Mind the gap and your back, Mummy
Diastasis Recti is a serious-sounding name for the infamous ‘stomach split’, when the two sides of your elusive six-pack find a new home, a little (or a lot) further away from each other than before.
Before you start feeling queasy, unlike a hernia, diastasis recti does not usually involve an actual tear, but rather an elongation of the connective tissue (the linea alba) between the two vertical sets of muscle called the Rectus Abdominis.
It is a condition which most women experience to a certain extent, during the third trimester of pregnancy and immediately postpartum. It can also affect men and coincidentally, newborn babies. However, my focus is how it relates to us mothers.
The basics are available here and there are many sources of online help (or hindrance, depending on your mood that day!). According to most professionals, only 2.7cm or more counts, but there is no universally consistent way to quantify your ‘gap’. Usually, one to two fingers’ width is considered safe and even normal, but I believe this is still undesirable, arguably unnatural, and possibly a symptom of some dysfunction in how you move your body as a whole.
Over the course of my lengthy research, I have also discovered that prodding in different positions can give you a different width, as well as evening forays, after a decent meal, etc. And some helpful people are now saying the depth of the gap is more important (FYI, the shallower, the better)! I could go on.
When I measure my gap right now (nine months after the birth of my second baby), it is about one finger width, two at the belly button (the widest spot for most people). I retained a similar gap after my first pregnancy, but despite this, from around twelve months postpartum, I was happy enough with how my stomach looked (it was a lot better than this time!). However, I continued to experience mild, consistent pain in my mid-back, as well as tenderness on the muscles themselves (ok, I did have to poke around to feel this – a particular skill of mine).
Unhelpfully, I don’t remember with certainty when or how the back pain eased (possibly when I stopped carrying my son in the sling for six hours a day). I adapted certain yoga poses in my one strong, weekly practice, from around a year post-partum (I had been practising normally from eight weeks until that point). Cue actually pull in your navel during ‘plank’ – oops, pregnancy had turned off this previously automatic action!
I continued with daily (mum-life-permitting) core, pelvic and glute exercises from the NHS Women’s Health physio (I had to nag for this), and attended a weekly circuits and weights class. It is this which I believe not only strengthened individual muscles, but gave me a sense of functionality in the body as a whole. If all that sounds overwhelming, outlined below are some simple but effective exercises you can do – quickly, at home, with your baby next to you.
As an undeniable side note, your stomach will probably never look the same as before – perhaps a small price to pay for that beautiful person your body actually grew! Personally, I now have an outie – sort of saggy – belly button, and a lot more potential expansion after a big meal (at 6pm daily I look six months pregnant). I also recently realised that I have never regained quite the same feeling of solidity or substance in my core. The truth is, even with the right exercises for you, it can take up to two years or more to recover. The jolly concept of bouncing back should probably be banned.
Unfortunately for us modern, hyper-informed and ever-achieving women, my conclusion is that Diastasis Recti is really a symptom rather than a condition, and therefore quite a mystery. Often, its stubborn endurance cannot be attributed to any single cause, nor fixed by any one set of exercises. As with diet, no one prescription will fit all. In my ideal world, an experienced, specialist physio would study your gait and musculoskeletal habits and tailor a program just for you, which would likely include quitting the office job and moving to the country, barefoot! So let’s move on to what we can do…
Initially after birth, your priority is to retrain your six-pack (it’s still there, no matter how deep) to actually engage, as you move through your day. These muscles mostly switch off at the end of pregnancy, to accommodate your growing baby, and sometimes struggle to reawaken.
1. From those first few tiring (and special) days, pull your navel in and up – lightly – when you move or get out of bed. Focus on elongating your waist
2. Continue with the many kegel exercises you were doing before the birth, specifically:
- drawing up the pelvic floor fully and holding for 10-15 seconds, 10 times (say three times per day), building up gradually to hold for longer.
- also practice fast kegels, pulling in and up, and fully releasing, without a hold.
3. As soon as you can (six weeks postpartum, if not before) lie on your back with knees lifted and feet flat. Pull in gently around the navel. If your pelvic floor or any other muscles automatically become tense, do lots of this! You want to be able to engage the core on its own. The key is to very lightly contract the stomach muscles, and stay there for as long as you can, making sure you can breathe deeply. Notice if they tremor or turn on and off – this means they need strengthening (which you’re doing, about three times daily, right?! Great).
These are helpful, safe preliminary movements but long-term, you want to work towards whole-body functionality. Diastasis endures due to a high level of intra-abdominal pressure, i.e, a pushing out of the stomach. This can be caused by endless things, from eccentric breathing patterns, to toilet straining, or just the way your right arm picks up your baby all day long. The list goes on!
To use bio-mechanist Katy Bowman’s analogy, we need movement nutrition like we need vitamins from our food. The human body was not designed to mostly perch on furniture. She recommends hanging from your hands for a minute a day (you can buy no-install pull up bars which fit in a normal door frame – or just go and find a tree) and a lot of walking, ideally in minimal shoes on natural ground (start slow).
During your recovery, you should actually avoid crunches, sit-ups, all intense core exercises, such as planks, as well as challenging twisting motions. Functional fitness, however, focusing on recruiting whole muscle chains within the body, from your toes to the crown of your head, is spreading, with more and more classes becoming available. Yoga (my passion and work) is also a great holistic exercise for the body. If you are new to the practice, start with a beginner’s course, or something slower like Iyengar yoga, which focuses on correct alignment. Just remember to skip or modify the movements mentioned above.
Most importantly, look after yourself in all ways, as well as your baby, children and whoever else is on that list. Your body has grown a whole new human being! Change takes time, and it is never too late for improvement.
Below are some links I have found helpful: