Give yourself the best chance to avoid the common and limiting condition of diastasis recti (often misleadingly referred to as “mummy tummy”).
Education is key in the prenatal phase for prevention, and to ensure best chance of:
What is Diastasis Recti?
Diastasis recti (or DR) is the over-stretching of the connective tissue adjoining our rectus abdominus, or our 6-pack muscles. Imagine the connective tissue as a nylon stocking that loses its elasticity. That connective tissue can't do a very good job of holding our insides in place when it’s all stretched out! This is what 30% of mothers quietly experience after their first pregnancy (often in addition to related symptoms below). The incidence increases to upwards of 60% in second and third pregnancies. For some women, the healing happens spontaneously. For others, it’s not that simple, and close attention and rehabilitation is required. Take action now and you can feel confident you are doing everything you can do to prevent this limiting condition.
Symptoms and Conditions Related to DR
In order to prevent diastasis recti, it’s important we understand exactly what it is and how it is caused. The earlier in pregnancy we empower ourselves with this knowledge, the more we can do to protect ourselves.
There are certain contributing factors that we may not be able to control (ie. age of mother, size of baby, family history), but our focus is to learn more about the factors we can control.
DR is caused by unsustained intra-abdominal pressure. So we need to investigate and identify the factors that cause this downward and outward pressure and stop them!
We follow a strict list of guidelines during pregnancy to protect our babies; so we ought to follow a similar set of guidelines in order to protect ourselves.
Prevention: Things to Avoid
1) High impact exercise after the second trimester
Just think about it; our pelvic floor (the hammock of muscles that support organs and growing babies) is conditioned to sustain only so much pressure. This downward pressure increases enough day-by-day with our growing bellies. Keep the cardio alive with walking, upright spinning, or swimming, but please refrain from jumping jacks until many months after giving birth and you have restored your core and pelvic floor.
2) "Hoiking" or "jack-knifing" out of bed
This is a less obvious one because it’s an action we perform daily. Any movement that causes the belly to dome (like when performing a crunch) is indicative of too much of the downward/outward pressure that is a known cause of DR. Replace your jack-knife with rolling carefully onto your side and pressing up with your hands (known by some as "the sexy senior"). Use it getting up from savasana during yoga classes as well.
3) Crunches and front-loaded postures
Planks and crunches well-known for being exercises to avoid during pregnancy, but I’ll explain why. When we crunch, our bellies dome, a symptom of this unwanted downward pressure on an area that is already vulnerable due to pregnancy. The logic behind avoiding planks is similar: imagine how much weight the film of tissue bears already, and then add practically the entire weight of your body on top of that? Definitely something to avoid.
4) Overly straining during bowel movements
This can be a challenge during pregnancy, as pregnancy often causes constipation, but do your utmost to remain well-hydrated and consume plenty of fibre to avoid over-straining during bowel movements. You’ll avoid pesky hemorrhoids this way, as well!
Prevention: Things To Be Cautious About
This is a huge one. It is very tempting to hinge our body weight onto the front of our hips and drop our ribcage back behind the pelvis as our bellies get heavier (as I demonstrate in panel one, below). The impact of incorrect posture on our core muscles and pelvic floor is significant, and – in my personal experience – could be a sole culprit for DR. Please refer to my posture reference chart below for demonstrations of posture to strive for (panel 3), and postures to avoid (panel 1 & 2).
2) Be careful how you lift your kids
I always get a bit of push-back on this one, but here’s the thing: most women lift their kids incorrectly. If you inhale to lower by hinging your hips backwards and sticking your bum out, exhale, engage your core and then lift the child in toward the centre line of your body and up, then you are golden! But whether we lift properly or not, a lot of extra and unnecessary strain is on our core and pelvic floor. If your kid is big enough to walk, he should be walking on his own anyway!
3) Four-point postures
There’s a been a bit of healthy debate among experts on this one. Here’s the outcome: we perform four-point postures (being on all -ours) to tone and strengthen our cores during pregnancy, so why should we avoid them? And what about the Tracy Anderson pregnancy videos? She didn’t get DR and she spent half of them on all-fours! Be in tune with your own body. It won’t be the first time you’ll need to rely on this instinct in motherhood. If you have engaged your transverse abdominus, or internal corset muscles, doing four-point postures since the beginning of your pregnancy (like Tracy did) then yes, you may be strong enough to sustain the front-loaded weight of your growing baby while on all-fours. But, if you are at all unsure, steer clear of this one, just to be on the safe side.
Prevention: Things to Do
1) See a Chiropractor Throughout Your Pregnancy
I cannot recommend this one enough. It's always best to choose one that comes recommended by a trusted friend, family member or healthcare practitioner. It is something I did not do during my pregnancies, because at the time, I did not understand the benefit. Chiropractors have a stereotypical image of being bone-cracking spinal manipulators, and this reputation could not be further from the truth, especially for modern ones. Good chiropractors are alignment specialists and healing bodyworkers who can identify and release areas of tension and stress in the body and its related systems (muscular, connective, skeletal). They work with you to create more space where it is required for the baby to make a healthy and smooth exit, which results in less trauma.
2) See a Pelvic Health Physiotherapist
This growing group of empowering women can help you connect with and generate awareness about your pelvic health where medical doctors currently do not. They can help you understand the health and status of your pelvic floor prior to your delivery and manage your expectations for recovery. When we deal with postpartum pelvic health issues on a reactionary basis, it can be much more overwhelming than entering motherhood with our eyes wide open about our recovery requirements. Knowledge is power.
What practices have helped you recover from your pregnancies? Share them with me in the comments below!