WHAT IS DIASTASIS RECTI / ABDOMINAL SEPARATION? Women's Health Physio

Charlotte Conlon is a Women’s Health Physiotherapist from Flow Physio Co Sutherland. Today she talks to us about abdominal separation (diastasis recti) during and after pregnancy.

What is a Diastasis Recti?

An abdominal separation that occurs when either side of the rectus abdominis muscles (the 6-pack muscles) separate from the linea alba.

What is the linea alba?

The linea alba is a connective tissue which runs vertically down the centre of the abdominals.

What happens during pregnanacy?

In pregnancy, this stretch of the linea alba can be caused by a number of factors including; hormonal changes, weight gain, weakness of the abdominal muscles, stretching of the abdominal wall or heavy lifting.

Is it normal?

It is considered a normal part of pregnancy and should decrease in the weeks after birth as the uterus shrinks.

When is considered abnormal?

It is considered abnormal to have greater than 2cm separation at 6-weeks post partum.

WHAT CAN YOU DO?

We recommend having a 6 week check up with a Women's Health Physiotherapist who will assess your abdominal separation and the integrity of your pelvic floor. It will also involve assessing the position of your pelvic organs to make sure there is no prolapse.

Following this, your Women’s Health Physio will be able to safely prescribe a postnatal exercise program for you to begin (see here: Returning to Exercise Safely after Pregnancy).

2019 Guidelines for Physical Activity in Pregnancy - Flow Physio Co Sutherland - Women's Health Physio

The 2019 Canadian Guideline for Physical Activity in Pregnancy  provide guidance for pregnant women, obstetric care and exercise professionals on prenatal exercise.

The guidelines provide evidence based recommendations regarding physical activity throughout pregnancy in the promotion of maternal, foetal and neonatal health. 

The Benefits of Being Active through Pregnancy

In the absence of contraindication, following these guidelines is associated with fewer newborn complications and maternal health benefits such as:

• Decreased risk of gestational diabetes and preecplamsia

• Less risk of Instrumented-assisted delivery; and

• Decreased risk urinary incontinence post birth

What is Recommended?

The guidelines make 4 strong recommendations and 2 weak recommendations:

1. All women without contraindications should be physically active throughout pregnancy (Strong recommendation, moderate-quality evidence)

2. Pregnant women should accumulate at least 150 of moderately intense physical activity each week to achieve clinically meaningful health benefits and reduction in pregnancy complications (Strong recommendation, moderate-quality evidence)

3. Physical activity should be accumulated over a minimum of 3 days per week, however being active everyday is encouraged (Strong recommendation, moderate-quality evidence)

4. Pregnant women should incorporate a variety of aerobic and resistance training activities to achieve greater benefits (Strong recommendation, high-quality evidence)

5. Pelvic floor muscle training may be performed on a daily basis to reduce the risk of urinary incontinence - instruction on proper technique is recommended (Weak recommendation, low-quality evidence)

6. Pregnant women who experience light-headedness, nausea or feel unwell when they exercise flat on their back should modify their exercise position to avoid the supine position (Weak recommendation, very-low quality evidence)

Enhancing maternal health and reducing pregnancy complications

In conclusion prenatal exercise should be therefore considered the front line therapy for reducing the risk of pregnancy complications and enhancing maternal physical and mental health. 

What should you do?

You should check with your obstetric care provider or Women’s Health Physio to make sure you don’t have any contraindications to exercise and enjoy the wonderful benefits of being active through pregnancy.

Source:

• 2019 Canadian Guidelines for Physical Activity in Pregnancy