Donna Sarna Physiotherapy 102-897 Corydon Avenue, Winnipeg, MB R3M 0W7 Phone: 204-452-2608

How to Test for Diastasis Recti: • Lie on your back with

knees bent

• Place your fingers directly under your belly button so your palm is facing your head

• Gently lift your head and shoulders off the floor

• You will feel a separation between your finger tips.

• Measure the number of finger tips if a separation is present

• NOTE: This is not an exercise for diastasis recti

DIASTASIS RECTI

WHAT IS DIASTASIS RECTI?

Diastasis recti is a separation of the stomach (“6 pack”) muscle, known specifically as the rectus abdominis. The muscle separates at midline as a result of widening and thinning of the mid line tissue, known as the linea alba. The muscle separates into two sides in response to: 1) the force of the uterus pushing against the

abdominal wall as baby grows and 2) with the release of pregnancy hormones which softens connective tissue to prepare mom for baby’s birth. Separation can occur anytime in the last half of pregnancy but is most problematic after pregnancy when the abdominal wall is weak and does not provide adequate support for the torso and internal organs.

SIGNS AND SYMPTOMS

Diastasis recti presents as a ridge or a dip in the midline of the abdomen that can extend from the breast bone to below the belly button. A gap of more than 2 ½ finger widths when the abdominals are fully contracted is

considered significant. Diastatsis recti reduces the integrity of the abdominal wall, as well as the functional strength of the torso (the abdominal wall and the back) This can lead to lower back pain, pelvic instability, as well as problems with the pelvic floor (prolapse/incontinence). A severe midline separation in the muscle can lead to herniation of the intestines and other organs in the abdominal cavity.

NOTE: If at any time you see a round, hard, or painful bulge protruding from your belly button area, or along your mid line, consult with your OBGYN.

Donna Sarna Physiotherapy 102-897 Corydon Avenue, Winnipeg, MB R3M 0W7 Phone: 204-452-2608

Separation in a previous pregnancy significantly increases the

chance, and severity, of the condition occurring with additional

pregnancies. Women expecting more than one baby, petite women,

those with a pronounced sway back, or with poor abdominal muscle

tone are at greatest risk. Genetics also plays a big role.

HOW CAN DONNA SARNA PHYSIOTHERAPY HELP?

A physiotherapist can help in determining the extent of your diastasis recti and advise you on exercises and techniques that can lessen the separation in a safe and effective manner. Not all abdominal exercises are safe to perform after pregnancy if you have diastasis recti, and some exercises can make the separation worse. Strengthening of specific muscles that stabilize the core is the first step and is necessary to reduce the separation. Muscles that comprise the inner core include the diaphragm, as well as a specific stomach

muscle known as the transverse abdominus, specific back muscles known as the multifidi and muscles of the pelvic floor. Your physiotherapist will educate you in how to perform these exercises safely and effectively.

Physiotherapists at Donna Sarna Physiotherapy are specifically educated in assessing and training the pelvic floor musculature

ACTIVITIES TO AVOID WHEN YOU HAVE DIASTASIS RECTI

• Abdominal exercises that flex the upper spine off the floor or against the force of gravity such as: crunches, oblique curls, "bicycles," roll ups/roll downs, etc.

• Yoga postures that stretch the abs, such as "cow pose," "up-dog," all backbends, and "belly breathing."

• Exercises that require lying backward over a large exercise ball • Lifting and carrying heavy objects • Quadruped exercises performed on hands and knees or forearms and feet without

adequate abdominal support (i.e., opposite arm and leg lifts, planks) • Intense coughing without abdominal support