Prevention and recovery from Rectus Abdominis Diastasis in pregnancy

by Dr. Alison Gault

Rectus abdominis diastasis is one of the medical conditions occurring in pregnancy causing pain. It is also known as diastasis recti or an abdominal muscle split. During pregnancy, the extensive and often speedy stretching of the abdominal muscles can result in the connective tissue called the linea alba lying between the two rectus abominis muscles splitting. The gap between the two muscles needs to be above 2.5 finger widths to be called rectus abdominis diastasis.

The rectus muscles travel from the bottom of the rib cage to the pubic bone on either side of the midline and are joined by fibrous tissue centrally. These muscles are also known as the 6 pack muscles. The fibrous linea alba tissue splits if it is stretched beyond its limits.

Majority of the time, this condition spontaneously rectifies itself post delivery within 6 months. Emergency surgical intervention required if there is any herniation of structures from the abdominal cavity through the gap. After 6 months, if you are not planning anymore children, you can elect to have a tummy tightening surgery to join the two muscles again.

There are several things you can do in pregnancy to prevent developing or worsening rectus abdominis diastasis

  • Avoid all sit up like motions from approximately the 12th week of pregnancy. It is best to get into the habit of rolling onto your side and pushing yourself up to get out of bed.
  • A maternity belly support brace can reduce the strain on the abdominal muscles by more evenly distributing the weight of your bump as well as reducing the downward drag.
  • Maintain your weight gain to the normal ranges for your stages of pregnancy.  This will hopefully result in a more gradual growth of your belly enabling the linea alba to stretch.
  • Avoid twisting or extension movements.
  • Wear a maternity lumbar support brace if you are required to do heavy or repetitive lifting.

These recommendations should be followed post delivery until the midline of your abdomen has returned to its pre-pregnancy firmness and there is no bulging with coughing, sneezing or sit up like movements. 

There are several interventions available to you to speed up your recovery postpartum

Hands on treatment from a physical therapist such as a physiotherapist, osteopath, chiropractor, myotherapist or acupuncturist. Treatment can assist in realigning your body and taking pressure off the abdominal muscles.

Premium quality compression products specifically designed to speed up the recovery post delivery.  Compression is required in and around the rib cage to provide support and a centering force to the abdominal muscles.  This compression assists in protecting the abdominal muscles when you are active as well as encouraging the muscles to join back together in the midline.  Unlike a corset or rigid brace, the compression garments enable and encourage the abdominal muscles to work resulting in strengthening of the area.  A rigid garment worsens the condition over the long run by preventing the abdominal muscles from having to do any work resulting in weakening.

Appropriate and professionally guided exercise is very important in closing the gap and strengthening the abdominal muscles. Ensure your instructor is knowledgeable in this area as inappropriate exercise can have a negative effect on this condition.

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