Each of us who is or has been pregnant has had a separation of your front tummy muscles. It happens to all of us a long, accompanying the miracle of bringing life into the world. But what happens after?
The medical words are Diastasis Rectus Abdominus (DRA). The common words are Split Middle or Mummy Tummy. Just a few moments online will “enlighten you” with numerous blogs and even more online programmes that you can buy to “fix” your problem. Don’t do it! Learn from the experts instead. In July 2017, the world’s top experts on DRA gathered their information together. This is a summary of their wise words.
We’ll begin with correct anatomy then share the latest information to help you with this challenge.
The structure that is separated is the Linea Alba (LA), not the Rectus Abdominus (RA) muscle. This is important because the LA is pivotal in controlling the pressure system of your middle or core cylinder. It’s a disruption of the pressure system, not a broken muscle. Stitching the RA together surgically with your own tissue or with mesh is likely to fail over time; but even more exciting is that this surgery may be unnecessary if you address the causal dysfunction.
Let’s learn general principles about how to prepare your tummy during pregnancy and to reinvigorate your central core pressure system after delivery. If you need more help, you can refer yourself to a women’s health/pelvic physiotherapist to help you find a bespoke approach that is right for you!
While you’re pregnant:
• Avoid exercises that shorten up your superficial tummy muscles (like crunches, sit-ups, curl-ups)
• Engage co-activation of your inner tummy muscles during exercises
• Promote effective, tension-free low belly breathing
• Learn alternative postures and movements that reduce straining and breath-holding
• Reduce straining movements and habits on the toilet
Right after you’ve delivered your baby:
• Avoid all exercises that shorten up your front (crunches, curl-ups) + front loaded exercises (planks and push-ups)
• Avoid exercises in which your pelvic floor muscles are overwhelmed (leaking or pressure in/on your pelvic floor)
• Avoid high impact exercise (running, jumping, burpees)
• Learn a timed and coordinated pelvic floor muscle contraction during exercise (learn with help from a pelvic physiotherapist)
If you notice doming or sinking of your tummy muscles at rest, which worsens when you lift your head up while lying on your back:
• Avoid exercises and daily movement patterns that cause doming or sinking of your tummy muscles and/or pelvic floor weakness. Pay attention to your tummy.
• Carefully introduce front loading of your tummy muscles when you’re able to maintain tension through your LA and progress exercise when you can control your LA tension during exercise and daily activity. Ask for help.
• Avoid exercises that cause challenge to your pelvic floor (incontinence or pressure)
• Get physiotherapy assessment/treatment for your pelvic floor, pelvic girdle (bottom half) and thoracic girdle (top half) of the core cylinder from a women’s health/pelvic physiotherapist