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 five years, and then in September 2017 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 abdominal 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.
What causes diastasis recti?
Diastasis recti can be caused by many things. Men can often end up with a diastasis from lifting heavy weights without engaging their core first – and it can sometimes be caused by doing a lot of crunches or sit-ups without making sure the core is enganged.
Probably the main reason women get diastasis recti is pregnancy. When you are pregnant your abdominal muscles separate naturally, to allow space for a baby to grow. When the baby is born, the muscles should slowly work their way back into place – but for many they do not.
How common is diastasis recti?
According to this article, about two-thirds of pregnant women get a diastasis. We tend to measure the gap of diastasis recti in fingers – as in, how many fingers you can fit into the gap between muscles. At its widest, mine was four fingers.
How do I tell if I have diastasis recti?
To check whether you have a diastasis, or to measure how wide it is, lay on your back with your knees bent and 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 abdominus and tell if there is a separation. I think it can often occurs around the navel, but it 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 tensed my abdominal muscles my belly sort of domed outwards in a sort of ridge. I thought it was strange, but didn’t think much else of it.
After S was born, I realised this doming of my abdominal muscles was still happening and so I showed a midwife on the post natal ward. She gave me a leaflet about postpartum exericses, 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, or what any of this meant. I scoffed at her; I knew plenty of women who were mothers 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 yet gone back in – 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 physiotherapy instead.
What is an umbilical hernia?
It turned out that 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 umbilical 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.
I had physiotherapy, where they taught me simple exercises to strengthen my core and pull the rectus abdominis back together. 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 ws discharged from physio.
This may sound silly, but I was not told that I should continue with my physio exercises; it didn’t occur to me that my diastasis wasn’t just fixed and although I made various attempts to do abdominal exercises, I didn’t keep up with the exercises from the physiotherapist. 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 diastasis. 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 soneone who has specific experience of diastasis recti.
It is important to find someone who has experience of diastasis recti because it is something many people – even fitness professionals – have never even heard of. I once attended a gym where a trainer admitted he had no idea and would find out about it… the next time I attended he tried to get me to do an exercise I knew was a bad idea and when I said so he informed me that it would be absolutely fine; he had checked with another trainer who worked there and “she’s a woman.”
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 own diastasis after pregnancy suggested my diet may be exacerating 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, in summer 2017, I went to the GP again and asked to be referred for physiotherapy. The words of my previous GP back in 2012, that an operation of this sort of thing was “like sewing together two pieces of plastic bag” were still at the forefront of my mind. 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.
By this point I was regularly 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 secondsbefore popping back out. I hoped that I could be referred for physiotherapy which would help to bring my abdominal muscles back together, thus helping to keep the hernia in place.
The GP I saw asked me if the hernia ever got stuck. I answered truthfully that yes, it got stuck around once a week. When this happened I would usually either go to bed and it would be okay in the morning, or if it was the middle of the day I would lay on my bed and concentrate on felaxing as much as possible, until I was able to push it back in. Upon hearing this, the GP insisted on referring me to 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.