From what you need to know about diastasis, or abdominal separation, to how to manage the common postpartum condition, this Women’s Health With Evolve column considers how the latest research offers women greater confidence in their recovery journey
Diastasis recti (abdominal separation) is a common concern among expecting and postnatal mothers, yet the lack of research and often conflicting information available can leave women fearful of the condition, its implications and what can be done about it.
Traditional views on diastasis focused on a single band of tissue (linea alba) between the recti abdominis muscles that could lead to problems such as pelvic floor dysfunction and lower back pain. It was thought that women should avoid certain exercises and wait until the gap had fully “closed” before resuming activity following a diastasis diagnosis. The latest research has enabled a better understanding of what it means to have diastasis and has challenged these ideas.
What is diastasis?
Diastasis or diastasis rectus abdominus (DRA) is when the linea alba, the tissue that connects the recti abdominis muscles, widens and thins. Did you know that 100 percent of women who become pregnant will experience diastasis in the later stages of pregnancy? It is a normal physiological adaptation to allow the belly to expand and the baby to grow. Research tells us that for most postpartum women the DRA will recover. However, in up to 30 percent of women it will persist longer than six months.
Additionally, diastasis isn’t always limited to pregnant populations, and can occur in people who do bodybuilding or strength training, or in those who carry an increased abdominal girth.
Is it all about the “gap”?
When we look at what happens during pregnancy it is the entire core that changes to accommodate the growing baby. This includes all four abdominal muscle layers, the pelvic floor and diaphragm, plus the linea alba. The focus on the “gap” is likely because it is the most visible area that becomes stretched, plus we can measure the inter-recti distance and hence give it a value. Following delivery, as well as weakened function, some women may report dissatisfaction with how their abdomen looks and feels and complain of a “Mummy Tummy”. Whilst some presentations may be due to a relaxed linea alba, some may be due to the relaxation of the entire abdominal wall, plus skin stretch and adipose tissue, or even a combination of all of these factors. Only by considering and assessing all of these factors do we then begin to shift the focus from “a single band of tissue” and finger width measurement, to a more holistic approach.