Get the facts about a common post-pregnancy body change

Causes and symptoms of abdominal separation — diastasis recti — and how to close the gap

Get the facts about a common post-pregnancy body change

During and after pregnancy, some women find that their stomach muscles weaken and leave a lingering pooch or bulge in the belly.

In fact, there’s a diagnosis for that.

It’s called diastasis recti and according to experts at Sanford Health, it can affect up to 33% of women.

“Diastasis recti typically occurs as early as five months pregnant with excessive weight gain, multiple pregnancies and women who report heavy lifting — more than 20 pounds weekly,” Jaclyn Iverson, DPT, told Sanford Health News. “The majority of women continue to present with symptoms of diastasis recti six weeks postpartum and one-third of women continue to present one year postpartum.”

How do I know if I have diastasis recti?

According to one national source, you can put one hand on your belly, with fingers on your midline at your navel. Press your fingertips down gently and bring your head (shoulders stay on the ground) up into a mini crunch-like position. Feel for the sides of your rectus abdominis muscles and see how far they are separate.

Iverson is a physical therapist at the Sanford Aberdeen Medical Center in Aberdeen, South Dakota.

She says other symptoms include:

  • Difficulty lifting objects
  • Difficulty walking or performing everyday tasks
  • Pain during sex
  • Pelvic or hip pain
  • Urine leaking when you sneeze or cough
  • Constipation

“The female body goes through so many changes during pregnancy and the body needs time after pregnancy to gradually heal,” Iverson said.

What happens if diastasis recti goes untreated?

The Center for Minimally Invasive and Robotic Surgery says rectus diastasis creates a visible bulge in your abdomen, but it’s more than just a cosmetic concern. Untreated rectus diastasis can weaken your abdominal muscles over time, leaving you with chronic lower back pain and reduced mobility.

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For some, this condition doesn’t go away on its own.

That’s where physical therapy comes in.

Working with a Sanford physical therapist

Sanford Health providers perform a clinical test and diagnostic ultrasound to determine the width and depth of the gap.

“The goal of physical therapy is for the abdominal wall to function properly,” said Patricia Smid, DPT, who is also a physical therapist at Sanford Health in Aberdeen.

“Physical therapy can help patients get back to their normal routines while avoiding future injuries. We will work with patients one-on-one to help your body heal at its own pace.”

A Sanford Health physical therapist will complete a thorough evaluation, during which they may feel around your abdominal muscles with their hands.

The evaluation will also measure factors that affect your strength, mobility, and endurance such as posture, breathing, flexibility and overall muscle strength and movement patterns.

“A physical therapist will be able assess the ability of the abdominal wall to function properly, then select exercises that are of the appropriate level for each patient’s needs,” Iverson said. “This allows the patient to begin exercises at the desired intensity without over straining the abdominal wall and potentially worsening the diastasis recti.”

As the patient is demonstrating improvement in form and ability to properly activate the core muscles, providers say, the physical therapist can advance the exercises until a final home program can be established.

In most cases, diastasis recti will resolve on its own. But again, up to one-third of women will still have diastasis recti a year after delivering baby.

Preventing diastasis recti is possible

Providers say many women are motivated to return to their pre-pregnancy level of activity, but they encourage it to happen slowly to allow for proper muscle activation.

“Beginning with exercises that are more strenuous than the body can tolerate can lead to poor form with compensation from undesired muscles and potential for injury,” Iverson said.

Some women start strenuous abdominal exercises too fast, too early, which may ultimately delay diastasis recovery, she added.

If you’re looking for ways to prevent diastasis recti, there are a few things to keep in mind:

  1. Starting a core and pelvic stabilization program early in pregnancy is effective in prevention.
  2. In some cases, maternity belts or belly bands can provide external support during pregnancy to help relieve back or abdominal pain.
  3. Before pregnancy, adopt a wellness program into a daily routine to include cardio as well as strength training and core stabilization exercises.
  4. During pregnancy, avoid excessive weight gain and minimize heavy lifting to maintain the muscular integrity of the abdominal wall.

Sanford Health experts say the first line of defense for diastasis recti treatment is physical therapy and exercise. While surgical intervention typically is not necessary, it is an option.

Find a solution that’s right for you through physical therapy and rehabilitation at Sanford Health.

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Posted In Aberdeen, Internal Medicine, Parenting, Pregnancy, Rehabilitation & Therapy, Women's