One of the questions I’m asked most as a perinatal physiotherapist is ‘when can I return to sport?’ There are lots of answers to this, but I always advise new mums to check if they have diastasis before attempting any exercise as this can do more damage than it’s worth.
Diastasis recti (also known as abdominal separation or divarication) is the partial or complete separation of the two abdominal muscles. During pregnancy, to make space for the growing baby, your diastasis rectus abdominus muscle separates. One study suggests that up to 60% of women experience abdominal separation after pregnancy.
Diastasis recti makes your stomach muscles weaker and often leads to these symptoms:
- Tummy doming and feeling ‘still pregnant’
- Bloated tummy at the end of the day
- Lower back pain
- Poor posture
You can also check whether you have diastasis at home. Here’s how:
- Lie flat on your back with your knees bent and your feet on the floor.
- Lift your head and shoulders off the floor.
- Run the tips of your fingers along the midline of your abdomen.
- Press gently down along your midline, above and below your belly button.
There are three major things to look out for:
- Can you fit any fingers in the gap between the two sides of your stomach muscles? If there is a gap, how big is it? Is it bigger than 2.5cm, which is about two fingers?
- Are there visible changes to your belly? Tricky, I know, when your body has gone through so much change during pregnancy. But have a look to see if your belly button used to be an innie and is now an outie, or if your skin has stretched and lost some of its tension.
- Is there any resistance when you press down? Can you get more resistance with a strong breath out, which will activate your transverse abdominals, and draw the navel back towards the spine? It’s not all about the gap. If you have a small gap but no resistance, then you’ll probably not have the control that you need, so it’s important to check this too.
If you think you probably do have abdominal muscle separation, don’t worry - there’s so much that can be done. The good news is that two thirds of women with a gap in their abdominal muscles of around 2cm or less tend to spontaneously recover by about eight weeks postpartum.
But some separations are more severe and will need some rehabilitation to recover from. In fact, not all separations will close, however all should get to the point where you can still have a very functional abdomen and feel strong. If your gap is 2.5cm or larger, or if it’s been more than six weeks since you’ve given birth and there’s still a gap, I recommend you get in touch with a physiotherapist or speak to your GP who will be able to refer you. You can also message me right here on Tinto, and I’d be happy to give you more specific advice.
You can then work together to rehabilitate your diastasis and build strength in the core. This will help you return to doing the things you love safely and confidently.