New Research: Top 4 Insights on Pregnancy-Related Diastasis Recti

 

A diastasis recti (DRA) is the gap in the abdominal muscles that occurs during and after pregnancy while your body accommodates for your growing baby.  Here’s some new information that is emerging

 

  1. The size of the “gap” in the rectus abdominal muscles is not clinically relevant: really?  This distance is what has traditionally been measured to determine the presence of the DRA, but now what is seen as more relevant is measuring the tension through the linea alba (connective tissue of the “gap”).  This is determined through a contraction of the pelvic floor muscles
  2. The function of the linea alba is interdependent with the function of the pelvic floor—the “inner unit” needs to have good control before outer unit and functional exercises. Translation:  work on pelvic floor muscles and breath/ pressure control first, then one can add other “core” work—lower abs, glutes, inner thighs, functional exercises like squats and lunges
  3. Optimal management of intra-abdominal pressure is key: the “canister” of the core is created through the deep back muscles, the pelvic floor group, the diaphragm, the abdominal muscles and the linea alba between the abs—all muscles need to work together and consider the abdominal pressure produced.
  4. It is safe to move, and women should ensure they stay moving throughout the process of helping their DRA

 

The Most Important Muscle You Didn’t Know You Had

Many people can happily live their lives without ever giving their diaphragm much thought at all. You don’t have to think much about breathing, it just happens automatically. But when you take in air, your diaphragm lowers to allow room for your lungs to expand.  It is attached to the lower six ribs, the xiphoid process (bottom part) of the sternum, and the first three lumbar vertebrae.  There is also a connection between the diaphragm and the psoas (hip flexor) muscle and the quadratus lumborum (stabilization) muscle.

 

A Physiotherapist can quite easily examine if your diaphragm is functioning properly by placing their hands around your ribcage with thumbs next to the spine, and watching if there is symmetry in the movement when you take a deep breath.  It is also helpful to examine the psoas and QL muscles for tightness and trigger points. The nerve that supplies the diaphragm, namely the phrenic nerve, arises from C3-C5 in your neck, and those vertebrae should be examined to see if mobilization there has any influence on diaphragmatic symptoms. The junction of the thoracic and lumbar spine (T12/L1) should be assessed as that area often develops stiffness or less mobility– remember the diaphragm attaches to L1-L3.  If you have lower back pain, it could be in part due to a restriction of normal movement in this area of the spine.