What Causes a Diastasis?
Diastasis Mini Series
Part One: What Causes a Diastasis?
Part Two: Healing a Diastasis Post Partum
Part Three: Breathing Techniques to Heal a Diastasis
Part Four: Proper Posture to Heal a Diastasis
Part Five: Hypopressive Training to Heal a Diastasis
Diastasis is a common concern during pregnancy and post-partum, and is highly misunderstood. I’d like to clear up this misunderstanding so you know when a diastasis is problematic and when it’s not; what causes a diastasis and how to prevent it; and how to effectively heal a diastasis for good post partum.
In this 5-part mini series, we’re going to discuss what diastasis recti is and how to support your body to naturally heal a diastasis post partum. We’ll start with what causes a diastasis and the difference between a normal diastasis during pregnancy and a clinical diastasis that hasn’t healed properly post partum. Next, I’ll explain how to naturally heal a diastasis. Next, I’ll explain how your breathing can speed healing of a diastasis. Then, we’ll discuss how your posture impacts the healing of a diastasis. Finally, I’ll share a hypopressive training flow for a diastasis.
What is a Diastasis?
A diastasis, also called diastasis recti, refers to the separation of the rectus abdominis muscle, commonly known as the "six-pack" muscle, along the midline of the abdomen. These muscles are connected by a thick band of connective tissue called the linea alba. During pregnancy, the abdominal muscles separate at the linea alba to accommodate your growing baby. This separation allows the abdominal wall to stretch and make room for your expanding uterus. This is a normal part of carrying a baby and happens in every pregnancy.
When does a diastasis become problematic?
Every women gets a diastasis during pregnancy. The abdominal muscles must separate to accommodate your growing baby. It’s when the abdominal muscles fail to close post partum that a diastasis becomes problematic. In a healthy core, a diastasis is a temporary condition that resolves naturally within the first few months postpartum. In the situation of core dysfunction, the separation of the abdominal muscles persists post partum and fails to close adequately. A diastasis becomes problematic if it does not close during the first three months post-partum.
A separation of greater than 2.5 fingers beyond 3 months post partum is what I consider to be a clinical diastasis.
When a diastasis is persistent and requires rehabilitation, you might experience common symptoms related to core weakness and compromised abdominal integrity such as a visible bulge or doming in the midline of the abdomen, especially when attempting activities that engage the abdominal muscles, such as sitting up or performing certain exercises. Additionally, you may struggle with decreased core stability, which can lead to lower back pain, poor posture, and difficulties with activities that require core strength, such as lifting objects or carrying your new baby. Some people also notice a feeling of "hollowness" or lack of support in their abdominal region. Addressing these symptoms through targeted exercises and rehabilitation can help restore core strength, improve posture, reduce pain, optimize organ position, improve digestion, elimination, and hormonal regulation.
If you have a diastasis, rest assured, it can be fixed no matter how far post partum you are! In The Core Recovery Method® Online Program, you can learn all the skills and exercises necessary for closing a diastasis in a simple and comprehensive protocol. The Core Recovery Method® is ideal to use during pregnancy as well, to prepare you for delivery, prevent diastasis post partum, reduce pain and other common pregnancy-related symptoms. The same protocol is that is used during pregnancy is also implemented post partum to close the abdominal muscles.
What causes a Diastasis?
A diastasis is caused by core muscle dysfunction. What causes core muscle dysfunction? 1) Chronic exposure to increased pressure in the abdomen resulting in weakening of the core fascia, and 2) reduced range of motion and decreased strength of the abdominal and pelvic floor muscles. After birth, the abdominal and pelvic floor muscles are weakened because of the pressure they endured for 10 months and how much they stretched during pregnancy and delivery. If the abdominal muscles are not rested, unloaded and rehabilitated properly after delivery they can get stuck in this weakened state. Add carrying around a growing baby constantly, and breastfeeding all day and night, and lack of proper rehab exercises, and you have a recipe for a diastasis. Poor posture and poor breathing mechanics post partum can also lead to continued core weakness, increased intra-abdominal pressure, and a diastasis that does not close.
There are also certain exercises that can cause a diastasis post partum. Many women have good intention and try doing typical “core exercises” to rehab their belly post partum, thinking it will help reduce their waistline and get rid of their diastasis post partum. However, typical “core exercises” actually make a diastasis worse and distend the waistline even further. So first, I’d like to explain what exercises are harmful post partum and can cause or worsen a diastasis. Then in the following posts of this mini series, I will explain what exericses will close a diastasis, and how your daily posture and breathing can either create or heal a diastasis.
Understanding Harmful Core Exercises
Choosing the right exercises post partum is very important to ensure you regain your optimal core function post partum. Remember, core function is about more than just abdominal muscle strength. Your core is responsible for posture, movement, respiration, circulation, nerve conduction, thinking, feeling, talking, digestion, immunity, hormonal regulation, detoxification, spinal stability, and internal pressure management. So if your abdominal muscles don’t close properly post partum, all of those functions can be affected!
The post partum period is an extremely vulnerable time. So you want to be cautious about the inputs you give your body post partum to ensure the abdominal muscles close properly and you regain optimal core strength. Performing exercises that stress the linea alba and increase the pressure in the abdomen can actually cause a diastasis and delay healing post partum.
There are certain "core exercises" that can be extremely harmful to a post partum core because they over-stress the linea alba leading to further weakening the abdominal fascia. These “core exercises” also increase the pressure in the abdomen leading to lowering of the pelvic organs and compression of the pelvic floor muscles. Performing exercises that increase the pressure in the abdomen post partum can delay healing of tears and exacerbate the “lower belly pooch”.
Here are the “core exercises” that are harmful to a post partum core:
-
Crunches (of any kind)
-
Bicycles
-
Leg lowering (single or double with bent or straight knees)
-
Boat pose/ pilates hundred
These exercises can have detrimental effects on the post partum core for three main reasons:
They increase the pressure in the abdomen
These exercises increase the pressure in the abdomen by lowering the diaphragm and brining the rib cage closer to the pelvis. This posture places undue stress on the connective tissue and muscles of the core. This increased pressure can further strain an already weakened postpartum core, exacerbate a diastasis, delay healing of the pelvic floor, and reduce blood flow to the pelvic organs - especially the uterus.
They lower the pelvic organs
Any time the rib cage gets closer to the pelvis, making the abdomen gets shorter, the pelvic organs move down. These exercises lower the position of the pelvic organs, reducing their blood flow, and putting additional strain on the pelvic floor. This strain can negatively impact pelvic floor health and contribute to issues such as prolapse, incontinence, urgency, frequency, hemorrhoids, pelvic pain, back pain, constipation and bloating.
They inhibit the deep abdominal and pelvic muscles
Many people do these exercises thinking they strengthen the deep core. But the opposite is actually true. These exercises inhibit the activation and engagement of the deep abdominal and pelvic muscles, because of how much they increase abdominal pressure. So instead of the muscles absorbing the load of the increased pressure- the abdominal and pelvic fascia will, and this will either worsen or cause a diastasis. Inhibition of these muscles can lead to further weakness, core dysfunction, and the “lower belly pooch”.
When these three factors—increased abdominal pressure, lowered pelvic organs, and inhibited deep abdominal and pelvic muscles—occur simultaneously, it can result in an overloaded abdominal and pelvic fascia. Over time, this can lead to stretching, weakening, and tearing of the fascia, ultimately causing a diastasis. This is how a diastasis occurs. This is also how prolapse and disc herniations occur. It all stems from the same mechanical core dysfunction.
The Importance of Avoiding Harmful Exercises
I have often seen women post partum who have no diastasis at 3 months post partum and are doing great, then start incorporating these exercises into their routine — and boom, they get a diastasis. But don’t worry if this sounds like you — a diastasis can be closed with a simple protocol at any time postpartum! Make sure you check your core muscle function prior to performing exercises that increase intra-abdominal pressure (like running, jumping, high impact exercises and weight lifting). If your core muscles are not functioning properly, avoid high impact activities and continue the proper core rehab exercises until your core muscles are functioning properly. Once your core muscles are functioning properly again, cautiously start incorporating high impact activities into your routine again, being mindful of how your body feels and responds.
Post Partum Exercise Modifications
When you do start to incorporate more exercise into your routine post partum, remember the first 12-24 months post partum is a critcal and vulnerable time when your core muscles and abdominal / pelvic fascia need the RIGHT input to heal and recover again.
Yet, this is the time when most moms wan to hurry up and get back in shape again. Its great to be motivated to get strong again and feel good, and its also very important to choose the healthiest options for exercise.
Here are some ways to swap out harmful exercises for helpful ones:
-
INSTEAD OF: Crunches and Sit Ups, DO: Hypopressive Training
-
INSTEAD OF: Burpee’s and Jumping, DO: Squats
-
INSTEAD OF: Running, DO: Hill walking
Stay tuned to this mini series over the next few weeks for specific guidance on exactly what exercises will close a diastasis, as well how to use posture and breathing all day long to heal a diastasis without needing to set aside time for exercise! I will finish this mini series with a hypopressive training flow that is excellent for healing a diastasis and speeding post partum recovery.
