Let's take a dive into common misconceptions surround Diastasis Rectus Abdominus (DRA)!
'DRA is the separation or split of my abdominal muscles.'
DRA is in fact a thinning and widening of the Linea Alba, which is the connective tissue between your abdominals. This is a normal adaptation to pregnancy as baby grows. The length tension relationship of your muscles also changes, making it harder for them to work well on length.
'DRA can be caused by doing too many abdominal exercises during pregnancy.'
We now have some great research on the safety of certain exercises during pregnancy. No link has been found between abdominal muscle strengthening during pregnancy and a larger or abnormal DRA postnatally.
'Closing my tummy gap is the only thing that will make my abdominals function well again.'
Yes, closing the gap might be desirable. But we now know that the tension (or depth) of your tummy gap is more important. Developing good tension of your Linea Alba will mean your abdominals will start functioning better and you should feel much stronger!
'I should be able to get my tummy looking the same as pre-pregnancy.'
After pregnancy, as well as DRA, your skin and muscles will have stretched. The tension of your skin and muscles will improve over time, but remember your body has had 9 months of pregnancy (or more if multiple pregnancies), and the appearance of your belly skin may not drastically change with DRA rehab. Strengthening your deep core will however improve the look of your belly in standing, as it is responsible for the inward motion of the abdominal wall.
'I need to avoid certain abdominal exercises for life.'
It is a common misconception that certain abdominal exercises are dangerous with for those with DRA. Yes, it is important that we build loading up slowly to ensure we aren't exerting too much pressure onto your tummy gap, causing uncontrolled doming. But ruling out exercises altogether is not supported by research. With appropriate guidance you should be able to return to any exercise that you desire. If you experience any pain, leaking, prolapse symptoms or lose your form quickly, the exercise is likely too hard for you currently, and your Physio can help modify the exercise to make it more appropriate for you right now.
'My diastasis will heal in time , i just need to rest.'
Rest will not help 'close the gap'. The muscles and connective tissue needs to be exposed to a force 50-70% of its maximum strength to stimulate collagen production, tissue growth and thus increased tension. Connective tissue can take up to 2 years to rebuild, but differences in function are often seen much sooner than this!
If you don't feel confident to do this, this is where your Physio will be able to guide you through a graduated strength program. They should work with you to help find and activate your deep core, manage pressure effectively, progressively load to create tension across your gap, and build you up towards your specific goals.
'It's too late to do anything about my tummy gap.'
It is never 'too late' to build tension across your Linea Alba. Yes, it is definitely more helpful to address this earlier rather than later, as it will encourage good movement patterns that will help your body move better through life. But it is never too late to change this and feel better in your body!
Meg is a sports (MSK) and pelvic health physiotherapist based at Alma Physiotherapy, 25 Lower Redland road, Bristol, BS6 6TB.
Book via: www.almaphysiotherapy.co.uk/book-online
Email our PA Mei Lou pa@almaphysiotherapy.co.uk or call 07942 494506 for help booking.
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