Core and Diastasis Recti
There are so many questions on 4th trimester care these days, from when to integrate exercise and what is safe to do. Today we are going to focus on the core! There are common misconceptions about the core and what is “safe” and “unsafe” postpartum. This leaves women confused scared to move!
The term Diastasis Recti is confusing and leads women down a path of frustration. A diastasis recti (DRA) is the non traumatic separation of the rectus abdominis (the 6 pack muscle) that occurs normally during pregnancy as your belly grows.
Another misconception is that it only happens to pregnant women. This separation can happen to ANYONE; male, female, young or old. The separation is measured by the “number of fingers” or cm gap between the two edges of the muscle, however we are learning it’s more than the finger gap that’s important.
It’s more about the person’s ability to manage the intra-abdominal pressure (IAP) and the tensioning of the linea alba, which is the connective tissue that runs down the midline of the abdominal wall.
All cores are different!
Everyone’s abdominal wall is different and a 3 finger gap on one person may look completely different than a 3 finger gap on another person. Connective tissue and fascia play a role in the overall appearance and function of the abdominal wall. The research and clinical world is still trying to develop the language around this idea and how to best address this common dysfunction.
Narrowing of Core vs. Tensioning of Core
Current research is showing that the gap between the rectus abdominis does narrow as we lift our head BUT that does not mean the tissue is “tensioned”. Research does show that if we prime our system through our breath and activation of the transverse abdominis we can improve the tensioning of the linea alba and thus decreased inter-recti distance.
As Julie Wiebe has named it “Blow before you go”, means priming your system for movement with an inhale-exhale and core engagement.
As we continue to train the brain to manage this pressure system it will start to carry over to daily tasks and then to fitness.
Do’s and Don’t when healing a Diastasis Recti?
DO: Breath, give your body time to heal
DON’T: Hold your breath, perform a movement where you see excessive abdominal doming/coning
Again, everyone’s abdominal wall is different and your program will be individualized for you. We as Physical Therapist want women to return to fitness and not be afraid to move!
Can I resume planks? Answer: Can you manage your IAP and avoid breath holding and abdominal doming/coning?
Can I resume back squats: Answer: Can you manage your IAP and avoid breath holding and abdominal doming/coning?
Can I do sit-ups? Answer: Do you see a trend?
If you have additional questions about Diastasis Recti Rehab, contact Missy at 614-850-0500 by phone or email firstname.lastname@example.org
Lee D, Hodges PW. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study. J Orthop Sports Phys Ther. 2016; 46(7):580-9.