Diastasis recti abdominis is a separation of the rectus abdominal muscles at the linea alba.
With my first pregnancy I was 28, pretty physically fit and carrying one baby. My recovery was pretty straight forward. With my second it wasn’t.
When you’re told you’re carrying twins I don’t think many woman first think ‘oh no what about my body!’. There’s way too much other scary shit to worry about first. Like pregnancy, birth and having two newborns! So when the midwife came to see us on that first day at home with the twins, I was a little taken aback when she said that I had diastasis recti.
Now in normal language that you and I can understand, that means the stomach muscles have become overstretched during pregnancy and have separated down the midline. This results in a bulge after pregnancy and weakness in the area. This can be diagnosed during pregnancy but in my experience, it was the midwife who diagnosed mine a few days after the birth.
If you are unsure where you have a separation there is an easy way to check yourself. You can obviously look online for a guide on how to do this and should definitely speak to a professional but here is the general idea. You should lie on your back with your knees bent and your feet flat on the floor. Place one hand on your lower abdomin, in line with your belly button. Gently press your fingertips into the center of your abdomen while you lift your upper body in a crunch motion. Now I was told that most people will feel a hole immediately after birth as most woman will have some separation to begin with. The way Diastasis is measured is by how many fingers (I know, a bit gross) can be fit in the hole (by width from one side of your waist to the other). On that day the midwife explained that I had a four finger separation.
Now like I said I was a litle taken aback and concerned this was going to cause major issues. However the midwife was really patient and explained there were excercises that I could start doing immediately which would improve the separation very quickly. There was a simple, low impact pelvic tilt exercise that she recommended and explained that if I did this religiously, I would see a huge improvement in as little as 2 weeks. She would check again then, before she signed me off to the Health Visiting team.
I’m normally crap at those kind of things, but at the time I was having a bath every day at 5 as I was experiencing really strong emotions at that time of day and the bath helped. I did my pelvic tilt exercises in the bath religiously for two weeks. And low and behold, when my midwife checked again, it was almost down to a 1 finger separation.
It wasn’t just the exercises that I think helped. My midwife had asked that I tried to avoid any movements that would normally use my abdominal muscles. This included simple things like sitting up in bed. A really easy way for me to know which movements were putting strain on my abdominal muscles was the physical ‘doming’ that happened when I moved. For example, when I sat up in bed, my stomach would make a very very obvious dome down my midline. It looked quite alarming. I therefore changed these movements to avoid this strain. In bed, I would roll onto my side then push myself up. This visual cue was also hugely helpful when I later went back to exercising. I also think time was a big factor. I have heard that if the separation is not too wide that it can improve over time itself.
When I saw the doctor for my 6 week check, I was looking forward to being signed off to start gently exercising. The GP didn’t even ask about my DR or check it so I was a little confused by that as I had been told the doctor had to check. To be honest, I was nowhere near ready to start exercising as suprisingly, twin newborns were taking all of my energy. It wasn’t until around about the year mark that I seriously started to exercise.
I started back into fitness with pilates. I dutifully told the teacher I had Diastasis Recti as I had been told that final 1 finger separation would take the longest to heal. I was able to do most of the exercises but during some (most noticeably the plank), the doming was very obvious. I was frustrated by this stage and the bulge around my stomach was affecting my confidence. I felt a bit deflated and stepped away from excercising again as I just didn’t have the mental capacity to deal with it.
By this summer I was running a little and feeling more confident in getting back into exercise. I didn’t want to try the same route I had done before (gym and pilates classes) and really fancied working with a Personal Trainer who could tailor the exercises to me and my needs. I was so lucky to find a fantastic Personal Trainer, Katie McCaskey who worked locally in East Lothian.
We started meeting in late July and she started by seeing what strength I had in my abdominals. Not much was the answer to that!! I could only do about 2 sit ups, and needed Katie to stand on my toes to stop my feet raising. Over the next few weeks, we focused on whole body strength rather than focusing on core. It is important to avoid crunches, sit ups and most traditional core exercises until you have some strength. This is to avoid making the separation wider. However, after just 3/4 weeks when we tried sit ups and cruches again, I was able to complete a few more without any doming or pain.
I am now a couple months in to my personal training and I am so pleased with the results so far. I have had one PT session of 45 mins each week, the occasional run and a core workout I do some evenings. I have been watching what I eat as well and I have lost half a stone. Now that might not seem like much but for me the biggest change is in my stomach and how I feel in myself. In my last session with Katie, we did circuits with sit ups in between each activity. It was the first time I have been able to do sit ups without Katie on my feet and I completed over 200 over the 45 minute class, finishing with 50 to finish! It felt amazing! To see such an improvement and feel so much stronger has done wonders for my self esteem, let alone my general fitness.
I do still have a way to go. I would like to lose more weight, run more and eat better. But it’s a great start and I am so thankful to Katie who has been patient but also pushed me. I am still unable to do double leg lifts and I will not rest until I smash those as well!
I suppose the whole point in writing about diastasis recti, is to say that it takes time. In a lot of cases, time is all it needs! When told this has become an issue during, or after pregnancy, it can seem like another blow. Another part of your body rearranged and changed by growing a little person! But it’s not forever, and I feel like now 20 months on, I’m starting to see that.