By Jennifer Mohns, DPT
Are you a victim of the “Mummy Tummy” or chronic low back pain post-pregancy? As a Physical Therapist, I have come across many postpartum women who have a diastasis recti, or separation of their abdomen. Most women that I have found the separation on were not even aware that they had this deficit. The diastasis recti can also be a cause of low back pain, even after mommies have the lost all their baby weight.
Diastasis recti is a separation of the right and left side of the rectus abdominis muscle. Normally, the left and right sides of the muscle are joined by the linea alba which runs down the middle of the abdomen. See this link for the image.
Diastasis recti is commonly seen in women due to either pregnancy or obesity. In pregnant or postpartum women the diastasis is caused by the stretching of the rectus abdominus muscle during the growth of the uterus. Women who have experienced multiple pregnancies are much more susceptible to acquiring this defect.
I always test and measure for diastasis recti on all of my female patients that present to physical therapy with low back pain. Most women are unaware that Physical Therapists can help with this condition. There are many exercises, manual techniques, and taping techniques that I use in order to help my patients. With physical therapy treatment, the separation can actually grow back together over time.
There is a relatively easy way for you to check for diastasis recti. Start by lying on your back with your knees and feet flat on the floor. Relax your whole body. Place your fingers (palm facing you) about 3 inches above your belly button. Slowly lift your head, neck, and shoulders off the floor while you press down with your fingertips. If you feel a gap that is more than 1.5 fingers wide then you most likely have a diastasis. Do not be alarmed, this is perfectly normal and can be treated conservatively in physical therapy. There are two other important places to check for diastasis as well with the same procedure; right at your belly button and 3 inches below your belly button.
A lot of women ask, should I wear a belly binder or abdominal wrap to help the muscle grow back together? My answer to this is, YES, this certainly can help. The popular Tupler technique encourages women to wrap or bind their bellies to help draw the muscle back together. In my experience as a Physical Therapist, this wrapping technique is more helpful when there is a larger separation (4 or more fingers). The wrap or binder helps with awareness of your abdominal muscles and to actually support your lower back. HOWEVER, the wrap or binder should NOT be used as a substitute or replacement when exercising the abdominals. The idea here is not to just relax the abdominal muscles and let the wrap or binder do the work. This idea can be better explained by your Physical Therapist.
Women commonly ask, which exercises should I avoid when I have a diastasis recti? You should avoid sit-ups, crunches, twisting, and straight leg raises when you have this deficit. Again, your Physical Therapist can provide further education for certain exercises and activities to avoid.
If you are postpartum OR have been experiencing low back pain try this test on yourself. If you find a diastasis contact a Physical Therapist in order to begin treatment to help correct this deficit.
Please also visit the blog by Deborah Wood in TodayinPT.com for more information on DRA.
Dr. Mohns is a Physical Therapist at Boston Sports Medicine
