Going to go a little deeper with this blog but in a hopefully concise way....Rectus Diastasis, the gap in the midline of the abdominals isn't just about the Rectus Abdominis and is probably better described as a stretching, weakening, dysfunction of the entire anterior (front) and lateral (side) abdominal wall.
This includes the muscles of the abdominals and other connective tissue such as FASCIA and the APONEUROSES (a type of tendon) connected to each of the layers of abdominal muscles shown as the white areas shown in the second picture below.
The connections of muscles to bone are usually thought of tendons but muscles can also be attached by flat and sheetlike tendons termed aponeuroses. In essence, the aponeurosis is the membranous expansion of a muscle or a muscle group. Under a microscope, it appears similar to a tendon, but it has fewer nerves and blood vessels.
There are aponeurotic layers at the midpoints of all the layers of the abdominal wall muscles, the Rectus Abdominis, Internal and External Obliques and the TVA and when testing for a Diastasis, when you find an especially deep one, your fingers can be passing through several layers of the abdominal wall midline not just the Rectus Abdominis!
So many times, when we learn, we want a strict definition of critical issues and the issue of 'Diastasis' is no different. Many of the Fitpro's that I teach, working with Post Natal clients seek clarification and guidance on 'when is a Diastasis a problem Diastasis'. My answer:
'Ultimately the abdominal wall is part of the entire core and all components need to functioning optimally (muscles, tendons, fascia, bones, nerves, blood supply, skin......) for the core to do it's primary jobs of withstanding pressure/transferring load created by movement and providing a strong foundation for movement at the 'outer unit' - the arms and legs. So....... ANY GAP or leak of energy in the abdominal wall isn't optimal as it means that the capacity to withstand pressure and transfer load and force of movement WILL NOT BE 100%. And obviously the bigger the gap, the greater the potential for dysfunction. The lack ability to transfer load at the abdominal wall can also go hand-in-hand with a leaky pelvic floor especially in the client who has given birth'. Urinary Stress Incontinence can also be an issue as the downward pressure on the weakened/traumatized does not provide sufficient support for the bladder opening.
The one caveat.....
Women often end up with an enduring gap between the two bellies of the Rectus after birthing but when the midline is firm and can do it's job, they usually are much more functional and indeed sometimes TOALLY FUNCTIONAL than those who's midline remains soft to the touch.
Aponeurosis Fast Facts
1. The abdominal aponeuroses are a type of tendon.
2. Consists of primarily COLLAGEN.
3. Collagen is 30% dry matter, 70% water - WATER & GOOD HYDRATION IS ESSENTIAL when trying to heal your Diastasis.
4. Of the dry matter the largest single components are 86% = Collagen and 2% = Elastin. So, movement is an important part of Diastasis recovery but THE RIGHT KIND OF MOVEMENT!
5. Repair/restrengthening of the collagen requires there to be a gradual crosslinking (above) of the collagen fibrils which results in the tissue becoming stiffer and the midline regaining it's functional properties alongside a better looking/flatter post baby belly 🙂
6. And finally, the million dollar question.....How long does this all take? Answer: How long is a piece of string!? Every woman is an individual, her age, genetics, size of the stretch during pregnancy, nutrition, hydration, stress levels and hormonal profile will all have an effect of her healing. Our job as fitness professionals ultimately is to work with a progressed protocol that ensures we do everything possible to take the client toward Diastasis healing and not the reverse and this is mainly done by helping the client realize that her journey back to a better belly in the early days post birth isn't about doing sit-ups at all!
Need INSPIRATION for your programming for the Post Natal client? Join Metabolic Mommy!