diastasis RECTi reHAB

Diastasis Recti is a widening of the distance between the two sides of the rectus abdominis (“six-pack”) muscle. A gap is created along the linea alba (connective tissue that runs from the pubic bone to sternum) and you might notice a bulge along this line when you e.g. move from lying to sitting, do a crunch. When standing you might have a drooping tummy or a ‘pooch’. Physically, having a diastasis can be the cause of lower back pain, sacroiliac joint issues, pelvic floor dysfunction and lax abdominal muscles. Emotionally, the cosmetic postnatal ‘jellyness’ of the tummy can have a detrimental effect, and the midline bulging can frustrate and confuse women (and men) who are working hard in the gym to hone their body.

Diastasis and pregnancy

So baby can grow we need the abdominal muscles, tendons and linea alba to stretch. We call this a ‘natural’ separation and 2-3 fingers’ width is considered normal, even in the 4th Trimester.  It is also acceptable to have a gap many years later if there is ‘bounce’ in your tendons, you can control the body’s internal pressure systems, and have neither pain nor incontinence. When assessing I examine the appearance of skin, the shape of the belly button and the elasticity of the fascia beneath, as well as the length, width and depth of the gap.

If nutrition is good, care is taken, and the correct exercises performed, this gap should close naturally within a few months.  However, some Mums experience an ‘unnatural’ diastasis which can be the result of an exceptionally large uterus, too-strong abdominal muscles, being sat upright during the pushing stage or as the result of a c-section.  Sometimes I have clients who had no diastasis recti in their 4th trimester but a bout of e.g. constipation, coughing or sneezing, lifting their heavy toddler one too many times suddenly causes a diastasis. We will never know the cause (as it can be cumulative), but the Center Method has a proven track record in helping women where standard exercises have only strengthened the muscles but had no impact on the texture and tension of fascia and skin.

Who else can have a Diastasis Recti?

Men, weightlifters, elite athletes and gym-honed women: thanks to the proliferation of intense exercise regimes such as CrossFit, HIIT, as well as some boutique pilates studios offering a more intensive type of pilates workout.  It is  also believed that stress, poor toilet habits, incorrect breathing patterns, extreme hypermobility, belly button piercings (yes!), and  even childhood asthma can contribute.  Abdominal surgery can create adhesions which in turn can cause the fascial pulls that may misalign abdominal musculature.

Incorrect abdominal exercise technique is probably far more damaging than no exercise at all. There is always a “tipping” point when it comes to creating conditions: the body will adapt to whatever you are doing until it cannot anymore; this is what happens when a diastasis forms.  The fascia surrounding the abdominal muscles is put under excessive pressure during exercise and one too many crunches whilst holding a weight on your chest and suddenly, you have diastasis recti.  One of the ‘worst’ diastasis I have seen was on a sixty-year old man who sadly had not been shown the correct technique in his pilates class and with every flexion exercise he displayed the tell-tale coning of his abdomen along the linea alba.               

Centre Method for Diastasis Recovery

Strengthening abdominal muscles is only part of the solution. Our programme concentrates on correct breathing, releasing the fascia, realigning the bones and correctly restoring muscles to their proper function:

1.       Breathing: the first step is to check if you are breathing correctly. Over-exaggerated inhales and inflation of the tummy is not helpful and can be counter-productive, especially during the exercise segment.

2.       Release: the fascia using a specially designed ball and our “rocking to release” movements. We believe that when this fascial line is tight, the rectus abdominis may hang loose. It has been likened to the lining of a curtain that shrinks and the outer layer of the curtain droops. Releasing this area may have the effect of changing the tone of the rectus abdominis by offering more structural support. Clients feel very relaxed after these releases and many report an added benefit of reduced back pain the following day.

3.       Realign: manual realignment the rectus abdominis using the ball.

4.       Restore: a series of deeply-stabilising exercises, akin to those in beginners pilates.  These gentle exercises form part of your rehab programme and need to be done between sessions for maximum results. They gradually get more challenging and finish with a guided reintroduction of flexion of the torso to ensure correct technique.