After pregnancy, some women experience a condition known as diastasis recti – this is when the two large bands of muscles in the middle of the abdomen separate. This separation can weaken the abdominal muscles and may cause a bulge in the middle of the belly.
Diastasis recti can happen to women of all fitness levels; even pro-athletes. While it can be frustrating when you’re trying to shift your mummy tummy, thankfully there is something you can do about it.
Jenny Smith, lead midwife at Queen Charlotte’s & Chelsea Hospital and speaker at The Private Pregnancy Show, tells us more about the condition and what you can do to help heal your abdominal muscles after pregnancy.
What is diastasis recti?
Imagine your abdominal muscles being like a wrapped parcel, two strong strips at either side, with a horizontal strip beneath that and criss-cross strips beneath that, all muscles, need to be gently pulled in, to tone up.
During pregnancy, as the baby grows the uterus expands and the parallel muscles on either side of the abdomen separate in the midline like partially open curtains as the connective tissue in the middle “linea alba” weakens.
The condition is not helped by the fact that the hormones progesterone and relaxin, also relax muscles and this can lead to lower back pain and make it difficult to lift children or objects.
Women with increased likelihood of developing a more prominent separation of the rectus muscles are women older than 35 years, multiple pregnancy, babies of higher birth weight and repeated pregnancies.
How can I tell if I have diastasis recti?
After birth, it is important to assess the size of the separation of the abdomen. This is done by lying on your back with legs bent and feet on the floor. Raising shoulders slightly off the floor whilst looking at your toes, feel with your fingers the middle of your abdomen between the edges of the muscles above and below the umbilicus.
Assess how many fingers you can fit between the gap – it is usual to have a one to two finger width. It is also important to assess how deep the gap is too, a deeper gap would indicate the other deeper muscles criss-cross and transverse maybe effected. If your abdomen bulges a lot it may mean you have a hernia it is important to get this checked by your obstetrician.
How can I heal and strengthen my abdominal muscles?
It is important to maintain good posture in pregnancy, standing up tall and holding in muscles whilst walking and sitting on a birth ball at home to align the body. If the abdomen is pendulous sometimes a pregnancy belt or abdominal tubigrip can help support the bump. Doing regular pelvic floor exercises will keep you lower muscles toned and will also strengthen the connection to the abdominal muscles.
Exercises after birth have got to be gentle, sit ups can cause more damage to connective tissue. Exercises that are helpful are lying on back with knees bent, relax abdomen when breathing in and then tense abdomen for 5-10 seconds when breathing out. Repeat this exercise 5-10 times twice a day.
The other exercise the pelvic tilt, is also very good lie on your back with knees bent breathe in. As you breathe out pull in deep tummy muscles and gently squeeze up your pelvic floor at the same time. Tilt pelvis to flatten arch of lower back into the floor for 5-10 seconds then gently release.
When pulling up your pelvic floor think of three holes pull up bottom hole, vaginal hole and bladder hole. Think of them as a sling that needs toning.