There so much negative commentary & conflicting information surrounding diastasis in the pregnancy and post-natal world. It can leave so many women fearful of the condition and unsure of the best way to manage it. In fact diastasis, which occurs in 100% of pregnancies beyond 35 weeks is viewed as a normal physiological adaptation. The stretch & widening in the soft tissue (linea alba) and rectus muscle allows the abdominal wall to expand & grow a baby. Which is pretty amazing! By having a better understanding of diastasis and the latest research we can start to change the negative narrative surrounding this topic and empower women to view this pregnancy related phenomenon in a more positive light; with confidence.
What is Diastasis?
The most traditional definition of diastasis or diastasis abdominus rectus (DRA), is a widening or separation of the rectus abdominus muscles. It is often referred to as a pregnancy related condition. The linea alba, which is the tissue that connects the recti muscles, widens and thins.
However, did you know that it can also occur outside of the pregnancy/postnatal world? The condition can occur in people who participate in body building / strength training and in populations with increased girth circumference. So DRA is certainly not limited to just pregnancy or postnatal women.
In the postpartum world diastasis is often viewed as causing a “Mummy Tummy or Pooch” or a “distended or rounded lower/mid abdominal wall”. In fact, we know that there are several factors that contribute to this problem and we can’t just blame a single band of tissue (LA) on this problem. When we start to look beyond this narrow focus of separation, we start to view diastasis differently.
It’s all about “The Gap”
Historically, treatment revolved around the “linea alba” and “reducing inter-recti distance” . This led to exercises that focused on closing the gap and approximating the recti muscles. Treatment then shifted towards more protective management of the deep core and minimizing load through the soft tissue. This historical understanding of DRA limited our exercise repertoire and led to restricted ideas about movement, load and recovery.
Unfortunately, these outdated treatment ideas continue to exist online. The plethora of conflicting & confusing information, perpetuates fear of movement and at worst paralyzes women from recovery and normal functional activity.
It takes time to shift the pendulum forward and integrate new treatment ideas. Research in the area of DRA and knowledge is still evolving, brilliant practitioners such as Grainne Donnelly, Munira Hudani, AntonyLo are working hard to change the approach to this condition, and whilst this is still very much a developing research area there is a lot that has changed in how we manage this condition with a large emphasis on education to reduce the fear.
Moving beyond “The Gap”
As we discussed above, DRA is more than just the linea alba; this is not the only core structure affected during pregnancy. In fact, the entire core muscle complex is stretched to accommodate a growing baby, and other systems such as the pelvic floor and diaphragm are also influenced. A change in muscle function and motor patterns can also occur during pregnancy, which can in turn affect postnatal recovery. The degree to which these systems are affected by pregnancy is still very individual, however, common threads of general muscle weakness exist for all.
Therefore the focus of management of this condition should be individual to each person and what they are capable of doing with control, connection to their core muscles and considerations of their pelvic floor system and breathing. It should be an holistic approach to postnatal recovery and so much more than a list of “Safe/Unsafe” exercises”.
This new way of viewing and understanding diastasis also aims to reduce the fear by reinforcing the normal physiological process of the widening and thinning of the linea alba tissue and shifting away from negative words like “split/separated abdominals” or “injured abdominals that require fixing”.
Diastasis is so much more than a “number of fingers” or a list of “prescriptive exercises” and it’s time we moved beyond this thinking. At Joint Dynamics Evolve we are passionate about educating, empowering and supporting our clients to do what they want to do and carry out unique assessments, treatments and rehab programs that do just that!