Holistic ways to treat diastasis recti

Pregnancy is a time of tremendous (and rapid) physical and emotional changes to the female body. If you’re pregnant, you’ll typically experience hormonal and physiological changes through every stage. On top of that, those changes and new ones often continue in the postpartum (the time after birth) period. But rarely do changes to your body only affect your body. Dramatic or new physical changes can also affect your mental health, confidence, and even close relationships, so it’s important to address any concerns you might have. One of the most common conditions following pregnancy is diastasis recti—a partial or full separation of your abdominal muscles. The good news is that there are things you can do to help repair it to keep your Total Force Fitness on track.

Diastasis Recti. Shows normal rectus abdominis muscles with narrow lines of linea alba (connective tissue). Diastasis recti where rectus abdominis are separated by large gap where linea alba is located.What is diastasis recti

Diastasis recti (DR) occurs when the tissue between the bands of rectus abdominus muscles (your abs) becomes stretched out. This changes the direction that your abs are able to pull when you contract them, and causes a visible space between the muscles down the center of your stomach. Most risk factors for DR are associated with the changes that come with pregnancy (hormonal changes, increased uterus size, etc.), multiple pregnancies, Cesarean section (C-section), and some genetic conditions. Pre-pregnancy BMI and fitness level, and weight gain during pregnancy are often considered to be risk factors for postpartum DR. It’s very common during and after pregnancy, and usually resolves within 3 months.

How DR affects well-being and performance

  • Physical fitness. The stretching of your ab muscles—and changing the direction that they can pull—has a few different physical effects that can make it difficult to get back into shape. When your muscles aren’t able to pull in the direction they’re designed to—straight up and down your body, in the case of your abs—it makes it harder to stabilize your core. This makes it tougher to perform physical tasks, especially anything that requires you to use your arms overhead. It’s especially challenging to work back to your Service-required physical standards. The gap between the ab muscles that you see isn’t necessarily causing the physical issues, but it can help confirm the presence of the condition.
  • Body image. Body dissatisfaction (or the difference in what the ideal version of a body is and what you perceive your body to be) during and after pregnancy is very common. It’s also serious because it’s a risk factor for postpartum depression, which can potentially affect your caretaking abilities and long-term mental health. Many women feel that body changes (whether it’s weight gain or changes to your breasts or vagina) that occur during pregnancy are acceptable. However, after birth, there’s an intense pressure to return to your pre-pregnancy form, even when that’s not always realistic or possible. If you experience DR after pregnancy (and most women do for at least a short period), it can take time to heal and repair. And during that time, it’s important to monitor your feelings about your body image and how they impact your mental and emotional well-being.
  • Relationships. Navigating pregnancy, managing postpartum recovery, and adjusting to parenthood can connect you and your partner in some moments, while straining your relationship in others. The physical changes that women (and men) face after your baby is born can be particularly challenging to your relationship and your ability to feel comfortable being intimate. On top of a lack of sleep, adjusting to a new family member, and healing, body image and body confidence can play a significant role in your desire and whether you feel your partner is attracted to you. Issues with diastasis recti can contribute to your sense of confidence or adequacy (or even what you assume about your partner’s level of attraction to you) and potentially impact your romantic relationship.

Ways to address issues around DR

Treating the physical effects of DR boosts physical performance and goes a long way toward improving body image and other psychological and social changes.

  • Core-stabilization exercises are effective in treating DR, strengthening deep-core muscles, and reducing the size of the gap between your ab muscles. Core-stabilization exercises aren’t just for your outer ab muscles, so doing sit-ups, for example, won’t solve the problem.
  • Diaphragmatic-breathing (or belly-breathing) exercises can help treat DR. Your diaphragm is a big, dome-shaped muscle that expands your chest cavity, pulling air into your lungs. It connects to your deep-core muscles, including the transverse rectus abdominis (TrA) and pelvic floor muscles. Practicing belly breathing helps strengthen these muscles and can reduce the stretching of your outer abs.
  • Pelvic floor, or Kegel exercises, are helpful for treating DR too. They also connect to the TrA, which is one of the main core muscles that stabilizes your trunk.

Other performance-optimization strategies to consider

  • Focus on open communication with your partner. You’ll likely navigate many new and unexpected issues together as you adjust to life with your infant. Through it all, it’s key to maintain open and respectful communication. And while intimacy might be the last thing on one or both of your minds, make sure that you aren’t making assumptions about what your partner is thinking or feeling—especially when it comes to how they view your body or their attraction to you. Often women and men assume their partner isn’t attracted to or is even rejecting their new bodies, but this is often a misinterpretation or misunderstanding. So make sure you talk it out.
  • Assess your own values. When it comes to body image, much of what you feel will be influenced by the community and context you’re in. What’s considered the “ideal” body (before, during, or after pregnancy) is often something constructed from the outside and might not reflect your own values. Still, it’s normal to try and live up to those external standards. Instead, take some time to clearly think about what you value in your body and what matters most to YOU about your physical fitness. Then, chart a healthy and realistic path to get there.
  • Manage your mindset. If you’re struggling with diastasis recti or other physical issues after pregnancy, it’s important to check your mindset about your new body. A key part of getting through any stressful time with resilience is to adjust how you make sense of the adversity you’re facing. For example, if you approach your DR with a mindset that says “my body looks bad,” “I’m unattractive,” or “I don’t have control of my appearance,” you might find it hard to move forward. Whereas if you check your automatic thoughts and try shifting them to think “it’s normal for my body to undergo changes after pregnancy” or “I have the power to make changes to my body when I’m ready,” you’ll be in a better position to move forward with success.

CHAMP wants to know:

Did this information help change your opinion or perspective?

References

plus icon minus icon

Bordoni, B., & Zanier. (2013). Anatomic connections of the diaphragm influence of respiration on the body system. Journal of Multidisciplinary Healthcare. doi:10.2147/jmdh.S45443

Hodgkinson, E. L., Smith, D. M., & Wittkowski, A. (2014). Women’s experiences of their pregnancy and postpartum body image: A systematic review and meta-synthesis. BMC Pregnancy and Childbirth, 14(1). doi:10.1186/1471-2393-14-330

Michalska, A., Rokita, W., Wolder, D., Pogorzelska, J., & Kaczmarczyk, K. (2018). Diastasis recti abdominis — A review of treatment methods. Ginekologia Polska, 89(2), 97–101. doi:10.5603/GP.a2018.0016

Mickelson, K. D., & Joseph, J. A. (2012). Postpartum body satisfaction and intimacy in first-time parents. Sex Roles, 67(5–6), 300–310. doi:10.1007/s11199-012-0192-9

Silveira, M. L., Ertel, K. A., Dole, N., & Chasan-Taber, L. (2015). The role of body image in prenatal and postpartum depression: A critical review of the literature. Archives of Women's Mental Health, 18(3), 409–421. doi:10.1007/s00737-015-0525-0

Sweeney, A. C., & Fingerhut, R. (2013). Examining relationships between body dissatisfaction, maladaptive perfectionism, and postpartum depression symptoms. Journal of Obstetric, Gynecologic & Neonatal Nursing, 42(5), 551–561. doi:10.1111/1552-6909.12236

Thabet, A., & Alshehri, M. A. (2019). Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: A randomised controlled trial. Journal of Musculoskeletal & Neuronal Interactions, 19(1), 62–68.