No one is saying it's easy to whip your abs into shape — baby or no baby. But you may be one of hundreds of thousands of people suffering from an incurable condition that is making matters worse: diastasis recti, which literally means "abdominal separation."
The name alone makes this condition sound pretty painful, but the truth is, unless your doctor has given you a diagnosis, you may not even know you have diastasis recti. Still, it might just be the reason you can't exercise away a stomach bulge.
"Diastasis recti is the splitting of the two sides of the rectus abdominis muscle, the ‘six pack,’” says Dr. Scott Schreiber, a chiropractic physician who is double board certified in rehabilitation and clinical nutrition. “Pregnancy is a common cause of this condition, however additional causes include yo-yo dieting, performing sit-ups incorrectly and incorrect weightlifting technique.”
In terms of pregnancy, having more than one child, having twins or having a heavy baby all increase the chances of acquiring the condition, Schreiber says. In fact, approximately two-thirds of mothers have this condition. “During pregnancy or heavy weightlifting, increased pressure on the rectus abdominis muscles cause them to lose their shape, spitting in the middle,” Schreiber says. “When the muscle splits, there is only a small band of tissue holding the internal organs in place. The organs can push into the gap causing a hernia.”
Diastasis recti can also cause back pain, constipation, leaking urine and in extreme cases, the abdominal muscle can tear, Schreiber says. Unfortunately, pushing incorrectly when giving birth and pushing while constipated (which happens a lot after birth) can make the condition worse. And once you've got diastasis recti, there is no cure for it — though there are treatments that can help reduce its appearance.
"There are several physical therapists who will recommend exercises to tighten the core," says Dr. Melissa A. Doft at Doft Plastic Surgery. "In significant cases, I think surgical correction is the only option. This is a common repair performed during a tummy tuck. It is referred to as a rectus diastasis plication. The edges of the rectus muscle are sewn together, removing the space between them and creating an inner corset."
The best way to deal with diastasis recti is to do everything you can possibly can to prevent it.
Abdominal exercises should be avoided immediately after birth and can then be gradually added in under the supervision of a rehabilitation specialist, Schreiber says. Since folks with weak abdominal muscles are more prone to this condition, it’s helps to keep fit, both before and during pregnancy — though, obviously, while taking safety precautions not to overdo it while you’re carrying a child.
“In some cases diastasis recti may resolve, however, there is no way of knowing who, why or when that will happen,” Schreiber says. “Some studies show that after a year, some people still have the condition.”
It remains a frustratingly mysterious condition, but isn't it reassuring to know your weak core isn't necessarily a result of not getting in enough morning crunches? If you're experiencing any of the symptoms associated with diastasis recti, make an appointment with your doctor to get a checkup and diagnosis.
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