“So I asked around, and apparently I have a baby bump. And I’m here to tell you that I do! I am not pregnant but I’ve had 3 kids, and there is a bump… From now on, ladies, I will have a bump, and it will be my baby bump! It’s not going anywhere. Its name is Violet, Sam and Sera” – Jennifer Garner, “Ellen”, August 2014.
Having had 3 babies myself, I couldn’t relate more to these words from Jennifer Garner!
It turns out though, that although to some extent I may always have a ‘baby bump’, my post-children pooch may not be destined to look like that forever. I can do something about this, because yes, having carried 3 babies means that my body shape has changed, and my weight has yo-yoed a bit in the last few years, but mainly my tummy looks the way it does because I have diastasis recti.
As ominous as this sound, all it means is that there is a gap between my external abdominal muscles, which were pushed to the side during pregnancy by the increasing size of my uterus, and now they are in need of a little help to return back to where they should be. It’s because of this separation in the muscles that I still look a few months pregnant (!) despite my youngest son being over 1!
I’m not alone in this though, as it’s estimated that 2 out of 3 mums who have had 2 or more children have it, and it’s not uncommon for the muscles to remain in their newly found position unless and until something is done about it. The problem is that most of us might not even be aware of it, and in an attempt to regain our pre-pregnancy shape and flatten our stomachs we may end up doing more harm than good.
So let me tell you a bit more about how I found out about this, why it matters and what can be done to reduce the gap between your abs, or at least, to try and not make it worse for ourselves.
How I found out.
When my youngest was around 4 months old, I heard that a physiotherapist was due to come and do a little talk on the importance of the pelvic floor to one of the baby groups around my area, so I made a point of going to that – never a bad plan to hear someone reminding you about the importance of a strong pelvic floor! Well, it was a great job that I managed to go, as after hearing her talk and asking her a few question, it wasn’t hard to put 2 and 2 together and work out that some of the problems I was having at the time with lower back pain and knee pain could well be down to my core muscles not working as they should be. I also went to see her privately a few weeks later, and in short, she confirmed that my core is very weak. Part of the reason why is because I haven’t been exercising it properly to try and strengthen it, but it’s also because my abs didn’t return where they were before pregnancy, and this makes other muscles in my body (in particular my lower back) overcompensate for the fact that my core muscles aren’t doing what they’re supposed to do.
Why does it matter?
It matters because your abdominal muscles aren’t just there to give you a six pack (wouldn’t we all want one?). They help us bend forward, stop us from hyperextending (and hurting) our backs, give us stability when we walk and go about our everyday life. They also help us keep our uterus, bowels and other organs in place. Without them being where they should be, only a thin band of connective tissue is protecting these organs, and like it’s happening with me at the moment, if your core isn’t there to support you, other muscles which aren’t designed to do that have to step up and do the work, and the risk of you feeling pain or hurting yourself becomes higher.
How can YOU find out?
The easy answer is that you can assess your situation by yourself by lying down on your back with your knees bent, placing your fingers on your belly button, relaxing the muscles and gently lifting your head. You should try and be mindful of when you feel the muscles first coming together and come up and down with your head a few times to try and work out whether you feel a gap. There are plenty of resources and videos on the internet which can show you how to do this.
If you prefer to have someone else checking it, you can ask your partner, a family member or a friend to place their hands on your tummy, or ask your GP to check it for you. They don’t necessarily look out for this at your post-partum check, and they may not even be too comfortable diagnosing your diastasis (or lack of), but if you’re experiencing pain or discomfort, they can always refer you to a physiotherapist if they see fit, or you could potentially choose to go and see one privately for a full assessment.
What’s important to remember once you’ve found out that you do indeed have a gap between your tummy muscles is that this doesn’t have to be permanent – you won’t necessarily have a bulging tummy forever. Of course everyone is different, and you can totally live with it if you aren’t in pain – you may have a gap and still have good core stability, which is what matters, but you can also take steps to reduce that gap.
And there are more good news too – if you had a baby a few years ago, and you think your muscles are still separated, you can still do something about it. Although you will have heard of people having had surgery to get their muscles back together, remember that everyone is different, and their situation, motives, reasons and choices may have been different to yours. Just keep in mind that having diastasis doesn’t necessarily mean you have to have surgery to ‘fix it’.
The most important thing to remember once you’ve found out that you have a gap between your abdominal muscles is to know what to avoid so that you don’t hurt yourself!
What to avoid?
Because your muscles aren’t where they should be, you should avoid any postures that stress your abs, so anything that will make you flex the upper spine off the floor, like crunches or lying backwards on an exercise ball, for example. If your core muscles don’t engage correctly, you can actually cause your abs to bulge out even more and could potentially make the gap between the muscles wider and create postural problem for yourself, including lower back pain. You should also avoid lifting and carrying heavy objects (perhaps with your baby or other children being the exception there! 😉 )
How do I reduce the gap?
Reducing the gap between your abs can be achieved through lifestyle changes and focussed exercise – how you go about that is entirely up to you. With the help of my physiotherapist, and the very very simple focussed exercises she gave me, I managed to reduce the gap between my abs, but as of a few months ago, I still had a 3cm gap around my belly button. When my knee and back pain went away, and I started seeing positive results, instead of carrying on, I made the unfortunate choice of stopping with the exercises, so I suspect that the gap is still there now, but at least I know I can always go back to working on it, and these are some of the steps I can take for that…
We always hear that ‘we are what we eat’, don’t we? Well, ‘we are what we do’ as well. Our bodies take the shape of our habits, and habits are hard to change.
There are a few things that I want to start doing to see if I can help reduce the separation between my abs – these are either things that I was encouraged to do when I went to see my physiotherapist or things that I have researched when reading up about diastasis recti:
- Trying to untuck my tailbone (for example by sitting at the end of my chair) and trying to keep my ribs down while walking, reaching up etc. This helps to activate your core, and in particular, the transverse abdominis (or TVA), which is your deepest core muscle.
- When bending down to pick things up (how many toys are there in my living room at the end of the day?!) I should try to squat, rather than bend down from the waist. Squatting is good for your leg muscles and your pelvic floor.
- When getting out of bed or standing up from a chair or the car, I should try and lay on my side (or slide towards the side of the chair or seat), put my legs down first and then get up, rather than sitting up on the bed or again, bending from the waist when trying to get up from a sitting position.
- Heels aren’t great for my diastasis recti either, so flat but flexible and supportive shoes are the way forward. Plus, when standing for long periods of times we should be careful not to carry too much weight on our heels but distribute our weight across the whole foot.
- Another bad habit I have is to sit my children on my hips and then bend my back / waist sideways so that the child has plenty of room to sit on my hip, and they don’t feel as heavy. Well, as handy as that may be, I can tell that that can’t be good for my back at all! It doesn’t mean that I have to stop carrying my children on my hips, but I can make more of an effort to stay upright and use the strength of my arm to carry the child.
Should I join a programme?
If you want to work on your diastasis recti, you don’t have to do it on your own, of course. You could try and find out if any support is offered at your local gym, perhaps through the help of a personal trainer who could assist you in learning the right exercises for you to do at this time.
Or you could join a programme – buy a book, a DVD, an online course, download free exercises, watch some on YouTube… There is plenty of information available – whatever you do, you just need to be 100% satisfied that the information is correct and right for your body and circumstances.
There are a few programmes out there which claim to be able to ‘fix’ your diastasis recti in no time (or rather 4-6 weeks if you manage to do your exercises mindfully and consciously), but like with everything, you need to do your research first and make sure that whatever you decide to do is right for you in terms of commitment, availability etc. but also, and even more importantly, it’s something that will not end up harming you! It has to be beneficial for you and your body.
The one thing that all these programmes seem to have in common and seem to agree upon, is that you have to strengthen your core muscles from the inside out, so from your inner and deepest abdominal muscles (the transverse abdominis or TVA being one) working your way outwards towards your obliques and the most external abs. If you don’t, you’re at risk of making your core weaker rather than stronger, and a weak core can lead to other muscles in your body (and more likely your back) to overcompensate, overwork and therefore become more at risk of getting hurt.
Strengthening the TVA can be done through focussed exercise, but once again, through postural changes – you should try and engage your core in everything you do – not just getting out of bed or getting up from a sitting position but also sneezing, coughing, laughing etc.
So whilst a lot of it is about re-aligning posture and focussed exercise, eating the right food, avoiding stress, balancing hormones, reducing stress and being generally fit are things that will help close or reduce that gap a lot faster, and definitely help you keep it that way too.
For me, addressing my diastasis recti is very much still work-in-progress – postural changes don’t just happen overnight, and being aware, conscious and mindful of what you do and how your handle yourself and potentially what muscles you are using to go about your everyday life isn’t an easy task, especially if you’ve been quite oblivious to it all for a while. And as for the exercises, well that’s my next step. Hopefully I’ll be able to report some improvement in a few months’ time!
But for now, if you have any tips to share with me, or with all the other mums working on this (or planning to!), please share away, and thank you for reading!
Please note that the information contained in this article is not meant to be taken as medical advice and should never replace the advice given by a professional. If you experience any pain or discomfort, please consult your GP.