Mind the gap? Dealing with diastasis recti

I’ve mentioned my diastasis on the blog before, but over the months since I originally noticed the problem, the separation in my abdominal muscles seems to have become worse (or at least it’s no better). In fact, it has reached a point where I’ve been mistaken for being pregnant on more than one occasion, which is more than a little mortifying.

While it is normal to have a gap in your abdominal muscles (even if you have never been pregnant), and this can range from 0.5 to 2 cm, a recent check-up with a women’s health physiotherapist revealed that my gap (which is at its worse at the point just above my belly button) is 6 cm when I lie flat and 2.5 cm when I curl into a crunch position. While I found the 6 cm revelation pretty alarming, the good news is that I may be able to close the gap with a variety of exercises and that I haven’t left it too long to fix (which was one of my fears given that my daughter is now coming up to 2 years old).

As well as reassuring me that I haven’t left physiotherapy too late, I was also comforted to hear that nothing I did or could have done during pregnancy would have stopped the gap from forming.

I had been putting off seeing a physiotherapist and trying to resolve the issue myself. This (questionable and largely unsuccessful approach) was down to a combination factors: embarrassment over what my body had become, the feeling that my problem didn’t warrant the time or cost of a professional appointment and the fear that I would be told to stop running – something that I understand can make diastasis worse, but which also makes me feel so much better. Yet, having now sought professional advice I can’t even begin to explain how much better I feel.

Outsourcing the problem to someone who is qualified to give sound information and guidance took a weight off my shoulders and acted as such a tonic for my physical and mental health. Hearing that some of the side-effects that I’ve had since the surgeons ‘rummaged around’ in my stomach during the cesarean – which include painful visceral restrictions in my abdomen, bloating and difficulty going to the toilet (sorry for the overshare) – were all normal and resolvable was so reassuring. I also feel so much better about my body knowing that I am taking positive and sustainable action to resolve the embarrassment of being asked if I am pregnant (which is something that has been causing me quite a lot of upset).

While aesthetics obviously play a role, making adjustments to my diet and routine (including setting aside time everyday to go to the toilet, which as a mum is easier said than done!) to help with stomach discomfort and bloating, as well as doing exercises that make me feel stronger, is a real boost for my mental health.

I am also paying more attention to how I breath to make sure that my diaphragm is moving properly. The physio suggested diaphragmatic breathing might also help with my digestion as the movement of the diaphragm can massage the intestines, while shallow, restricted breathing and holding your stomach in (something I have done for many years now) can have a negative impact on your digestive health. She also encouraged me to think more about my posture, both at rest and when I lift and carry my daughter, so as not to put more pressure on my upper abdominal muscles, which could have been making the problem worse.

After our consultation the physio sent me videos of exercises to do daily. Bolstered by the positive feeling of outsourcing my treatment plan I also decided to enlist a personal trainer (who was fully briefed by the physiotherapist) to help keep me on track in my mission to close the gap.

Since starting on this new plan I am lifting heavier and pushing myself more than I have ever done before. This is thanks in large part to my incredible trainer, Abbie, who not only motivates me but reassures me that I’m not doing anything detrimental to my abdominal health. I now have warm-up exercises to do before I run to help ready my body for the pounding of the pavements, lots of asymmetric sets to improve my core strength and bring the muscles back together and I have been spending a lot more time with kettle bells and exercise bands.

And I feel great for it.

As someone who has always been doggedly determined to take responsibility for my health and fitness (sometimes to my own detriment), I have actually found seeking help with my diastasis a positive revelation. While I know the monetary cost of this is (and will be for me) a limiting factor, getting a good programme, advice and an MOT to check where you are at and what you should and shouldn’t be doing, is a good way of getting the ball rolling to make a positive change. Both the physio and PT I have seen have set me on the road to recovery and are available for me to check in with them online if I need further advice.

I’m still minding the gap, but soon I hope I won’t have to.

Claire Pacey is the physiotherapist I saw and she can be found here.

Abbie Smith is a North London-based PT and you can find out more about her on Facebook and Instagram @AbbiSmithPTLondon.

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