Understanding Diastasis Recti Abdominis, A Common Postpartum Injury

Jan 7, 2022, 12:14 IST

Diastasis Recti Abdominis

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More evident during the second and third trimester of pregnancy, Diastasis Recti Abdominis (DRA) may sometimes persist post childbirth as well. Ishav M Lamba, Senior Health Coach at MyHealthBuddy, further explains, “In order to accommodate the growing baby, the abdomen expands, stretches the skin, muscles and connective tissue. As such, all women will experience it by the end of their pregnancy.” Research shows that regardless of the belly or baby size, weight gain doesn’t affect the occurrence of DRA. To top this, noone is immune from experiencing DRA; everyone undergoes this condition at the time of birth (common in babies and young kids), people who never had babies, and even men.

Scientifically, DRA is the thinning of the connective tissue that binds each side of the outermost abdominal wall, attaches to the ribs, runs down the midline, and connects to the pubic bone. Talking about the impact of DRA on the body, Lamba says, “Diastasis recti is an issue that impacts your whole body, not just the isolated abdominal region. It is a symptom of how you’ve moved your entire body throughout your life.” In case DRA doesn’t go away after pregnancy or persists even without being pregnant, then addressing pressure management issues and identifying imbalances in core stabilisation can help. Restrictions in hip/pelvic and shoulder region can also help in easing excessive load across the abdomen.

Diastasis Recti Abdominis

Image: Shutterstock

Lamba says that the most common sign of DRA is a protruding belly, also known as ‘mummy tummy’ or the ‘beer belly’. “Many people also witness a lump or bulging out of their mid-line under load (referred to as doming or tenting) during activities like planks, pull-ups, sit-ups etc. This bulge can be present in anyone, more noticeable in people with lower fat levels, and may result in an abdomen that looks ‘still pregnant’,” adds Lamba.

 

Causes Of DRA

Diastasis Recti Abdominis

Image: Shutterstock


Interestingly, DRA can happen at different locations in the body and measurements of the same may vary. Many people wrongly assume DRA to be just some fat on the belly which doesn’t go away with general exercises or diet. So what exactly causes DRA? Lamba replies, “DRA may occur if the core pressure isn’t managed well, resulting in an imbalance in pull from abs or pressure bulging out through the midline. As a result, it exaggerates separation or thinning of connective tissue.” Examples of exercises that need pressure management are crunches, planks, sit-ups, surya namaskar, kapal bhati. Additionally, as mentioned, DRA may be a common postpartum injury but everyone irrespective of age and gender can be affected by this condition owing to intra-abdominal forces similar to pregnancy. “Coughing, laughing, pooping, breathing, moving, and birthing are all things that change the amount of pressure in the abdomen. Increased intra-abdominal fat pushing through connective tissue and poor body alignment are also causes of DRA,” adds Lamba.


Preventing DRA

Diastasis Recti Abdominis

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Monitoring of core functions during exercising and carrying out daily lifestyle activities will play a vital role in preventing DRA whether or not you’re pregnant or experiencing postpartum. “Doing too much too soon or exercising too hard or postpartum can make DRA worse. During pregnancy, postural compensations happen to accommodate growing belly, creating imbalances between abdominals, pelvic position and back. These imbalances can result in having a poor posture which can contribute to DRA significantly,” says Lamba.

 

Healing From DRA

Diastasis Recti Abdominis

Image: Shutterstock

Lamba suggests the following to deal with and heal from DRA.

  • Identifying and working on faulty breathing mechanics: Work on moving muscles of the ribs. 360° expansion and contraction is the key.
  • Alignment matters: Maintaining the ribcage stacked over pelvic position primes the core muscles to work well through the day.
  • Understanding and rectifying mobility restrictions in upper and lower body.
  • Working on the whole body: DRA can’t be rectified with a bunch of exercises. It’s about how you breathe, how you hold your body and it is your movement that determines the load on connective tissue.
  • Avoid moves that increase intra-abdominal pressure until managed well: Jumping, skipping, running- all these may cause bulging in linea alba or pelvic floor resulting in urine leakage issues.
  • Losing weight or fat can help in decreasing intra-abdominal pressure that adds pressure on the midline.

 

Even though a surgery might seem like the only way of healing, it will only repair  the damaged tissue, not your faulty movement patterns. Diastasis isn’t only a separation in your abs but an issue for your whole body and thus, various components need to be addressed. “Things can change and improve! Make sure you seek guidance from a pelvic floor physiotherapist or a certified professional who can work on healing your DRA by looking at the whole system intricately,” advises Lamba.

 

Read more: Your Expert Guide To Reducing Neck And Forehead Wrinkles