Today let’s learn a little about diastasis recti (DRA)! Specifically, how to check for it. It is best to get an official diagnosis from a pelvic floor physical therapist but if you are curious about how to check for yourself then here is the easiest way to do so.
Note: it is truly best to check in every position you utilize, and with every exercise you perform just to see what is happening with your abdominal wall. Lie supine (on your back) with knees extended and abs relaxed. Find your belly button, then raise your head without contracting the abs. Can you feel the margins of your rectus abdominis (the “six pack” abs)? How many fingers wide is it? Palpate above and below the belly button? How far down can you feel it, and how far up toward the ribs can you feel it, if at all? Next, repeat the same motion but this time begin by firming up your deep abdominals as if you are bracing against someone trying to tickle you. Then lift your head and re-check. Any different? Is it wider, narrower, soft and squishy, firm? Now how far down and up can you feel a separation, if any? DRA is very common in pregnant and postpartum women but it is not just this population that experiences it. In my clinical experience it has been just as common in men! I am in the habit of checking everyone who mentions low back pain, regardless of gender or childbearing history. It’s an easy check and can help guide rehab and corrective exercise prescriptions. As always, check with a pelvic floor physical therapist for an official diagnosis. This is meant purely as a fun curiosity check and by no means a diagnosis, but you knew that, right? 😎 Further, more and more literature is coming out revealing that the width of the separation is much less important than the depth of the separation and tension beneath it. Soft and squishy between the two sides indicates weakness of the deep transverse abdominis (TA), even if it is just a single finger width. But some people can have several fingers wide and able to create full tension of the TA when cued, and this is seen as being better than a narrow gap with no tension. Also of note, it is considered an "abnormal separation" when the gap is greater than 2.5 cm or two fingers wide. Why? Who knows. Because if the person cannot create tension in the TAs then 2.5 cm is significant. It all just depends! *By the way, I had a video that went along with a portion of this post originally posted on my Instagram account, but it requires far more tech knowledge than I possess to learn how to do that here :)
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Ab gripping. It is way too common, especially in women. AKA “sucking in.” It is something we do so much that we stop even noticing we are doing it.
Are you doing it right now? Take your had and place it on your abdomen, close to the ribs and gently jiggle the abs. Feel relaxing? Or was it hard to do? Probably gripping. Check out your abdomen in the mirror: is there a cinched in area at about the level of the belly button, looking from the side? Gripping/sucking in. Are the top abdominals more defined than the lower half? Gripping. Can you "zip up" your abs from the pubis/crotch without those upper abs firing? Gripping. Looking from the side, does it look like your lower abdomen sticks out farther than the upper half? Gripping and lower abdominal weakness. It is constant, long term tension in a group of muscles (usually upper rectus abdominis/"six pack abs" and upper transverse abdominals (TA)) and over time, those muscles adapt to what we ask of them and shorten/weaken so when you go to ask something of them (a heavy lift, core exercises, weight gain, pregnancy, etc.) they have nothing left to give and the pressure has to leak out somewhere, soooooo...yea, diastasis recti (abnormal separation of the abdominal wall) prolapse, leaking of urine or feces, inability to control gas, disc herniations, herniations of the abdominal wall, hemorrhoids, etc. Fun, huh?! Imagine flexing your biceps muscles all day every day. You wouldn't really be able to use your arms very effectively if your biceps were constantly flexed, ha! What would you expect to happen with those muscles? They would shorten and become very tight. Same idea with your abdominal wall. This sort of abdominal weakness is perfect staging grounds for lots of fun stuff, as mentioned above. Men, too! Women are by no means the only ones suffering these issues. Men are just as likely to develop these kinds of problems via means other than pregnancy. Obviously :) If you can’t just relax your abdomen on command (one way to tell you REALLY need this!) then get down on all fours and allow gravity to assist you. Let your belly relax down toward the floor gradually. I know, it feels really weird at first and you will likely be able to feel your body tensing against it, but work through this. Try to keep the shoulders engaged and don’t sink into them. Keep your spine as neutral as you can, trying not to let your low back curve too much. Focus on breathing deeply and slowly, in and out🧘♀️ If you can get in the habit of checking in throughout the day and seeing what your abs are doing (particularly in times of stress) make note of it and try to relax. Hate having your belly "pooch" (terrible word, but everyone can picture it!) out? I get it! But that is what loose-fitting shirts are for in this stage of the game, right?! All sorts of things improve when we stop holding tension, particularly in our abdomen. Digestion, breathing, stress response, constipation, you name it. Try it out and I hope you find some relief! |
PaigeRunner, lifter of children, PTA, CPT, PCES, pelvic health zealot Archives
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