What is diastasis recti? And how can you combat abdominal separation after birth? Tamsin Brewis speaks to postnatal experts.
Having a baby – especially for the first time – changes a lot of things. Your sleep pattern, the state of your home and your ability to engage in normal, adult conversations, to name but a few. But, ultimately, it’s your body that goes through the biggest change. One of the common problems mums face is abdominal separation (often called diastasis recti).
To comfortably and safely carry your baby through pregnancy, it’s undoubtedly your stomach that does the most work, as the muscles in your abdomen lengthen. The technical description? This is when the linea alba, the tissue between that set of muscles, thins allowing for a wider gap between the left and right sides. For a high percentage of mums, this can cause a post-pregnancy bulge of the abdomen.
Tamsin Brewis, baby specialist and owner of baby swim school, Water Babies Bucks and Beds, has collaborated with two post-natal fitness experts – Camilla Hollweck, Level 3 Pilates instructor and co-owner of post-natal Pilates programme, Mamma Method and Jo Dyson, a Women’s Health Physiotherapist and owner of Mother Nurture Pilates – to get the answers to your questions about abdominal separation.
My first question is, how can a new mum check for abdominal separation?
Camilla: A really simple way to check for diastasis recti is to lay on your back with your feet flat on the floor and your knees bent. Curl your head off the floor slightly, so your stomach muscles tense, and feel for the indent down the middle of your tummy.
Start at your belly button and feel just above and below in a vertical line. If your fingers can press down further than a fingernail and the gap is as wide as 2cm, then that’s abdominal separation. You should always seek the support of a professional, like a physiotherapist, to officially diagnose your diastasis recti but this is a great way to initially recognise it.
How can abdominal separation be managed?
Jo: There are a whole host of exercises and measures you can practise to help rebuild your core and generate better tension of the linea alba.
Pregnancy causes massive changes to your postural alignment and centre of gravity so I always recommend practises that will restore the natural curve of the spine. Aligning properly means muscles are able to work optimally and generate the tension they need to work efficiently.
That all sounds very complicated and a little daunting! Is this something that mums can do at home?
Jo: A tip I often give new mums is to stand in the mirror with just underwear on and observe your side profile. Are you standing tall, or slouching? Is your belly protruding or are you guilty of sucking in your mummy tummy?
Try tipping the pelvis back and forth, then shifting body weight side to side and forwards and backwards over again every day until you feel you’ve ‘re-learnt’ how to stand well and are happier with the side profile alignment.
Another top tip? The midline of our tummies is made of a fibrous connective tissue called collagen, which is 70% water. It’s not rocket science – if you want to build collagen, drink lots of water!
Is exercise safe if you have abdominal separation and does it make it better, or worse?
Tamsin: There’s an awful lot of pressure on mums today to get back to the gym and ‘lose the baby weight’ and all sorts of other ways we’re supposed to conform.
Camilla: A major cause of abdominal separation might surprise you – exercise! Although I’d definitely recommend low-intensity workouts, like the baby-wearing Pilates classes we host at Mamma Method, or your Water Babies classes, some routine fitness moves, including crunches, sit-ups, push-ups, press-ups or front planks, can make abdominal separation worse.
Therefore, little things like sitting up to get out of bed or lifting a baby carrier out of the car can emulate the exercises we recommend avoiding altogether. Making minor adjustments to your routine, like rolling onto your side before getting up out of bed, will make all the difference in the long-run.
How soon after having their little one should new mums think about exercising again?
Camilla: For some new mums, tackling any sort of fitness regime is the last thing on their mind, whereas others find comfort in rediscovering their love of exercise. The key thing is to take things at your own pace and listen to what your body is telling you.
Is there anything that new mums can be doing at home?
Camilla: We often recommend a few different activities mums can do at home, including Kegel exercises, but I’m a real advocate for starting off slowly before jumping in with a structured programme. Start off by taking a long walk, once a day, or going for a light swim and incorporate usual activities – like walking up the stairs – as a low impact workout, by controlling your breathing and recognising the muscles you’re using. We believe that building strength is more than just getting your body back to where it was, pre-pregnancy – it’s about a healthy mindset before finding something that works for you. Taking half an hour out of your day, whether that’s at home, attending a Water Babies class with your little one, or a Pilates class with other mums, is a great way to get back to you and incorporate exercise at the same time!
Tamsin: It’s really important to note is that all bodies – and pregnancies! – are different so try not to compare your post-birth recovery to other new mums. Once you start the process of trying to heal, you can start to see results in as little as six weeks, but it can take more than a year.
The key to tackling abdominal separation is healing in a way that is healthy for you. And if you plan on having another child, it’s especially important to make a full recovery before getting pregnant again. For activities and programmes that are customised to you and your needs, I’d always recommend seeking the support of specialists before going ahead with any post-natal regimes.
For more information about Water Babies Bucks and Beds, visit www.waterbabies.co.uk/lp/baby-swimming/bucks-and-beds
More information on diastasis recti…
Becky Dickinson consults Caroline Bragg, head PT with postnatal retreat group &Breathe, for more top tips of dealing with diastasis recti.
What to do if you think you have DR
It’s best to consult a professional first. Once you’ve been given the go ahead, here are some basic exercises to try at home.
“Diaphragmatic breathing is key as it works with your pelvic floor and core,” says Caroline. Lie on your back, with your hands on top of your lower ribcage and inhale. Feel the diaphragm make the lower ribs expand into your hands. As you exhale, focus on contracting your diaphragm.
Single Leg Heel Slides
Lie on your back, knees bent and feet flat on the floor. Keep your arms by your sides. Engage your pelvic floor muscles (as if stopping the flow of urine). Keeping your pelvis and spine neutral, exhale to slowly extend one leg out, keeping the heel on the ground. Inhale to slowly slide the leg back in. Repeat on the other side.
Tabletop Toe Taps
Lie flat on your back and lift both legs to a tabletop position, with your knees directly over hips. Without letting your lower back lift off the ground, slowly lower one leg to the floor keeping the same tabletop shape. Keep pulling your navel into your spine as you exhale. When your toes touch the ground, inhale and lift your leg back up to the original position. Repeat with other leg.
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