Post-Baby Body Problem: Diastasis Recti

 For a new mom, getting rid of the "baby belly" is usually a top goal. Not only will it help you look better, but it also is practical, getting you back into your pre-baby clothes. If your belly just doesn't seem to be going away over time, however, you might have a common condition known as diastasis recti.

What is diastasis recti?

In the front of your abdomen, you have a large, muscular sheath known as the rectus abdominis. Running down the middle of rectus abdominis is the linea alba, which is a section of connective tissue. When you are pregnant, the rectus abdominis and the linea alba both expand outward to make room for your growing baby. This occurs to some degree in all women, but in some instances, the stretching is severe enough that the two halves of the rectus abdominis appear separated. You might notice a bulge along your midsection when you try to sit up.

Why is diastasis recti a problem?

The stability of both the spine and pelvis relate to the strength of your abdominal muscles. If your abdominal muscles and the linea alba are stretched out too much, then it's very difficult to maintain good posture, which can lead to pain in your back and hips. Diastasis recti also makes it more dangerous to lift heavy objects, because it's harder for you to pull in your abdomen enough to provide proper support your lower spine.

How do you know if you have it?

While on your back with your knees bent, try to sit up as if you're doing a basic crunch. Place your fingers in the hollow space that forms along your midsection. If you can fit two or more fingers side by side in the space, then you have diastasis recti.

How do you treat the condition?

In the majority of cases, the separation between the two halves of the abdominal muscles closes on its own over time. If the separation is stubborn, however, exercises are usually the first line of treatment. These must focus first on building strength in the transverse abdominis, which is the deeper muscle under the rectus abdominis, and which is the main girdle around your tummy. Without strength in the transverse abdominis, you won't really be able to bring the rectus abdominis back together properly.

Many basic balance exercises, such as simply balancing on one leg, will engage the abdominal muscles in order to keep you upright, so it's possible to work on the problem somewhat without isolated exercises. For a concentrated rehabilitation approach, however, you can try the following options:

Contraction of the core: Sit in a comfortable chair with good posture. With hands on your belly, contract the abdominal muscles as far back into your spine as you can, using your hands to gently guide them straight inward. Hold the contraction as long as you can, working up to at least 30 seconds. Repeat six to 12 times. Alternately, instead of holding the contraction, you can do shorter contractions of two to 5 seconds and work toward a goal of 75 to 100 repetitions.

Wall push ups: Stand roughly arm length away from a wall, facing it. Put your hands against the wall and let yourself come forward, drawing your abdominal muscles inward toward your spine as you lower down. Inhale as you push yourself back up. Repeat 20 times.

Gravity pulls: Get on your back on the floor with knees bent. As you exhale, draw your abdominals down toward the floor as deeply as you can, imagining gravity is taking them over. Hold for two to five seconds. Let them release as you inhale. When you are strong enough to control this, do the same exercise with your head slightly lifted and supported by your hands.

NOTE: Do NOT try to do standard exercises such as regular situps with a band around your middle to keep your muscles together. If you do this, the band is doing all the work your muscles should do, and in some instances, you can make the separation worse! You should avoid any exercise that causes your midline to bulge, which generally rules out most spinal flexion exercises. You also need to watch out for twisting exercises, which can further pull on your muscles and linea alba. Stay away from exercises that stretch your abdomen, such as upward dog from yoga.

If your diastasis recti is severe, it might require a tummy tuck. This is generally considered a last resort, and the majority of women have no medical need for surgery even if they do not like the aesthetic look of the condition. Whether you remedy the problem with at-home exercise therapy or need surgery, the good news is that diastasis recti is treatable and most definitely does not need to be permanent.

By Wanda Marie Thibodeaux