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Written by: Stephanie Higgins BHSc, MPT Registered Physiotherapist
A common condition that occurs during pregnancy is a Diastasis Rectus Abdominis (DRA) or Diastasis Recti. This is when the linea alba of the rectus abdominis stretches to allow room for the growing fetus, leaving a gap between each set of recti. The rectus abdominis functions:
DRA is not limited to women. Men with large “beer belly” abdomens experience the same doming of the linea alba when it is stressed. This can be seen as a bulge when sitting up from a reclined position.
Every pregnancy will have some degree of DRA. DRA can be classified as either “functional” or “non-functional”. In a functional DRA, when the inner core muscles are properly contracted in a pre-contraction, tension will be created across the linea alba and the correct load transfer occurs. In a non-functional DRA, the inner core muscles are unable to work synergistically and the tension in the linea alba remains slack. The size of the gap left between the recti is influenced by the different compensatory strategies used by other abdominal muscles such as the internal and external obliques. Non-Functional DRA can present itself as low back pain, pelvic pain, pelvic organ prolapse, incontinence, poor muscle tone (ie. a “mummy tummy”) and non-optimal compensation strategies for core stability.
The chances of ending up with a non-functional DRA can often be minimalized during pregnancy. Learning which exercises and movements are safe to do is important. As well, learning the key exercises to help strengthen the inner core muscles can make it easier to recover once the baby is delivered. Working with a physiotherapist can help determine where the muscle imbalances are and how to properly cue the inner core muscles to work together to help restore the functional core.
Movements to avoid during pregnancy include anything that puts extra stress on the linea alba. Once their belly gets to a certain size, pregnant women should:
Strenuous exercises such as planks or push ups in prone may be modified based on the current condition of the abdominal wall.
There is more than just vanity when it comes to complaints of a “mummy tummy”. The presence of DRA can have significant effects on core control and stability. Through the guidance of a physiotherapist, a pregnant woman can still exercise in a safe manner and promote proper development of her inner core muscles. Strong core muscles will allow her to recover well from pregnancy and be ready for the other challenges that come along with motherhood.
Steph graduated from the University of Western Ontario, Master of Physical Therapy in 2009. Prior to this, she completed a 4 year Honors Specialization in Health Science with Biology also, from the University of Western Ontario in 2007. Since completing her Masters, Steph continues to further her post graduate education pursuits with a strong interest in manual therapy, sports physiotherapy, pre and post-natal care and acupuncture. Steph is a Kitchener native who has always had a passion for sports and physical activity. She has participated in many competitive sports throughout her life and continues to promote the importance of health and physical fitness, including being a National level Ultimate (Frisbee) player. In her spare time, she enjoys traveling and exploring the culinary world with her husband and their young family.
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