Diastasis Recti and Umbilical Hernia: My Experience
Like many women, after having a baby I found myself with a diastasis recti – and then an umbilical hernia too. I lived with these for 5 years, and then in September last year I had an operation to repair the umbilical hernia. After this I had physio which has helped to repair the diastasis recti. This blog post details my experience. You can read about my experience of umbilical hernia repair with mesh here.
What is diastasis recti?
In short, diastasis recti is when your ab muscles – the rectus abdominis – have pulled apart, leaving a gap in the middle. The rectus abdominis is two lines of muscles that run down the centre of the belly; they are held together by a band of connective tissue called the linea alba, and sometimes the linea alba is stretched or even damaged, causing the rectus abdominus muscles to separate to varying degrees. This can be caused by many things, but probably the main reason women get it is pregnancy. When you’re pregnant, your abdominal muscles separate naturally, to allow space for a baby to grow. When the baby is born, the muscles should slowly go back into place – but for many they do not. According to this article, about two-thirds of pregnant women get a disastasis. We tend to measure this gap in fingers – as in, how many fingers you can fit in the gap. At it widest, mine was four fingers.
To check whether you have a diastasis, or to measure how wide it is, lay on your back with your feet on the floor. Gently tuck your chin and lift your head/shoulders off the floor. This should tense your abdominal muscles, and you should be able to feel along the rectus abdominis and tell if there is a separation. I think it usually occurs around the navel, but can occur anywhere along the length of the muscle.
Towards the end of my pregnancy (which was only 35 weeks as S was premature), I found that if I was laying down and tried to sit up, my belly domed outwards in a sort of ridge. I thought it was kind of weird, but didn’t think much else of it. After S was born, I realised this doming of my abdominal muscles was still happening, and showed a midwife on the post natal ward. She gave me a leaflet about postpartum exercises, and told me I should never again do abdominal exercises with both feet off the ground. She didn’t explain to me that I had a diastasis recti, or what any of this meant. I scoffed at her; I knew plenty of women who had had babies and still carried on as normal in gym classes!
When S was a few months old, still blissfully unaware I had a diastasis – or even what it was – I found that my “outie” belly button from pregnancy had not gone back in yet, and it hurt. I went to the GP; she told me that “they” don’t like to operate on these things, because it’s “like sewing together two pieces of plastic bag” and can easily tear. She referred me for physio.
What is an umbilical hernia?
It turned out the “outie belly button” that was causing discomfort was in fact an umbilical hernia. Because of the diastasis, something from inside my body was poking out of the gap. That something could be fat, or it could be part of the intestine. My hernia, when it was playing up, always made me feel quite sick and affected my digestion – so I always assumed it was part of my intestine poking through.
I had physiotherapy, where they taught me simple exercises to strengthen my core and pull the rectus abdominis back together again. My gap went from four fingers to one finger; a one-finger gap is not considered to be a problem. My umbilical hernia had all but disappeared, and was easily popped back in again if it did show. I was discharged from physio.
This may sound stupid, but I was not told I should continue with these exercises; it didn’t occur to me that my diastasis wasn’t just fixed and although I made various attempts to do ab exercises, I didn’t keep up with the exercises from the physio. In fact, I carried on going to various “bootcamp” and exercise sessions where I did planks, crunches and all sorts of exercises which are actually not a good idea if you have a disatasis. I even took part in – and won – a plank-off. Not wise.
If you have a diastasis recti, avoid all exercises that put pressure on your abdominal muscles and seek professional help from someone who has experience in this sort of thing.
A few years later, my diastasis had widened again, and my hernia was causing me problems. A friend who is a fitness professional and had successfully closed her diastasis after pregnancy suggested my diet may be exacerbating the situation. I scoffed and thought, you idiot; of course this is not diet related. I then took part in a month-long “Drop A Dress Size” challenge she was running, the first week of which involved cutting out lots of foods including wheat and sugar. My hernia stopped hurting. This was when I decided cutting out wheat was probably a good idea in the long term. For me at least, wheat and gluten have a bloating effect, and this caused pressure inside of my abdomen, causing the hernia to swell.
Eventually, last summer, I went to my GP again and asked for a physio referral. The words of my previous GP back in 2012, that an operation for this sort of thing was “like sewing together two pieces of plastic bag” were still at the forefront of my mind, and this coupled with my memory of my mother having an umbilical hernia repair operation when I was a teenager, meant I didn’t even consider surgery to be an option.
At the time I was wearing a thick corset-type support band around my waist which supported my muscles and made things feel a little better. Without it – and often even if I was wearing it – the hernia was “out” all of the time. I could easily push it back in, but it rarely stayed there for more than a few seconds before popping back out. I hoped that I could be referred for physio which would help to bring my abdominal muscles back in, thus helping to keep the hernia in place.
The GP I saw asked me if the hernia ever got stuck; I answered honestly that yes, it got stuck about once a week. When this happened I would usually either go to bed and then it would be ok in the morning, or if it was the middle of the day I would lay on my bed and concentrate on relaxing as much as possible, until I was able to push it back in. Upon hearing this, the GP insisted on referring me to see the surgeons at my local hospital. I thought this was a complete waste of time and resources, but reluctantly agreed.
When I saw the surgeon, I expected to be laughed out of the room; instead he poked at my belly for a while before declaring that I would have an operation to repair the hernia, within six weeks.