Diastasis is a much talked about issue post pregnancy and many women get very concerned during pregnancy when they detect a gap in their abdominals.
So what do we mean by diastasis? Diastasis refers to the gap that can occur at the middle of the abdominals. Think about your six pack muscles - the central line down the middle between those muscles is the linea alba. During pregnancy the gap at the linea alba between the rectus abdominals (six pack muscles) gets bigger to allow for the growing baby.
Post natally the gap should return to around 1cm with good tension but for some women this doesn't happen on its own. Where there is an ongoing gap, women often report weakness in the core and they often feel they continue to look pregnant even months after giving birth. They may also have other symptoms of a weak core such as back pain and stress incontinence.
It is important to note that it is not only women post pregnancy who get diastasis! Men can get it too. It can be caused by weight gain, muscle imbalance or medical history.
The things is, it's not just the gap that gives therapists an indication of what is going on with the core. When I assess the gap, I'm actually more interested in the tension that is present when the abdominals are activated than the width of the gap. A small gap with good tension can provide good core support in every function, but a small gap with weak tension is more likely to be problematic.
The goals of therapy are to regain good tension at the linea alba and more often than not, the gap will reduce too.
Check out this video on how to self check your abdominal gap. When you feel the in between the gap do you feel like your finger could just keep going? Or is there good resistance as you press down into the gap?
In other European countries (eg. France) it is a routine part of post natal care to have a course of Physiotherapy after birth.
Unfortunately, in the UK that is not the case. As a result, common post natal issues (eg. leaking with exercise, prolapse and diastasis) have been seen by the female population as a normal part of motherhood, something that just has to be put up with. Many women assume incontinence pads are the answer (thanks largely to a leading brand that have convinced women it is the only solution) and don't even consider that a course of pelvic floor strengthening will improve and in many cases cure the problem.
Even if you don't suffer any pelvic health issues, your pelvic floor will have been significantly stretched and weakened by childbirth. Look after your pelvic floor and core now and you are less likely to suffer problems after subsequent pregnancies or later in life. Check out this video to see how pregnancy affects your pelvic floor.
A Women's Health Physiotherapist has had specialist training to assess your pelvic floor muscles. They can detect whether your pelvic floor is tight or weak, whether pelvic floor muscles are contributing to other painful areas (such as the sacroiliac joint) and can also assess neighbouring muscle groups such as the gluts which have an impact on pelvic floor activity. They can also check you are recruiting your pelvic floor muscles correctly.
Once your baseline strength has been assessed an appropriate holistic strengthening programme can be prescribed. Improving your pelvic floor/core strength can improve many conditions including back pain, prolapse, posture, sacroiliac problems and incontinence. Your Physiotherapist can advise how to safely return to higher impact activities such as running and sport, ensuring your pelvic floor rehabilitation is focussed on your personal goals.