Understanding the conspicuous pooch that comfortably sits on your abdomen.

Facts on the diastasis recti
1. The rectus abdominis muscles run down the center of your belly and are casually known as the “six pack”.
2. Diastasis recti can cause back pain, constipation and leaking of urine
3. Babies and children can have diastasis recti that later naturally and gradually closes as they grow.
4. Uncoordinated exercises can make the condition worse.
5. A quick test for diastasis recto can be done at home.

Do you have a persistent bulge from your stomach that won’t go away?

This conspicuous pooch that comfortably sits on your abdomen happens when the left and right muscles widen causing a gap that conspicuously protrudes outside.

Consultant physician Esther Dindi says it occurs when the strength and stability in the pelvic region and midsection is affected, a condition known as diastasis recti.

When loosely translated, diastasis means separation while recti refers to the abdominal muscles called the ‘rectus abdomini. Interestingly, it affects both men and women largely for different reasons, but it is more common in the latter due to their child-bearing role.

“It does not cause any medical condition but getting rid of it definitely adds cosmetic value and self-confidence “said Dr Dindi who is also passionate about fitness.

In men, the gap is caused by the cyclical gain and loss of weight, doing sit-ups wrongly or lifting weights in an uncoordinated way Dr Dindi added.

For women, Dr Dindi is quick to say that although pregnancy does not cause the bulge, the burden on the mid-section is worsened during this time and about three out of every ten pregnancies end up with diastasis recti.
“In the last four months of pregnancy or during delivery especially a vaginal birth, the abdominal muscles are strained hence the bulge when pregnancy ends,” she said.

Other factors that would increase the likelihood of the condition include pregnancy above 35 years, delivering a baby above 3.5 Kgs, carrying multiple pregnancy of twins or more and also having children very close together.
“Spacing children is very important to reduce the pressure on these muscles because they weaken with every pregnancy,” said Dr Dindi.

Dr. Esther Dindi

Dr Dindi who is also a fitness enthusiast says the bulge can be unnerving especially for persons who ascribe to body aesthetics.

“It affects self confidence in both men and women. A disciplined exercise regime can get rid of the gap over time but patience is also needed,’ said Dr Dindi in an interview with MyDawa.

She prescribes a simple test from the heart of your living room to check whether you have diastasis recti.
“Lie on a mat with the head facing up. Bend your knees and have your soles firmly on the ground. Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.

She describes the next recipe of steps.

“While still in a relaxed mode, gently press your fingertips into your abdomen while moving your fingertips to the front and the back of your midline. This enables you to feel for the right and left sides of your rectus abdominis muscle. While here, check for separation at, above, and below your belly button,” says Dr Dindi.

A diagnosis of diastasis is given when the space is about 3cm, the gap does not shrink when you contract your abdominal wall and when the protrusion is seen on the midline of your abdomen, Dr Dindi added.
Unfortunately, the test may be more difficult to perform on persons who have a lot of abdominal fat.
According to Dr Dindi, some of the exercises that can improve the condition include swimming, regular aerobics, leg crunches, tummy vacuum exercise, squats, reverse and side crunches.

‘Exercising is a personal decision to heal the gap. What works for a friend may not be suitable for you hence an individualised programme is needed,” she said.

Dr Dindi also acknowledged that abdominal support including binders can be worn during exercises that strengthen the stomach and the lower back thus giving the desirable effects faster.
“External abdominal support may also be helpful for some people. However this needs to be cautiously sued to prevent damage to the back,” Dr Dindi added.

“One of the effects of the condition is that it may cause back pains due to the weak muscles but this can be solved by seeking a consultation with the doctor who advices on a change of lifestyle, perhaps adopting an exercise regime,” Dr Dindi added.

Before medical clearance, she advises that all activities that strain the mid-section and stretches it unnecessarily should be avoided because they expand the abdominal wall thus doing more harm than good.
Lifting and carrying heavy objects should also be avoided, she added.

For persons who have received the greenlight to exercise, Dr Dindi says that initially it should be targeted at reducing the bulge rather than increasing it.

“Exercise should be supervised by a qualified instructor so that the diastasis does not lead to persistent back pains that can also lead to hospitalization,” said Dr Dindi.