We chatted with Nadine Adams, a Licensed Physical Therapist to learn more about Diastasis Recti. She suffered a 3-finger separation herself after her second child and has been passionate about helping other woman treat and manage their diastasis for almost a decade. She is the owner of P3 Fitness: Pilates, Personal Training and Physical Therapy and is based in Hanover Massachusetts. She offers treatment and management programs for pregnant and post-partum woman in the form of 6 week small group training classes, private and duet services available and offers Educational Workshops on Core Rehabilitation in the Presence of an Abdominal Separation.
5 common Questions about Managing Diastasis Recti (Abdominal separation)
What is a Diastasis Recti?
A Diastasis Recti is a separation of the two sides of the Rectus abdominus muscle caused by a weakening and stretching of the abdominal connective tissue. There are different ways to measure the size of the separation but a 2+ finger width separation or larger is considered clinically significant. Here is a video demonstration on how to check yourself for a Diastasis Recti.
What causes this Separation?
Intra-abdominal pressure most commonly from a growing baby inside mothers’ uterus but can also be caused by other forces on the connective tissue that put pressure stretching out the connective tissue. In pregnant women the increase release of hormones that loosen your ligaments and connective tissue to prepare for labor allow this stretching to happen again. Diastasis can occur in men and infants and is not just caused by pregnancy.
How Do I know I have one?
One of the more common signs post baby is a protruding belly and a woman still looks pregnant even after she has lost most of her pregnancy weight gain. During pregnancy, a doming or coning effect can often be seen when leaning back or bending forward from the hips. This coning can also happen during exercise when the person can not control the tension between the 2 sides of the muscle and further can compromise the connective tissue.
Other symptoms can include lower back and hip pain due to a weakened core, improper posture and body mechanics, various kinds of pelvic floor dysfunction often causing stress incontinence.
What are the common exercises to Avoid?
Temporarily avoiding crunches, oblique twists, side bending movements, front loaded planks, and for some early on even avoiding exercises in the hands and knees position might be recommended. These either increase intra-abdominal pressure or put abnormal forces on the connective tissue. Once healed, most of these exercises can be performed again if done correctly with good core engagement. No two separations are the same, just as no two individuals are the same and a person’s ability to control these abnormal forces is something that should be continually assessed while returning back to exercise and during day to day functional tasks.
Can it be healed?
Finding a qualified health care specialist who has experience treating Diastasis Recti and can guide you through an appropriate exercise program, exercise modifications, splinting, alignment and postural re-education and management techniques is the best way to heal your Diastasis.
What is considered a healed Diastasis Recti?
The goal is to promote connective tissue healing and prevent putting abnormal forces on the tissue to allow the two sides of the muscle to come back together. The connective tissue also heals from the inside out and improvement of both the size and depth of the separation are signs of healing. Closing the gap fully isn’t as important as regaining functional use of your core and pelvic floor. Proper retraining of the 4 deep core muscles will help support your spine and pelvic girdle and minimize the abnormal forces and control the tension on the connective tissue during day to day functional activities and exercise.
The goals and functional needs will vary from person to person but treating Diastasis Recti needs a whole-body treatment approach for successful functional use of the core. For some the goals may be taking care of their babies, doing housework, return to leisure activities or to your favorite sport or workout regimen. Correct alignment, proper breathing to retrain the deep core muscles to support how the body moves and protecting the connective tissue from abnormal forces during day to day activities are some of the techniques used in Restore Your Core REHAB™ Diastasis Recti treatment and management program.
Nadine Adams graduated from Simmons College with her master’s in physical therapy in 1992, has worked with pregnant and post-partum woman the past 10 years, specializing in Diastasis Recti management the past 8 years and has been a Certified Fitness instructor and personal trainer for 30 years. She combines her experience in the health care and fitness industries to provide a well-rounded approach to care for her clients.
To learn more about the program please visit www.restoreyourcorerehab.com