The number one reason that post natal mums contact me is for post natal fat loss – in their words, ‘getting their body back’. The second main issue they contact me with is regarding diastasis recti, aka, tummy gap/mummy tummy. These are often related.
So what is Diastasis Recti Abdominis (DRA)?
Simply put, during pregnancy, as the baby grows, your belly needs to grow with it. This is possible due to connective tissue called the linea alba, which connects the two sides of your ‘ab’ muscles. The linea alba stretches to accommodate the growth of your baby, which causes a separation of the abdominal muscles. This separation is normal and expected when pregnant, but for some women the separation remains long after giving birth – this is Diastasis Recti Abdominis.
What are the implications of DRA on our body?
Diastasis is commonly the cause of “stubborn mummy tummies” – you may still appear to be a few months pregnant and no matter what you do you cannot ‘flatten’ your midsection. You may see ‘doming’ of your stomach especially when coming up from a lying position on your back (e.g. situps)
More importantly, it affects core and pelvic floor functionality, so you may experience things such as low back pain, instability in your pelvis, incontinence, and prolapse or hernias.
How do I heal my diastasis, or ‘close’ the gap?
DRA is a common occurrence that in most cases can be healed naturally. However, there are many factors to consider, rather than simply performing a few exercises. Here are the KEY pieces of the puzzle:
1. Posture, Alignment and Muscle Imbalances
Sitting and standing in optimal alignment and dealing with muscular imbalances is essential for core recovery. For example, many post natal women have an ‘exaggerated’ curve in their lower back, and as a result their abdomen pushes out. This creates pressure on your already weakened midline, and keeps the muscles lengthened, so re-connecting to the core and regaining proper tension will be more difficult.
Incorrect posture is generally a result of muscle imbalances, i.e. some muscles that are ‘too tight’ or overactive, and others that are ‘too weak’, or underactive. Therefore, addressing these muscle imbalances is key in healing your diastasis – you need to get your body functioning optimally before you can achieve a strong, functional core. This can be done by performing ‘release’ exercises for overactive/tight muscles, and activating the weak, underactive muscles.
2. Breathing Technique
Breathing, something we do naturally without even thinking about it, can also be affected by poor posture and incorrect habits. In fact, many women are not breathing in the way our body was designed to. The way we breathe is another key factor in healing a diastasis, and this one alone is HUGE – it in fact forms the foundation for all further exercise prescription.
Excessive belly breathing or chest/shoulder breathing puts further pressure on your core and pelvic floor and means that your core is not functioning optimally. We want to breathe into our ribs and belly. Another important thing to remember with regards to breathing is to NOT ever hold your breath when exercising, and also to always EXHALE on EXERTION – this reduces the intra-abdominal pressure that can maintain, or even worsen, a diastasis and weak pelvic floor.
3. Gut Health
Hippocrates once said that all illness begins in the gut – this has some truth to it. We absorb nutrients through our digestive system, so if it isn’t working well then we won’t absorb the necessary nutrients properly.
If we’re constantly ‘backed up’ this also increases the pressure within the pelvis and against the abdominal wall and further cause posture problems. If we strain and ‘push down’ to have a bowel movement, then we are further weakening the muscles of our pelvic floor and core AND again increasing the intra-abdominal pressure that maintains or worsens diastasis recti.
Focus on improving your gut health and ‘toileting technique’ and you’ll already start to see a flatter, more comfortable belly.
We all know we should be drinking a minimum of 8 glasses of water a day – but are you? This is important for overall health, but in the case of healing a diastasis, dehydration can delay or stop any improvement. Why?
As already mentioned, the linea alba is what has stretched to separate the abdominal muscles. The linea alba is connective tissue. Collagen is the building block of all connective tissue. Collagen is more than 70% water.
Simple: drink up!
This is a big, but often overlooked factor. There are certain nutrients, vitamins and minerals that play an important role in repairing and healing the body. There are also foods that have an inflammatory effect on our body and can move us away from healing. The topic of nutrition is vast and not the scope of this article, but in brief, remember to Just Eat Real Food – include protein in every meal, adequate healthy fats, and plenty of vegetables. Avoid sugar, processed foods, and alcohol.
It doesn’t have to be complicated or time-consuming – on my page and in my newsletter I post recipes and quick meal prep ideas that are all good for healing, repair and recovery.
This is the main reason post natal women first approach me – they ask me what exercises they can do to ‘close the gap’. Whilst there are a number of exercises I recommend for re-connecting to your core and healing a diastasis, these exercises would depend on the individual – for example: how wide is the gap, how much tension is there in the muscles, what muscle imbalances are present, which movement allows the individual the greatest connection to their core? The exercises prescribed are also gradually progressed to go from lying to seated to static standing to moving standing and to rotational.
Also, these exercises are only performed once optimal breathing technique is mastered, and are performed in synergy with the breath.
What exercises should be avoided? To name a few and the most common culprits: situps, crunches, leg raises, planks, pushups, rotational exercises, high impact exercises. Basically anything that increases intra-abdominal pressure, puts more pressure on your core and pelvic floor and does not allow proper support and re-connection.
7. Stress and Emotional State
Stress and emotional distress can cause physiological effects that move the body away from healing. Cortisol (the stress hormone) is naturally higher during pregnancy and immediately after childbirth – and this remains raised in the post natal period due to lack of sleep and the new overwhelming role you have.
It is impossible to completely remove stress from our lives, but making adequate time and effort to manage that stress positively will make recovery and healing quicker and more effective.
On a related note, coffee has been shown to raise cortisol levels in our body – so try to find alternatives (e.g. lemon + ginger in warm water, or Tulsi tea).
8. Everyday Activity
What you do in your everyday life is how your body moves most of the time – if you’re lifting heavy loads (or kids), sitting or standing in bad posture, pushing the buggy with hunched shoulders, holding your breath, constantly sucking in your belly – then you’re not giving your body the conditions it needs to heal and re-connect to your core.
When standing up from a lying down position, turn to your side first rather than do a ‘situp’ to get up.
Some simple things to remember in your day-to-day life: align your body in a neutral position; sit and stand ‘tall’; exhale on any exertion (e.g. lifting your baby out of the cot or simply going from sitting to standing); let it go, i.e. do not suck in your tummy; deep breaths into your ribs; keep hydrated.
As you can see, healing a Diastasis Recti is a WHOLE BODY ISSUE – it’s not just about exercise! Each topic listed above is so vast so this blog only skims the surface by summarising the key elements. Also, every woman is different, and there is no ‘one-size fits all’ answer. The Holistic Core Restore® Diastasis Healing Programme goes deep into each of the above factors on an utterly bespoke, personalized basis, to ensure you get the results you deserve.