Ask The Physiotherapist

DIASTASIS RECTI – Separation of the abdominal central wall
Diastasis Recti

What is it?

It is the midline separation of the Linea Alba. The Linea Alba is the central line down the abdomen (see pic) connecting the abdominal muscles. It runs from the bottom of the breastbone (sternum) down to the pubic bone. Unfortunately it is an all too common side effect of pregnancy hormones, which encourage laxity and of course that ever-expanding uterus! Up to 50% of women have a split of some degree immediately post partum. This usually resolves by 6 weeks but in some cases it can linger afterwards and at that stage normally needs some specific intervention to reduce the gap.

In fact, in a particular study (Spitznagle et al, 2006) it was found that 52% of women presenting to a Urogynaecologist with pelvic floor dysfunction post partum were also found to have diastasis recti. So it may be more common than we realise and should not be ignored!

Self Check for Diastasis Recti
Curl-Up Test

Lie on your back with your knees bent. Slowly lift your head neck and shoulders up off the floor keeping your chin tucked in (not far off ground)

Diastasis Recti is present if you can fit two or more fingers (width-wise) into the space just above the belly-button. (A small gap of one finger breath may be present immediately post partum and this is usually not a problem).

However if the gap at the midline…

• is more than 2 ½ finger widths
• Does not shrink if you tighten your abs further
• There is a small mound protruding at the midline

…. You have Diastasis Recti

What to do?

• It is really important that you inform your fitness instructor at Baby Body Fit so you can modify your exercise approach. This will involve avoiding certain exercises for example, double leg lifts and aggressive sit ups or twists with weights until you are stronger. There are lots of alternatives that your instructor can suggest though that build your abs in a different way, such as planks, side planks, squats and push-ups.
• Always try to ‘engage’ your inner core and draw up through your pelvic floor during EVERY exercise, if you can think of it!
• If you feel the gap is substantial and is not reducing you should see a physiotherapist for a specific assessment and home exercise programme to accelerate healing and closing of the gap and prevent further issues.
• Know your limits and work within these, building strength in your core from the inside out.It may take a few months to reduce the gap but persist with the exercises as they do work!