Understanding Diastasis Recti
Diastasis Recti, a condition often ignored by the medical community, is a problem that screams for more attention, and that is why Everybelly® should be checked for diastasis recti.
Here are some frequently asked questions about diastasis recti:
Question: What is a diastasis?
Answer: The word diastasis means separation. The recti muscles are the outermost abdominal muscles. So, it is a separation of the outermost abdominal muscles. When the muscles separate the connective tissue (linea alba) joining these muscle stretches sideways. The job of these muscles (called rectus abdominis), is to support your back and your organs. So why should you care if your muscles are separated? Because separated muscles are weak muscles. Separated muscles cannot do their job of supporting your back and organs. To achieve a strong core, your muscles must be close together. The sideways stretching of the connective tissue causes it to become thinner and weaker. So, what happens is this weak saran wrap-like connective tissue is NOT effectively supporting your belly button, back and organs. They are only supported when the muscles are close together.
Question: Who can get a diastasis?
Answer: Everybelly® means all women (baby or no baby), men and children are at risk for having a diastasis. Many people have diastasis recti and just don’t know it because checking for a diastasis is not part of any medical or fitness evaluation.
Question: At what age can you get a diastasis?
Answer: Everyone is born with their muscles separated! Usually, the muscles come together when we are three years old after our nervous system has developed. But this does not necessarily happen with everyone. Because our belly button is a weak spot in the connective tissue, even if the muscles do come together, there is always the risk that they may come apart again with continuous stretching of the connective tissue.
Question: What causes a diastasis?
Answer: A diastasis is caused by continuous stretching in both a forward and sideways direction of the connective tissue that joins the outermost muscles. This stretching is caused by pregnancy, weight gain in the abdominal area, abdominal surgery where they fill the abdominal cavity with air, exercises like crunches and Pilates 100, activities where you arch your back like gymnastics and swimming which flare your ribs, and crossover activities like tennis and golf.
Question: What are the effects of a diastasis on the body?
Answer: Back pain, abdominal hernias, poor posture, pelvic floor problems, gastro- intestinal disturbances like constipation and bloating are all effects of a diastasis. They occur when the support system for the back and organs are the weak connective tissue instead of the muscles. Most women who have had a baby do have diastasis recti.
Question: What are some signs of a diastasis?
Answer: Signs of a diastasis are a bulging belly, an outie belly button, a half football bulge when bringing the shoulders off the floor, a belly that gets bigger after eating and at the end of the day.
Question: Why is my belly button an outie?
Answer: Right smack in the middle of the connective tissue is your belly button which is a weak spot in the connective tissue. When the connective tissue stretches sideways and becomes thinner and weaker, your belly button loses its support and then becomes an outie. An outie belly button puts you at risk for an umbilical hernia. When you strengthen the connective tissue with this program your belly button will go back in.
Question: When I check myself for a diastasis what am I checking for?
Answer: When you check for a diastasis you are checking for two things. The first is the “distance” between the two muscles. You want to see how many fingers fit between the two separated muscles. If you have a protruding belly button, feel a pulsing or have the half-football like bulge you will need to use two hands. The second thing you are checking is the “condition” of the connective tissue. The deeper your fingers go, the weaker the connective tissue. The pulsing, protruding belly button and half football like bulge are all signs of weak connective tissue.
Question: How do I check for a diastasis?
Answer: To learn how to check for a please click here to watch Julie’s video.
Question: When I check myself for a diastasis why does it hurt?
Answer: This is a sign that your connective tissue is very weak. Please remember to only check yourself in week one, three, six, and week eighteen of the program.
Question: What is the “pulsing” that I feel when I am checking myself for a diastasis?
Answer: This pulsing you are feeling is coming from your organs. This is a sign of very weak connective tissue.
Question: What is the half-football like bulge when I get up from a back lying position?
Answer: When the muscles separate the connective tissue stretches sideways and it now supporting your organs. When you get up from a back lying position this bulge is your organs moving forward against this weak connective tissue. This bulge is a sign of a very severe diastasis which needs two hands to check.
Question: Do some people’s diastasis close faster than others if they do the program exactly the same way?
Answer: Yes. This is because everyone’s connective tissue is not the same quality. Weaker connective tissue will take longer to heal. Hormones such as relaxin (pregnancy related) or steroid injections weaken the connective tissue. Naturally flexible people and people that get stretch marks also have weaker connective tissue. Weaker connective tissue takes longer to heal.
Question: Can a diastasis close on its own?
Answer: In my experience of checking women during and after pregnancy for over 25 years, I have never seen it close on its own. After a first birth, it may come together a little but not close. So, then you would be starting a pregnancy with the diastasis. With each pregnancy, you will show faster, and it will get larger. That is why it is important to do the Tupler Technique® Program during your pregnancy. Closing a diastasis is all about healing the connective tissue. To heal the connective tissue, you have to put both the muscles and connective tissue closer together, protect it from getting stretched and strengthen it.
Question: Why do some women have a severe diastasis after the first pregnancy and others do not?
Answer: Probably because they went into their pregnancy with a diastasis from one of the causes listed above.
Question: How long does it take to close a diastasis?
Answer: How long it takes depends on the severity of your diastasis and your commitment toall 4 steps of the program. It can take anywhere from 6 weeks to a year or more. However, you will start seeing the healing process starting within the first 3 weeks. So, make sure you take before photos before starting the program. They will motivate you for sure.
Question: Is it ever too late to close a diastasis recti?
Answer: No. It is never too late to close a diastasis. There is a myth that you can only close your diastasis right after you have had your baby. This is not true. Pregnancy is just one of the causes of a diastasis. Men and children have this condition also.
Question: Can you close a diastasis at any time?
Answer: Yes. Anyone can close a diastasis at any time. This is no statute of limitation on closing a diastasis! It is all about healing the connective tissue. Pregnancy is just one of the causes of a diastasis, so it does not matter how long ago you had your baby. During pregnancy, you can make it smaller but probably not close it.
Question: How do I know my diastasis is closed?
Answer: Closing a diastasis is all about healing the connective tissue. Shallow connective tissue is the most important indicator that you have closed your diastasis. You know your connective tissue is shallow when you put your fingers in to check your diastasis and they do not go down that deep. As the connective tissue becomes shallower the muscles come together. A one finger diastasis with shallow connective tissue is what you are striving for.
Question: Does a diastasis cause back and hip pain?
Answer: Yes. The function of the outermost abdominal muscles (recti muscles) is to support your back and organs. When the muscles separate the connective tissue stretches sideways and now becomes the support system for the back and hips. Back pain occurs because connective tissue is not a good support system for the back and hips.
Question: Does a diastasis cause constipation?
Answer: Yes. When the muscles separate the organs (i.e. intestines) get displaced. This displacement puts the bowel out of alignment which is a cause of constipation. Splinting the muscles and putting your feet up on a foot stool with help with treating constipation.
Question: Can a diastasis come apart once it is closed?
Answer: Yes. There is a weak spot in the middle of the connective tissue that joins the outermost abdominal muscles. This weak spot is your belly button. Continuous intra-abdominal force and pressure on this weak spot will create a diastasis again.
Question: Can a diastasis get worse from doing incorrect exercises?
Answer: Yes. Exercises that stretch the connective tissue either in a forward or sideways direction can create a diastasis or make it worse. Examples of exercises and sporting activities that do this are crunches, Pilates, swimming, golf, tennis and softball.
Question: When is surgery necessary?
Answer: Surgery is necessary when the connective tissue has torn away from the muscle with abdominal trauma and the organs are exposed. It is also necessary when the organs associated with the abdominal hernia becomes “strangulated.” This means there is no blood to them. Surgery is also the only way to help very stretched out skin.
Question: Is an umbilical hernia related to a diastasis?
Answer: Yes. An umbilical hernia is a side effect of a diastasis recti. When the connective tissue stretches sideways it becomes thinner and your belly button is not supported so it will become an “outie”.
Question: Should I surgically repair my umbilical hernia?
Answer: Unless you are having extreme pain from your umbilical hernia it is best to wait with your surgery and do the Tupler Technique® program first to see if it will help. You have nothing to lose and everything to gain. If you repair, it with the Tupler Technique® then surgery is not necessary. If the program does not work, you are still ahead of the game as you will be prepared for the surgery. Strengthening your abdominal muscles and learning how to use them in the recovery process will make your recovery faster and also maintains the integrity of the sutures. This is very important as without this preparation many umbilical hernia surgeries come undone. An umbilical hernia is a side effect of a diastasis. When surgically repairing the hernia, the diastasis is not repaired at the same time. So, if you are separated above and below the umbilical hernia and you repair just the hernia the surgery will come undone easily with intra-abdominal pressure. The Tupler Technique® will teach you how to avoid intra-abdominal pressure after surgery.
Question: Should I use mesh to repair it?
Answer: The FDA is now investigating the mesh. Here is a link so you can read more about it. Many people are allergic to the mesh. There is no test to perform before the surgery to find out if you are. Mesh is usually absorbable which means it co-mingles with your connective tissue. Once it does this there is no way to take it out. If you are allergic to it your body will keep trying to reject it. This rejection process is very painful and there is no solution other than medication. Make sure you are an informed consumer before using mesh.
Question: If I have had surgery with mesh can I still close my diastasis?
Answer: Yes, you can get closure. Depending on the type of mesh you may not be able to close it all the way. With the absorbable mesh, you can definitely get more closure.
Question: Will a c-section scar prevent me from closing my diastasis?
Answer: Yes, it can make the process harder. That is why after the scar has healed we recommend mobilizing the scar. This will also prevent the “muffin” top the c section scar causes.
Diastasis During and After Pregnancy
Question: Is it normal to get a diastasis during pregnancy?
Answer: Yes, it is “normal” but not “necessary”. The muscles can stretch without separating. If you start doing the Tupler Technique® early in your pregnancy you can prevent a diastasis from occurring or make your diastasis smaller. You can start doing the exercises in your first trimester. We recommend that you start wearing the splint in your second trimester when you are feeling better. Wearing a splint can sometimes cause nausea.
Question: Can a diastasis cause a C-section?
Answer: Yes. Weak connective tissue cannot support a top-heavy uterus. The top of the uterus then tilts forward. This forward tilt makes the cervix face sideways instead of vertically. The cervix must be lined up with the vaginal canal in order to provide a path for the baby to come out.
Question: Do all pregnant women get a diastasis?
Answer: In my experience of checking pregnant women from 1990 to the present, only a small percentage of women do not get a diastasis. Women that do the Tupler Technique® early in pregnancy can prevent themselves from getting one.
Question: Can pushing incorrectly in labor cause a diastasis?
Answer: Yes. It can create a diastasis or make a diastasis worse. It can also cause hemorrhoids, urinary incontinence and pelvic floor prolapses. Pushing is a learned skill and must be practiced during pregnancy so it is second nature in labor. You cannot learn a new skill (pushing) while in pain. It takes around 21 days to learn a new skill. To protect their abdominals and pelvic floor muscles women must learn how to push with their strengthened and splinted abdominal muscles while relaxing their pelvic floor muscles.
Question: Is wearing a front- loading baby carrier bad for my diastasis?
Answer: Yes. Absolutely! You cannot heal the connective tissue when you have all the baby’s weight putting pressure on the weak connective tissue. If absolutely must wear one, use the ones that are on a diagonal. When your baby gets head- control put them on your back. If you can use a stroller, that is the best scenario.
Question: How does a diastasis effect my pregnancy and birth?
Answer: A diastasis can cause back pain and constipation during pregnancy and put you at risk for a C-section in labor as the cervix will be pointing sideways instead of downwards.