Is Diastasis Recti The Reason for Your Mummy Tummy?

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I recently blogged about the many excuses reasons you might have a mummy tummy, but couldn’t possibly do anything about it.

Diastasis recti is without doubt a major culprit. If you have a postnatal belly which bulges or protrudes, & seems to form a cone shape when you get up from lying on your back, then you probably do have split abdominal muscles, or diastasis recti. You will also likely be suffering from weak core muscles – that’s the muscles that support your lower back, define your waistline & are connected to your pelvic floor.

Appropriate exercises for diastasis recti are the core activation & strengthening exercises discussed here. You see, the muscles that have split – the outermost, vertical recti muscles of your abdomen – are connected to the important transverse abdominus muscle that lies deep inside.

Any exercise that strengthens the transverse muscle & draws it IN, by default will also draw the recti muscles TOGETHER.

Multi-tasking exercise. We like that.

But I would like to add a cautionary note, that follows on from my post about the psychology of excuses… if you do not perform these exercises on a daily basis to repair your diastasis recti & strengthen your core AS WELL AS eat & exercise intensively to lose fat… you will not get rid of your mummy tummy.

Diastasis recti is:

1. Reparable

2. Not the only problem with most mummy tummies

In our determination to identify the one issue to place all our focus on, we easily lose sight of the maybe more obvious stuff. I recently dealt with a client who was so fixated on diastasis recti as the key to all her mummy tummy woes, she chose to ignore (or at least downplay) her excessive sugar consumption. The abdominal gap wasn’t the big deal in this particular case, the sugar in her diet was. But it was easier to focus on the former as that felt more ‘medical’, more out of her control, or was maybe just less painful or less hassle to deal with.

Postnatal fat loss does not have one isolated answer.

This is why my MuTu System (soon to be available even if you don’t live in London… watch this space!) incorporates 5 essential components, ONE of which is treating diastasis recti.

Don’t kid yourself into thinking that if you could just close the gap in your abdominal muscles, all would be flat & gorgeous. In some cases this may be the predominant problem (every individual is unique), but there are 4 other issues. Ignore them, & you will make improvements, but you won’t have solved the problem.

Are you confused by the extent of your own diastasis recti, & how much it contributes to the appearance of your tummy? Let me know where you’re struggling & I’ll try to clear it up for you!

Does Your Mummy Tummy Still Look Pregnant? Diastasis Recti (& Other Causes!)

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the mummy tummy masterclass

Yes, I KNOW this one's just a bit flabby, but I didn't have many model volunteers. Anyone?

An enquiry about my MuTu Masterclasses today has got me *all cross* about the lack of information being given to women about diastasis recti.

Yet again I hear from a mum who has been told, by her doctor, that she has to accept a 7 month’s postnatal tummy, that looks like it’s 5 month’s pregnant, as ‘just what happens after you have children’.

A Mummy Tummy that protrudes, domes, causes backache, & inspires ‘Oooh, when’s the next one due?’ comments, is NOT any fun at all, & more importantly NOT something you have to just put up with. Whatever your doctor says.

I hear all the time from women who feel like they’re the only one who feels like their innards are falling out the front of their tummy. Like they’re the only one who wets herself *just a little* (or maybe quite a bit) every time they sneeze, cough or try to run for the bus.

I promise you they’re not. Each of us may or may not want to invest the time & effort to attaining a six pack (ahem… I don’t), but you can achieve a lot firmer, flatter & less pregnant-looking version of what you’ve got.

This particular lady had bought a quite-well-known mummy tummy book (don’t worry, as soon as I get my publishing deal, you’ll get a mummy tummy book with ALL the answers! Plug Plug :) ) which she had found slightly confusing, quite hard to follow & well… her mummy tummy was still there.

Diastasis Recti (the focus of the book & the ‘Technique’ she had tried) is a major factor in determining the shape of many women’s mummy tummy. In order to correct it there are some exercises you absolutely must do & some you absolutely must not (if you don’t want to make it worse). And the book she had read is very thorough & effective at correcting diastasis recti.

But Diastasis Recti is ONLY ONE FACTOR. There are 4 more, which my MuTu students learn in a one-off intensive, half day workshop. Knowing ALL the factors that cause a mummy tummy is the first stage. Learning how to engage, use & strengthen all the right muscles, how to exercise very effectively in a short space of time, how to eat, how to actually make it all happen… that’s the next very important stage!

Please don’t despair of your tummies, fellow Mums! And don’t believe anyone who tells you that there’s absolutely nothing you can do about it… Because you honestly can.

Have you been asked the dreaded ‘Having another one?’ question on the school run? Or been told by a doctor or ‘expert’ there’s nothing you can do? Please share your stories – I never, ever tire of Mummy Tummy stories… I think I need to get out more! ;)

Diastasis Recti, Pregnancy Pelvic Girdle Pain, Symphysis Pubis Dysfunction… What Does It All Mean?

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Diastasis Recti is one of the causes of your mummy tummy, Symphysis Pubis Dysfunction means you can’t get out the car comfortably when pregnant… and then there’s the acronyms for all these pregnancy & postnatal aches & pains: SPD, PSD, PGP, DR, RD. You need a copy of Gray’s Anatomy just to give a name to your sore joints & back ache once you’re pregnant!

Confused? You’re not alone. A few new clients lately have been feeling a little flummoxed by some of the terms being used for whatever it is they’re suffering from…  sometimes midwives, antenatal teachers, doctors, personal trainers or your best friend, don’t use the same language.

So I’ve done a mini glossary of the ones you’re likely to come across or suffer from. Hope it helps, & if you have any others you’d like to know about, do ask!

Diastasis Recti, Rectus Diastasis or Rectus Distension all refer to a very common separation of the rectus muscles at the front of your tummy during pregnancy. I post frequently on this condition & here you can find some instructions on how to test for diastasis recti, which exercises are recommended & which ones you should avoid.

Diastasis Symphysis Pubis (DSP) is not the same as diastasis recti, it is an actual separation of the Symphysis Pubis Joint. This can only be confirmed by diagnostic imaging by a doctor or physiotherapist.

Pregnancy-Related Pelvic Girdle Pain (PGP) & Symphysis Pubis Dysfunction (SPD) refer to the same thing.

Pelvic Girdle Pain is the term more used more nowadays, but both refer to pregnancy-associated pain, instability & dysfunction of the Symphysis Pubis Joint &/or the Sacro-Iliac Joint.

Pain may be a minor discomfort, necessitating some modification of movement… right up the scale to severe pain & disability. Make sure you consult a physiotherapist or professional trainer who specialises in this area, & don’t go to just any generic exercise class or instructor.

The joints affected are the ones at the front & back of the pelvis. You may feel pain over the front of the pubic bone at the front, across your tummy, or across one or both sides of your lower back, or down your legs.

You may feel a clicking or grinding in your pelvis & have difficulty walking, especially up or down stairs. This ‘shearing’ movement (one leg in front of the other) or abduction (legs out to the sides) may also hurt, making getting in or out of a car, your bed, or any number of other everyday activities, painful.

Pregnancy-Related Pelvic Girdle Pain affects around 1 in 5 women, at varying degrees of severity. Around 7% of women continue to have problems postnatally.

In general:

You will be advised by your Midwife or doctor to avoid or adapt as many painful movements as possible. So avoid heavy lifting, go carefully & slowly up stairs; keep your knees together as mush as possible when getting on or out of the car; roll over onto your side to get out of bed…but many of these are part of life, & can’t realistically be avoided.

You can however help to alleviate pain with correctly prescribed core strengthening exercises.

The stability of your joints is affected by the pregnancy hormone, relaxin, but also by the strength of the muscles that hold them in place. Do NOT go to a generic class or instructor with PGP, they cannot be expected to accurately prescribe the correct exercises for you. But controlled, guided core strength & lower body resistance work will definitely help to strengthen & stabilise your joints, & reduce pain.

Let me know what else you need on these conditions – I know from my clients that they are  commonly diagnosed, but also often misunderstood pregnancy & postnatal considerations which affect the exercise you can comfortably undertake.

DIASTASIS RECTI Test, What Works and What To Avoid

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Frequently Asked Questions About Exercises to Alleviate Diastasis Recti or Postnatal Abdominal Separation.

Q: How do I test for diastasis recti?

A: Lie on your back with your knees bent & your feet flat on the floor. Relax your head & shoulders & place your fingers (palm facing you) just above your belly button.

Lift your head, neck & shoulders slightly off the floor & press down with your fingertips. If you feel a gap, that’s the diastasis. You will feel the muscles close in around your fingers as you lift your head & neck. Don’t lift your shoulders up too high.

Repeat the test in two other place: directly over the belly button, & a couple of inches below.

A diastasis recti gap is measured in finger width’s. You are aiming for 1-2 finger gap or less, but don’t panic if it’s much bigger at first – up to ten fingers is not unheard of!

Q: Should I use a splint or abdominal wrap to bring the muscles back together? What’s the best exercise for diastasis recti?

A: Many women, & some popular exercise techniques such as the Tupler technique, advocate wrapping or binding the mid-section to draw the split recti muscles back together. Binding has also been traditional practice in many parts of the world for generations.

In my experience, it can be helpful when the gap is wide (4 fingers or more), & certainly helps with awareness of the abs & for lower back support. However don’t use a wrap or splint as a substitute for caution when working the abdominals. The point is not to ‘switch off’ & let the splint do the work!

To use a splint (a towel does the same job) to encourage your muscles to ‘knit’ back together:

Lie on your back with your knees bent & feet flat on the floor. Wrap a towel under your tummy & cross it over your abs, holding onto each end.

Slowly & gently lift your head, neck & shoulders off the floor, whilst drawing your belly button towards your spine & tilting your pelvis. This will activate your transverse abdominal muscle. As you lift, pull the towel tighter around your waist.

Do about 10 reps, building up to 30-40 a day (you don’t have to do them all at once!).

Q: How Common is Diastasis Recti?

Over a third of women will have a gap of two fingers or more after their first baby. After second or subsequent pregnancies, this figure is more like two thirds, especially if the gap wasn’t closed effectively after the first.

Q: How Do I help a Diastasis Close Up?

A: Think about the ‘bellybutton to spine’ contraction discussed in this post, with everything you do – not just when you’re specifically exercising your abs. When you sneeze, cough, pick up your baby, do any type of exercise, stand up from a crouching position, or turn around.

Try to get back in touch with your body & be aware of your core muscles doing the work to stabilise you in every day activity.

Q: My Youngest Is At School…! – Can I Still Reduce a Diastasis?

A: Yes – activating & engaging your core transverse abdominal muscles at any stage post partum can improve the gap.

If you did a lot of crunches &/or oblique crunches post baby, then you may have developed a ‘cone’ shape on your abdomen where you have worked the muscles hard, but in the wrong direction…  Practice belly breathing, engaging your transverse abdominus & pelvic floor & do the towel exercises explained above.

Persistence will pay off! These exercises might not feel like you’re doing much, but do them daily, as many reps as you can, & you will start to see a difference in 6 weeks.

Q: Which Movements or Exercises Should I Avoid?

Crunches, sit-ups, oblique (twists) combined with crunches; anything that  ‘jack-knifes’ the body, by pivoting at the hip & placing strain on the abdominals such as straight leg lifts or holds from lying on your back & some Pliates moves.

In terms of every day movements, avoid lifting straight up from a horizontal lying position – always roll to your side & push up from there; be careful when twisting & turning from the waist, keep thinking ‘core’ & pull belly button through to spine whenever you lift, twist or get up from lying, bending or crouching.

Diastasis Recti & a Mummy Tummy: What Works?

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I am asked all the time: ‘HOW do I get rid of my Mummy Tummy?’ & ‘Is it due to Diastasi Recti?’

Well, partly, yes it is. Diastasis Recti is ONE cause of a mummy tummy, & you definitely need to address it for a complete solution.

SO WHAT WORKS?

Cardio? A bit, to lose some extra flab maybe, but it won’t address the root problem.

Pilates? You could certainly borrow a few core & postural principles from pilates … but some moves could even exacerbate the problem.

Yoga? Good for lower back strengthening, which will help relieve back pain & improve posture, but it’s not going to repair the mummy tummy.

Or crunches? NO, NO, NO!!

What is a ‘mummy tummy’?

That saggy, loose, flabby tummy that just doesn’t seem to go away after your baby’s born, & REALLY refuses to go away after you’ve had more than one baby!

Firstly, you need to differentiate between a flabby belly (ie excess fat over your tummy), & the mummy tummy which is partly caused by diastasis recti, a (perfectly natural) separation of the abdominal muscles during pregnancy which makes way for the growing uterus.

Incidentally, you may have a diastasis and a flabby belly, but we will deal with both, so don’t worry!

I’m going to cover the physiological process of diastasis, as well as an easy self test, in another post, but for now, we’re going to look simply at what works, & what doesn’t! Obvious indicators that you have a diastasis, are a bulging, or ‘doming’ above or below your belly button when you contract your abdominals (especially if you attempt a crunch or sit-up type movement).

There are a number of important muscles you need to exercise (in the right way) to repair a diastasis, the most important of which is the transverse abdominus. This is the innermost abdominal muscle which runs right around your middle like a corset. It is attached both in front of, and behind, the rectus muscles (the ones that have split), so if you work the transverse abdominus (TA) correctly, your diastasis (the gap) will reduce, & stay put!

To start identifying & ‘engaging’ your transverse abdominus, you need to ‘belly breathe‘. Sit on a chair or cross-legged on the floor & place your hands on your belly. Breathe in, fill your lungs & let your belly expand. Then exhale, emptying your lungs, whilst drawing your belly button right back towards your spine. Keep your shouders down & your neck relaxed.

Now try doing this from all fours.

There are a number of visualisations which may help, (this is where it can be useful to borrow from pilates & yoga as well as restorative core work) :

Imagine your recti (the vertical muscle we’re trying to put back together) as a string attached to your pubic bone. Now use the string to pull your pubic bone towards your belly button.

Imagine ‘zipping up’ the gap from below the belly button, to above.

Whichever works for you, remember to exhale as you draw your abdomen inwards, & inhale as you allow your tummy to expand & your lungs to fill. Don’t raise & lower your chest (it’s all in the belly), don’t hunch your shoulders, & don’t hold your breath!

You will find that as you do this, your pelvis will naturally tilt forward as you contract the transverse muscle.

OK, now add in your pelvic floor (now we’re really multi-tasking!). As you draw in your transverse abdominus muscle, pull up your pelvic floor. Remember, don’t hold your breath, all these muscles work together best whilst breathing ;-)

Ready to get really clever? From the all-fours position, put a pillow between your inner thighs, & as you exhale, draw in your belly button and pull up your pelvic floor, squeeze the pillow between your thighs.

Do this 15 times, every day. (That took, what, 5 minutes??) & you really are on your way to repairing a diastasis recti & losing your mummy tummy, ‘muffin top’ or whatever charming term you refer to it as!

I’ll come back to this with more variations & more detail, but I promise you, identifying & learning to engage your transverse abdominus is the way to go.

Do not, under any circumstances, do crunches or sit-ups post-baby, & certainly not if you know you have abdominal separation.

Any crunching, rolling or jack-knife straining or movement will serve only to widen the gap & make the ‘doming’ or bulging worse. Some pilates moves will fall into this category, so avoid those ones for now. For the same reason, avoid crunches or sit-ups that work the obliques (your waist) in a diagonal direction, until you know you have closed the diastasis gap.

Strengthening your transverse abdominus & working your pelvic floor (because these movements work so well together it’s great way to remember to do your kegels) will repair a diastasis & close the gap. It will also help alleviate back pain, improve posture & increase pelvic floor control!

ps: not my tummy!!

look familiar?!

If there is extra flab as well (which if you’re post-baby, is a distinct possibility :-) ) then in order to see the difference, you will need to address your nutrition, & do some short sharp interval training (circuits) as well.

But your CORE is where you must start – so get belly breathing & ‘zipping up’ & find your pelvic floor… & you have the basis for the post-baby body you’re dreaming of!

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