lifts
- The linea alba is sagging,
- You still look 6 months pregnant whereas you are 3 months post-natal.
How can you assess it at home?
See the number of fingers that you can insert in the muscles gap above the belly button, at the belly button level and below your belly button. It should not exceed two fingers.
How can you restrain the severity of a DRA?
- Avoid straining on your muscles : adopt “the roll on the side attitude” whenever you need to get up from the floor, or from a sitting position or from the bed.
- Continue exercises that activate the transverse abdominal muscle.
- Try to avoid any exercise that would increase pressure against your abdominal wall.
- If you are in your second pregnancy and still have an important gap from a previous pregnancy, you could consider wearingan abdominal support from 21 weeks onwards: this could help prevent widening the existing gap.
How can you recover or help get your muscles get back together quicker?
- Wear an abdominal support from day 1: choose a soft one for the first weeks post-natal and change for a more compressive one after.
- Start activating your pelvic floor muscle as well as yourtransverse abdominal from day 1
- Avoid any movement that increases the intra-abdominal pressure such as carrying the pram up or down the stairs, carrying the car seat…
- Don’t resume running and workout too early.
- Don’t do any sit ups, plank, or crunches as that will contributeto widening your gap
- It is very difficult to predict how big a diastasis will be as many factors can influence that. However, being aware of the above will help you minimise it.