As a mama and an Osteopath who is an advocate for pelvic health, a lover of all things related to women’s health and a believer in #selfcare. It scares me the amount of misinformation being spread by so called health experts, aka influencers, that people then take as gospel.
I love Instagram and most of the messages and information being shared, but recently I read a post about Diastasis Recti (DRA). The postnatal fitness expert explained in great detail how a DRA occurs when the connective tissue separating the two halves of our six pack tears during pregnancy allowing our organs to fall out. NOOOOOO!
The worst part about this message (apart from it being seen by the masses) it creates fear in pregnant women in a time when they should be preparing for and enjoying this most spectacular time in their life.
Today I’m breaking down the misinformation and myths around DRA.
Separation of the rectus abdominal muscles results in tearing of the linea alba during pregnancy, and your organs falling out. Firsty abdominal separation during pregnancy is a normal, natural process. It occurs in response to the growing baba and allows the belly to expand. We need it and we should appreciate this process not fear it. There is some truth to this myth, in extreme cases the linea alba can tear, where a hernia can result, but do the organs fall out? No. This implies the organs are hanging out of a massive hole in the midline of the abdomen. Should there be a rare small tear, there are numerous structures separating the organs from the outside. They do not simply fall out. This myth creates so much fear and worry for expecting mothers and it is so unnecessary.
A DRA only affects pregnant women. Separation of the abdominal muscles is normal and a natural occurrence during pregnancy. It’s estimated that up to 100% of women by the third trimester have a DRA. The extra weight and force applied to the front of the abdomen stretches the linea alba and the rectus sheath (connective tissue separating and enveloping our abdominal muscles). We need this stretching, with the help of hormones it allows the belly to grow and expand in response to our bubbas growing inside. This also occurs when men and women who have an increase in abdominal weight and fat. This increases the stretch and force to the abdominal region in the same way a growing babe does. Thus creating a stretch to the fascia and abdominal separation. Babies can also be born with a natural separation of their abdominal muscles especially if preemie and in most cases it will close soon after birth. To all the gym junkies thinking they are safe, lifting heavy weights can also cause separation of the stomach muscles.
Closing the gap is the aim. We are not concerned with the size of your gap and closing it. Instead we’re interested in whether or not your body is able to generate tension within your linea alba (the connective tissue connecting the two sides of your stomach muscles) – this is achieved by efficient engagement of your deep core muscles. When this is achieved your DRA is considered a functional one, whether you have 1, 2 3 or even a 4 finger gap. When you are not able to generate tension, even with a single finger gap you are unable to transfer load effectively across your body and core strength and pelvic floor health is impacted.
My DRA gap is less than two fingers, now I’m right to exercise. 20 years ago the two finger gap (or less) was the unicorn. The postnatal aim for all mamas. And years ago I was guilty of using this as a milestone. Once achieved there was a blanket rule allowing the patient to do whatever exercises they wish. I cringe at this now. When I hear health and fitness experts saying this I want to scream NOOOOOO! So what does a two finger gap tell us? Exactly that, you can fit two fingers in your gap. Nothing more, nothing less. What is important is that you have a functional gap. See myth three.
My mummy tummy is due to my DRA. Can a DRA cause a ‘mummy tummy’ or a pouch? Sometimes. If I have a ‘mummy tummy’ I must have a DRA, MAYBE. Some people believe the mummy tummy and a DRA come hand in hand. This can be the case but it is far from a rule. For many suffering with a mummy tummy, diet, posture, breathing strategies and core engagement can all contribute to or be solely responsible for the pouch. I see women in the postnatal period all the time worried about their DRA and that they still look pregnant. I understand this, I’m postnatal too. No one wants to look pregnant when they aren’t and for this reason most grip their tummy muscles, hold their breath to try and minimise the belly. Reality is, this makes the mummy tummy worse. So if you are reading this and thinking ‘oh yeah I do that!” STOP. RELAX and BREATH.
I have a DRA I should avoid anything that increases the intra abdominal pressure.
NO NO NO… like any tendinous injury we need to progressively load the area. Is this the first stage of rehab. No. First is connecting with your breath and coordinating engagement of the breath with the rest of the core muscles (deep abdominals and pelvic floor muscles).