Abdominal fascial weakness affects more than 1/2 of postpartum women
Diastasis recti abdominus (DRA) is a common problem of the fascial connective tissue that affects almost ½ of women during their first year
postpartum.1,2 This separation of the two parallel muscle bellies of the rectus abdominis occurs when the growing baby causes the connective tissue between mommy’s muscles to stretch beyond its tensile strength. The British Journal of Sports Medicine followed 300 first-time mothers through their pregnancy and for one year afterwards to see how common this problem was. They found a separation of at least 2-fingerbreadths in 60% of these women 6 weeks-, 45.5% at 6 months-, and 32.6% at 12 months post-partum. Why is it bad? DRA is correlated with health complications such as persistent lower back pain, pelvic pain, altered trunk biomechanics, poor posture. Left untreated, this abnormal separation of the fascial support of the trunk can result in stress incontinence, fecal incontinence, and pelvic floor dysfunction.
Can it be prevented? At this time, the research is conflicting on whether your exercise routine before or during pregnancy can predict whether or not you’ll have this problem. Can it be fixed? Looks like there is pretty strong support in the scientific literature for abdominal exercises to decrease the amount of separation between those tummy muscles. Mommy & Baby exercise classes and videos usually include these targeted exercises. On your own, you can do regular abdominal exercises like posterior pelvic tilts, reverse crunches, and trunk twists on the floor. When done for 3 sets of 20, 3x/week for 8 weeks, these exercises were effective in reversing DRA. Even better results can occur perhaps, if you add abdominal bracing, diaphragmatic breathing, pelvic floor contraction, and plank exercises. Do I have this? The easiest way to determine whether or not you have a diastasis recti abdominus, or DRA, is to lie on your back with your knees bent and feet flat, folding your arms on your chest. Now while performing an abdominal crunch, lifting your head and shoulder blades off of the mat, feel for a midline separation between the two longitudinal abdominal muscles both above or below your belly button. Using your index and middle fingers, see if you can fit them into a trough (or soft protrusion) between the muscles.
Thabet AA, Alsherhri MA. Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. J Musculoskelet Neuronal Interact. 2019;19(1): 62–68.
Sperstad JB, Tennfjord MK, Hilde G, et al. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. Br J Sports Med 2016;50:1092–6.
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