Y’all have heard of the term mummy tummy, right? Well, let’s talk a little about what that really is and some of the less talked about implications of this condition. Clinically referred to as Diastasis Recti Abdominis, or DRA for short, this mummy tummy is more than just a saggy belly with a pooch that makes swimsuit shopping a special form of torture. It is, at the core (no pun intended), a sign of potentially significant dysfunction in the structure and/or function of the core stability system and the abdominal wall.
So what really is DRA? Simply put, it is an abnormal distance or separation between the right and left superficial abdominal muscle layer, the rectus abdominis. Normally the right and left sides are separated by just a few millimeters by a structure called the Linea Alba (LA). When this collagen based structure gets stretched out, especially during pregnancy or the case of significant weight gain, the muscles get further apart from one another. That excessive separation is known as Diastasis Recti Abdominis.
Even as a women’s health professional, this is something I have struggled with for the last 11+ years, following the birth of my oldest child. As a new mom, exhausted and just trying to get it all right so that I didn’t mess up my precious little bundle, the last thing on my mind was trying to fix my tummy muscles. I mean, nothing is ever the same after childbirth, right? So I kept on exercising, eating well, and hoped as long as I was careful and didn’t do sit ups (totally makes DRA worse), it would get better. Mind you, I knew enough of what not to do, but wasn’t really actively trying to correct this split.
Then, baby #2 came along and any work that I had done trying to “close the gap” was lost. So, for 11 years, on and off, I have tried to heal this DRA. We had always been taught that anything more than a 2 finger separation between the muscles was a clinical separation and “healing” meant getting that separation closed. Then I came across this amazing book, Diastasis Recti Abdominis: A Clinical Guide for Those who are Split Down the Middle, by Diane Lee. Now there is research that shows there is so much more to DRA than just getting those muscles back together. It really is all about the function of the muscles and the tension across the linea alba and how well they can do their job as opposed to just getting it closed.
Did you know that poor abdominal wall function is correlated with conditions like urinary incontinence, bowel dysfunction, pelvic girdle pain, lower back pain, and pelvic organ prolapse? Of course, getting the muscles closer together can make our tummy flatter and helps us get back into our favorite jeans, but we also need to consider that there is so much more we are affecting when we take the time to really restore our core function. And if you have any of those other conditions listed above, it may be worth checking yourself to see if DRA is also present.
Lay on you back, knees bent. With fingers aligned across your tummy just above your belly button, raise your head from the floor. How many fingers fit between the edge of the right and left muscles? Is there a little ridge that pops up? Do this again about 2 cm below the belly button and just under your breastbone.
Our bodies our so intimately connected top to bottom and front to back. If there is a break down in one area, symptoms area bound to show up in other areas too. Getting our abdominal wall working well again has the potential to help us address so many other common women’s health concerns. We can gain confidence and continence, reduce belly bulging and improve pelvic floor support to limit risk of pelvic organ prolapse (POP), and deal with that persistent lower back pain that has been hanging around for a while as a constant reminder we are getting a little older every day. Over the next few weeks, I will share some of the great tidbits of information from this book and other resources that can help to get our whole core system functioning well again. And if you don’t mind, I may share more of my journey to finally, truly heal my own DRA. Ya with me?