Can we stop calling it mommy tummy?
1. I hate the phrase, kind of like I hate the word moist.
2. It is not just moms that are affected by it.
We don't call an ACL injury, football knee because it mainly affects football players. The technical term is diastasis rectus abdominus or DRA for short.
Ok, so what is it anyways?
Well, DRA is when the abdominals separate in the middle, more specifically when rectus abdominis muscle (6-pack muscle) separates along the linea alba. It is typically diagnosed when the distance is 2 cm. or greater. It DOES typically occurs in pregnancy, but like previously mentioned men can get it too. Some research supports the notion that it happens in 100% of women in pregnancy, but that is not necessarily a bad thing.1 The women's growing uterus needs a place to expand. However, it can become a problem when it doesn't resolve after pregnancy. Women with DRA can develop low back pain, pelvic pain, prolapse or even incontinence. It is not just a cosmetic issue. It is important to identify this condition as it improper exercise can actually increase the size of the DRA.
Many women will ask their trainers, fitness instructors or even ob/gyns......"What can I do to prevent this from happening during pregnancy?" Unfortunately, any advice given is not supported by any current research.
Wait, What ?!?!?! So there's nothing I can do to prevent this from happening to me?
Maybe, maybe not. The point is we don't necessarily know why it happens in some women and not others. It's not due to excess weight gain, it's not due to having multiples, and it's not due to large babies.2 There's not enough research out there on DRA yet to make specific recommendations of what to avoid during pregnancy. Most advice is based on theories or opinions.
So please ladies, don't blame yourself. We got enough that we need to avoid during pregnancy, we don't need to add any more things to our "AVOID list in Pregnancy". We already miss our wine and sushi!
The postpartum period almost needs to be treated like any other injury or trauma to the body. We aren't just magically healed at 6 weeks postpartum. We need to take the time to take care of ourselves.
DRA is treatable condition, even large DRA have been showed to be treated effectively with conservative treatment like physical therapy.3 However, correcting DRA is not a one size fits all approach, so if you tried an online program and it didn't work for you, there's likely a reason for it. One possible explanation is that you are only training the abdominals and not evaluating the function of the pelvic floor. It's like trying to fix a crack in the wall, and not addressing the the huge crack in the foundation of the house. The wall will just develop another crack until the foundation issues are corrected. Same with DRA. If only the abdominal separation is treated, and the pelvic floor is not addressed, it's likely that issues will continue to happen. DRA treatment is most effective when the entire person is evaluated and their treatment is personalized to their own impairments and functional limitations.
How can you do that? The best way is to seek out help from a pelvic health physical therapist.
1. Gilleard, WL & Brown, JL. Structure and function of the abdominal muscles in primigravid subjects during pregnancy and the immediate postpartum period. Physical Therapy. 1996; 76 (7): 750-762.
2.Mota, PG, Pascoal AG, Carita AI, and Bo, K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbopelvic pain. Manual Therapy. 2015; 20 (1): 200-5.
3. Litos, K. Progressive Therapeutic Exercise Program for Successful Treatment of a Postpartum Woman With a Severe Diastasis Recti Abdominis. Journal of Women's Health Physical Therapy. 2014; 38 (2): 58-73.
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