Diastasis recti; working around it
A birth story, part two.
Two years after Lourdes was born, I felt like
I was ready for baby number two;
Step 1 - Make sure that our first child was potty trained
Step 2 - Convince my husband that I was ready for baby number two
Other measures that were put in place for the second time around were:
Postpartum support for at least a month
A months worth of frozen meals
Mommy friends
Daily exercise postpartum plan.
I want to say everything went according to plan, but it didn't. Our little one was prepared for battle and it was a fight to get her out (Her names literally means ready for battle, so it was foretold). She decided to hangout in my womb longer than what was medically allowed, so I was given a date to be induced. As if she was in on the conversation, 2 days before our induction appointment, she sprung into action and I went into labor. Labor was long, but I was prepared to have her vaginally without medication. So much for a plan! After getting into every position known to man... some new ones that I made up, I progressed to dancing and pacing. Hours later, there was still no progression, so we decided to go the medicated route. There was still no progress, then we were told that her heart beat had begun to weaken, and as a physical therapist understanding the implications of what lack of oxygen can do to the brain, we were off to the OR (Operating Room). An unplanned C-Section took it's course (more on that in the next post).
Adhering to all the C-section precautions I was given, I eased back into activities and exercise, but I felt that it was taking longer than usually to get back into my physical routine. I wasn't able to see progress with my stomach appearance. I couldn't understand why after more than a 1 year I was finding simple things like single leg standing challenging. I tried to think back to my pregnancy and wondered if there was anything that could explain why it was taking so long for me to recover. After retracing my steps, I recalled an afternoon where I sneezed and turned my body at the same time and I felt a painful burning sensation down my belly. I thought I had strained a muscle, which was very possible. However, a year into trying to regain my function I realized there was something just not right. For some reason I didn't think it was a Diastasis recti. I wasn't assessed for a Diastasis recti at my 6 week postpartum check up, so really didn't think anything of it. I was simply okayed to ease into my regular activities.
What is a Diastasis recti?
A diastasis recti is when the abdominal muscles begin to separate in the middle of the rectus abdominal muscle called the linea alba. This separation is a normal occurrence in pregnancy, which may occur more often during the third trimester. A separation of the abdomen occurs to accommodate your growing baby. However, if a separation is 2.7cm (about the width of 2 fingers) at the level above or below the belly, it is considered to be more of a concern especially if there are other postpartum issues occurring.
“Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com”
How is a diastasis recti screened?
Your pelvic health physical therapist will assess your abdomen for a diastasis recti by checking for the width, length and the tension the linea alba generates at rest and with activity. They will also assess your breathing pattern and its role in healing your diastasis recti.
You can screen yourself for a diastasis recti, however I recommend seeing a physical therapist that can specifically assess your movements and tailor a program for you type diastasis recti and functional level.
Diastasis Recti Self Screening Form below.
Diastasis Recti Self Screening Instructions Video HERE
I THINK I HAVE A DIASTASIS RECTI
What are a few things I can do to begin to heal my Diastasis recti?
Just to be clear, this information by no means is meant to replace a visit to your doctor or local physical therapist for an assessment if you have concerns. There is so much you can learn about your body and how it is functioning during this postpartum period when you visit a pelvic health physical therapist. Not all diastasis rectis should be treated the same.
However, if you suspect that you have a diastasis recti you can:
1. Wear an abdominal binder. Support bands have their place. There is no harm getting a little support, it's when it's being overused or improperly used that we tend to see few results. Healing a diastasis recti requires more work and effort than just a wearing a support band. However, here are a few to begin your search (no affiliation):
2. Diaphragmatic breathing exercises with pelvic floor engagement.
Lay on your back with pillows under your knees.
Place your hands on your belly.
Take a slow deep inhale through your nose. Allow your belly to expand. As you inhale feel your pelvic floor release and bulge.
As you exhale allow your pelvic floor to pull up and in towards your head. Repeat about 5 times and complete 2-3 sets.
As you begin to feel the connection between your breath and pelvic floor, try to perform it in different positions and activities (sitting, standing, lifting your baby up).
3. Minimize intra-abdominal pressure during functional lifting activities and exercise by exhaling during the most strenuous points of theses activities.
4. Begin gentle core stabilizing exercises first and progress to loading exercises accordingly.
5. Once you have learned how to proper engage your abdominal muscles for exercise and movement, you don't have to keep checking it. But if you are the curious type, no harm checking every 12 -18 weeks.
We hope this information was helpful and know that you don't have to do this alone.
Don't hesitate to contact us. At Little Antz Physical Therapy, we pride ourselves in educating moms. We offer in-office and virtual visits. If you have any questions don't hesitate to contact us by using our Complementary Discovery Call.