If you need to brush up on your anatomy about the true core, refer HERE
That’s what a Pelvic Floor Physiotherist patient said. He is a body builder, lifting heavy very often at the gym. He also does 300 crunches every day. He looks great, awesome physique, but one day, he lifted too much over his head and his hip gave out.
When he went to see his physio, he was assessed and had diastasis. His whole system gave out on that one max lift.
WHAT IS Diastasis Recti Abdonimus (DRA)❓
- “You have a 4 finger separation?? But your stomach is flat!”
- “I’m doing 10,000 crunches and I still look 6 months pregnant. Maybe I should eat less and do more cardio.”
- “My doc says I need surgery to fix my tummy”
Having worked in the fitness industry for almost 16 years, I’ve HEARD about this “separation of the abs”.
But here’s the deal:
🗣IT’S NOT JUST ABOUT THE GAP
🗣MEN & NON-MOMS GET IT TOO
DRA is the separation of the rectus abdominals, the outtermost layer of the ab group.
As pregnancy progresses, the linea alba (connective tissue between the RA), thins and stretches to accommodate the growing uterus.
DRA is the inability to create tension in the LA during recruitment of the deep stabilization muscles. Sticking fingers into the belly will continue to sink even when “flexing”
Pregnancy isn’t the only possible cause. Excessive crunches and other repetitive ab flexion movements puts forward pressure on the LA. “Beer bellies” on men also put strain. Genetics also play a role
DRA can be functional or non-functional. In functional, a precontraction of the #core4 (like a kegal) will tension the LA and provide correct load transfer. The gap may still be there, but tension is created and fingers will not sink further.
Non-functional is when you are unable to turn on the core 4 in synergy and the tension in the LA will remain slack
Postpartum, Most DRA will do well with physio, but some need surgery.
More often than not, DRA can be resolved through corrective posture, core breathing, and movement education.
If you’re preggo, there’s a good chance you may get it if not already. It’s ok, it happens. Your body is changing and creating space. U can modify.
For now, refrain from planking esp for long periods of time, and, unless u really HAVE TO, STOP CRUNCHES. FOREVER.
HOW TO SELF-ASSESS
ASSESSING Diastasis Recti Abdonimus (DRA)
🤰🏻 The width of the linea alba is the inter-Recti distance IRD. The curl up test (CUT) with finger measurement is clinically used to measure IRD.
🚨 Considerations: IRD is not about tension, but about distance. Finger measurement is not reliable or valid. Whether 3 fingers or 8, it doesn’t give us much info about function. As mentioned in previous post, DRA Is functional or nonfunctional. 👩🏻🏫A real time ultrasound study with DRA women (Lee D & Hodges), CUT showed IRD was independent of functional and non-functional DRA.
1. Assessing DRA and core function WITHOUT pelvic floor(PF) contraction
🔹lie supine, knees bent, expose your belly, relax abs. 🔹press index and middle finger directly onto midline of belly, starting from sternum, working down to pubic bone. Feel for change in tension. Can you press your fingers way down into your belly? Does the tissue feel supportive when you press into it?
🔹press fingers straight down just above navel. Tuck your chin towards your chest and slowly lift head as if starting a sit-up. Feel for the edges of the Recti come together and “hug” your fingers. Add more fingers if you do not feel hug right away. 🔹separation Width and dept will vary along LA. 5-6 finger widths is common post partum
2. Assessing DRA and core function WITH pelvic floor contraction
🔹repeat CUT with PF contraction, connecting to the core 4. Inhale, then exhale and Imagine you are sucking up a blueberry with your VJJ and up to your tummy. Suck milkshake out of a straw. Draw perineum to crown of your head. **these are some cues that may be helpful** 🔹Tuck chin, lift head SLOWLY. 🔹Was there change in tension? Were your fingers still able to sink? Did LA widen, narrow, no change? Did you lose tension during CUT?
Re-assess every 2-3 wks. The gap may or may not get smaller, but the quality of the tissue is what’s important.
See below for videos: