It's a condition that affects 60% of pregnant women, regardless of their fitness level or diet, leading many to ask "Why do I still look pregnant even though my baby is already here?"
Unfortunately, there's no easy answer. Every woman's body is different, and every pregnancy is different. Research shows that only 20% of women return to their pre-pregnancy weight within three months of delivery.
That said, a few things can contribute to the post-baby bulge, even if you have lost some of your pregnancy weight.
The worst offender is diastasis recti.
What Is Diastasis Recti, and What Muscles Are Affected?
Diastasis recti is a condition where the rectus abdominis muscles separate in the midline. The rectus abdominis muscles are the "six-pack" muscles that run down the front of your abdomen and are responsible for flexing your spine.
During pregnancy, the added pressure from the growing uterus weakens the linea alba, the connective tissue that holds the muscle together. The separation usually occurs at the level of the belly button, but it can extend above or below the belly button as well.
What Does Diastasis Recti Feel Like?
The most common symptom of diastasis recti is a bulge or protrusion in your abdomen. You might also see a noticeable gap between your rectus muscles, particularly when you strain or flex your abdominal muscles.
How Common Is It?
Diastasis recti is relatively common in postpartum women. One study of 300 first-time pregnant women found that 60% of women had at least a 2 cm abdominal wall separation by six weeks postpartum.
A smaller study of 84 pregnant women found that 100% had some degree of abdominal muscle separation by late pregnancy. However, the prevalence of diastasis recti decreased to 39% by six months postpartum.
How Do You Know if You Have Diastasis Recti?
The simplest way to determine if you have diastasis recti is to perform the modified curl-up test.
First, lie down with your knees bent and place your fingers above your belly button. Next, gently press into your abdomen and feel for any separation between the muscles. If you do not feel a separation, elevate your head and shoulders off the ground and gently press your fingers into your abdomen again. You can check for rectus muscle separation at the belly button and above and below it.
How Wide of a Gap Is Considered Abnormal?
There is some controversy over what is normal abdominal muscle separation. Some experts believe a more than 2 cm gap is diagnostic (approximately two finger widths). However, some women might have symptoms with a smaller opening.
Is Diastasis Recti Permanent?
Diastasis recti appear to resolve in some women spontaneously, but some have a persistent separation.
The same study of 84 pregnant women with diastasis recti found that over 60% of women had resolution of their abdominal muscle separation by six months. Similarly, the more extensive study with 300 women found that half of the women with diastasis recti had resolution by 12 months postpartum.
What Happens if It Goes Untreated?
If you are asymptomatic, you may not need any specific treatment. However, weak stomach muscles might predispose you to other issues, such as lower back pain and postural dysfunctions - where your spine and other joints are out of their normal balanced alignment.
With that said, diastasis recti is not the same as a hernia. A hernia is a protrusion of abdominal contents through a hole in the abdominal wall, and it can occur with or without diastasis recti.
It is essential to seek medical follow-up if you have a hernia, as abdominal hernias may cause serious complications.
How Can I Treat Diastasis Recti Naturally?
Diastasis recti is not a true hernia, so it doesn't have to be surgically corrected. The best way to treat diastasis recti naturally is with exercise.
In general, two types of exercises may be beneficial.
1. Core exercises: Dedicated core training will improve and restore midline strength in the rectus muscles. Doing so may help close the gap and prevent further separation of the ab muscles. You can find a complete list of beginner, intermediate, and advanced diastasis recti exercises here.
2. Pelvic floor muscle exercises: These exercises improve the function of the muscles that support the bladder, uterus, and rectum. These pelvic floor muscles work together with the transverse abdominis (TVA) to stabilize the trunk and decrease the risk of urinary incontinence and pelvic organ prolapse.
A pelvic floor physical therapist can help you identify the best exercises for your individual needs.
How Long Does It Take To Fix It?
In general, it might take anywhere from 6 to 12 months after your delivery to heal your diastasis.
However, no two situations are alike, and some women may have more severe separations than others.
If you have not seen any improvement in your abdominal separation after a trial of exercise and weight loss, surgical repair may be an option.
Be sure to speak with your healthcare provider to see if surgery is right for you.
What Exercises Make Diastasis Recti Worse?
Lastly, avoiding any exercise that places excessive stress on the rectus abdominis muscle is essential, as these movements can worsen the separation. You can determine if an activity stresses the rectus muscle significantly if you develop coning while performing the exercise.
Coning occurs when the connective tissue between your rectus muscles bulges outwards in the middle, giving the appearance of a cone shape.
Common exercises to avoid include sit-ups, crunches, planks, and hanging ab exercises.
Here is a safe diastasis recti workout that only takes 20 minutes daily.
If you are struggling with diastasis recti, know that you are not alone. This condition is relatively common, and there are conservative measures that may improve the separation. Either way, strengthening your core muscles can help improve your posture, abdominal stability, and quality of life.
This article was produced by The Postpartum Trainer and syndicated by Wealth of Geeks.