Diastasis after childbirth - how to determine how to remove it yourself?

Causes of diastasis after childbirth and provoking factors

The abdominal wall consists of supporting and connecting tissue, including collagen fibers. Due to pregnancy hormones, the tension in the fibers decreases and they begin to stretch, and the abdominal muscles give way to the growing baby. The separation of the rectus abdominis muscles along the midline of the connective tissue connecting them (linea alba) is called diastasis. The linea alba runs from the bottom of the sternum to the top of the pubis and is usually about 1 cm wide. Diastasis can occur anywhere from the top to the bottom of the midline. After delivery, this process will resolve itself and the collagen fibers will regain their normal traction force. However, prolonged stretching or tearing of the fibers may cause the binding tissue to fail to fully repair itself.

Having diastasis is completely normal during the third trimester. However, there are a number of factors that can increase the likelihood of developing a disorder that will be difficult to correct:

Pregnancy after 35 years
Already have two or more children
C-section
Pregnancy with twins or triplets
Large baby or increased amount of amniotic fluid
Incorrect type of load on linea alba during pregnancy
Constant constipation
The wrong kind of strength training during or after pregnancy

How can an osteopath help?

One of the best recovery methods is to visit an osteopath. It is this specialist who is able to improve the functioning of internal organs, help the spine recover, and also reduce the negative impact of scar-adhesive changes after operations.

And if the birth was complicated and required surgical intervention, then you definitely cannot do without an osteopath. Previous gynecological operations can disrupt the outflow of blood from the pelvis, and venous congestion leads to chronic pelvic pain.

The same condition is observed with adhesions that can form due to epidural anesthesia. Osteopaths know how to create a new healthy balance in the pelvis, reduce adhesions, and remove venous stagnation. And after 3-4 sessions the pain goes away forever.

Symptoms and methods for determining the presence of diastasis

Diastasis after childbirth is not accompanied by any pronounced clinical symptoms, but can cause the following unpleasant disorders:

Problems with posture and increased stress on the spine
Also, diastasis after childbirth can be complicated by the appearance of a hernia.

How to determine diastasis after childbirth? To identify such changes, you can resort to a simple test at home:

Lie on a hard surface, such as the floor, bend your knees and place your feet on the surface.
One hand should be placed behind the head and the other on the stomach, gently touching the midline of the abdomen with your fingers (the line is parallel to the waist, in the navel area).
Next, you need to take a deep breath and exhale, relax the abdominal cavity and press on it with your fingertips.
Then you should raise your torso and fix yourself in this position for a few seconds. During this time, you can feel how many fingers fit between the abdominal muscles and determine the “space”.

Such self-diagnosis will allow us to identify the size of the “space” and at least approximately know the degree of discrepancy. The more fingers the “space” has absorbed, the more pronounced the diastasis.

If you find such a “gap” a few weeks after giving birth, there is no need to panic. Over time, the connective tissue will return to normal and elasticity will resume. However, do not forget about special exercises that will speed up the recovery process.

Diastasis usually recovers naturally within the first six months after childbirth. After pregnancy, you can check your diastasis monthly to monitor your progress.

What physiological changes occur in the body of the expectant mother?

If you look at a pregnant woman in profile, you will notice that the spine begins to bend in order to redistribute the load: the lumbar and cervical regions go forward, the thoracic region goes back. The uterus grows and strives upward. The sacrum also tends to follow it. The muscles of the back of the legs and back become static - after all, they are the ones who need to keep the body from possible falls. The entire body begins to rebuild around the uterus, creating favorable conditions for the growth and development of the unborn baby. During labor, the following occurs: The tip of the sacrum deviates to accommodate the baby's head. For the pushing period, the vertebral curves should be smoothed out. In order to “push” properly, the expectant mother must take a special position: pull her knees to her stomach, press her chin to her chest. Those. the process of returning to the pre-pregnancy state begins already during childbirth.

Exercises for diastasis after childbirth

Exercise "bridge"

To perform the exercise, you need to lie on the floor and bend your knees (arms straight along the body). As you inhale, lift your pelvis, hold it for a few seconds and lower it as you exhale. Repeat 10-15 times.

Pelvic floor exercises can help strengthen the deep abdominal muscles because all the major muscles automatically contract as a group. These exercises can be performed in the early postpartum period.

Exercise “squatting near a support”

Stand straight next to the wall, pressing your back against it. Next, you should squat to a 90-degree angle, placing a rubber ball between your legs (if you don’t have a ball, you can use a book or a small bottle of water).

Leg raise exercise

Starting position - lying on the floor, on your back, arms extended along the body. One leg is bent at the knee, the other needs to be raised up and straightened, holding it in the air for 3-5 seconds. Repeat the same with the other leg. You need to reach 3-5 sets of 20 repetitions.

Reliable signs of diastasis

Diastasis has one peculiarity. Even if you have a pumped-up and flat stomach, literally half a mug of water radically changes the situation, and your stomach looks like it would if someone was never friendly with sports. The anterior abdominal wall protrudes, the navel falls out.

The appearance of the abdomen is determined by the location and degree of diastasis: in some it manifests itself as a “bloated” abdomen, in others – an inverted navel.

Breathing exercises for diastasis

Breathing exercises help retrain the diaphragm, or rather, return it to its normal position and functioning. During pregnancy, the growing uterus seems to push the diaphragm up and it loses the ability to return to its normal position. Since the diaphragm forms the upper part of the core muscles, it is important to retrain it and return it to its original position. Here are some good exercises:

Lying on your back, with a pillow under your buttocks, raised slightly above chest level, you should take short, shallow breaths into your stomach. This exercise should be done for a minute.
While sitting, you need to put your hands on your chest and take short and shallow breaths for a minute.

The distance between the two abdominal muscles is not the most important aspect. It is much more important that all the abdominal muscles can work together again, providing quality support to the spine.

A few words about our clinic

There is little that can surprise a modern person. Perhaps only excellent health. After all, everything depends on him: quality of life, family relationships, financial situation, etc.

The main goal of our “Quality of Life” clinic is to improve the patient’s quality of life, to give the opportunity to enjoy every day that comes, this is especially necessary for young mothers.

Children are the most important thing in the lives of many families. And women sometimes take unnecessary risks to have a baby. In almost 100% of cases, pregnancy leaves its mark on the life and health of the mother. That's why we strive to help you recover properly so that you can enjoy motherhood calmly and worry-free. A healthy mother means a happy baby. Restoring your figure after childbirth is certainly important, but not right away. But don’t waste time in fitness clubs, don’t exhaust yourself with hours of training, don’t put yourself on a strict diet in order to quickly get into your prenatal size, don’t look at yourself in the mirror with a dejected expression on your face, but don’t give up on yourself either. You are MOM! And now you are EVERYTHING for your baby. YOU are an example! It is YOU who bears all the responsibility and daily hassles. If pelvic pain and other pain syndromes appear, do not tolerate it. At the “Quality of Life” restorative medicine clinic, professional osteopaths and rehabilitation specialists are always ready to help you. Enjoy every day, give yourself and your body time to recover, and the results will not be long in coming.

Prohibited exercises when diagnosing diastasis after childbirth

Before you start working on eliminating diastasis, you should pay attention to exercises that are strictly prohibited. These include the following types of loads:

Exercises that require you to lie on your back on a fitness ball.
Yoga, namely poses that stretch the abdominal muscles.
Using heavy objects or doing barbell exercises.
A load that involves being on all fours.

About the timing of the convergence of the pelvic bones

The postpartum period is a time no less important than pregnancy itself. This is why many experts call it the tenth month. For nine months, the female body was actively preparing for the birth of a baby, adapting to his needs, and enduring discomfort. Therefore, it is not surprising that the recovery period after childbirth cannot be quick. Just for the reproductive system to recover, it takes at least 6-8 weeks, after which the woman needs to see a gynecologist.

The main changes in the female body when carrying a child occur due to the action of hormones. During pregnancy, they are actively produced, which is necessary for the healthy development of the fetus, preparing ligaments and bones for the upcoming birth. After the baby is born, the woman’s body again undergoes hormonal changes. Those hormones that were responsible for the development of the child fade into the background; the hormone prolactin, necessary for the production of breast milk, predominates. The process of restoration of a woman’s body after childbirth is called involution. It also provides for the convergence of the pelvic bones.

What happened to them before the baby was born? Obstetricians-gynecologists state that the divergence of the pelvic bones occurs immediately before childbirth. In essence, this is a softening of the cartilage tissue in the area of the symphysis pubis; the divergence of the bones does not go beyond one and a half to two centimeters. After childbirth, there cannot be a lightning-fast return to their original state. Even if the birth was easy and quick, the bones will return to their natural position for a long time. This often takes the entire postpartum period, that is, 6-8 weeks.

When is the best time to give birth after endoprosthetics?

So, the joint prosthesis itself does not have a negative effect on the health of the fetus and mother, which is already a big plus. You have every chance to carry and give birth to a healthy child after the procedure of replacing the hip joint and knee joint with an endoprosthesis. But, as you have noticed, the key worrying point is associated with the considerable likelihood of loss of stability of the non-native joint and rapid wear of its components. Let us repeat, the leading provoking factors for such an ending are musculoskeletal reorganization and rapid weight gain.

To minimize all these risks, a woman needs to postpone her pregnancy plans for at least 1 year after the operation. Let's explain why.

Until 12 months, bones, muscles, and ligaments are not ready to provide adequate support not only to the prosthetic joint, but also to the biologically native parts of the musculoskeletal system.
As a result, if you rush and underestimate the importance of high-quality recovery before childbirth, a woman risks developing arthrosis of other joints, as well as encountering dislocations, instability, and rapid wear of the implant. Pain syndrome and motor-support dysfunction will certainly also appear.
There will be only one way out of the described situation: endure painful symptoms before delivery, and then undergo revision surgery to reinstall the endoprosthesis, and be treated for new pathologies.

Moreover, if you get pregnant early, it is dangerous due to suture dehiscence and infection of the tissue around the prosthesis. The latter is an extremely dangerous condition for both mother and fetus. The danger is that it requires intensive antibiotic therapy. We think everyone is aware of the dangers of antibiotics. But if bactericidal therapy is not carried out in a timely manner, the life of the patient and the unborn baby will be at risk.

Doctors strongly do not recommend that a woman become pregnant for at least 1 year after hip replacement; for some, due to individual characteristics, it takes longer. Consequently, giving birth earlier than 21 months after the operation is conditionally contraindicated for the above reasons.

Please note that before you decide to become a mother soon, you should consult and obtain permission with professional guidance from a supervising orthopedic or prosthetic surgeon.

Dysfunction of the symphysis pubis

One of the reasons causing pathological divergence of the symphysis is DLS. There are three stages in the pathogenesis of this phenomenon: 1. The period before childbirth. Leading links: heredity, lumbar pain during early pregnancies, hypo- or hyperactivity, use of oral contraceptives, traumatic injuries to the pelvis or back. It is possible to develop DLS in multiparous women. 2. The birth itself. Obstetric operations, large or post-term fetus. 3. The period after childbirth. Lactation.

Consequences

To avoid an unfavorable outcome, women after childbirth should consult a doctor even if they have the slightest concern in the pubic bone area. The most dangerous consequence of the complication is ligament rupture, as a result of which the woman completely loses the ability to move and becomes disabled.

Patients who have experienced symphysitis have a high probability of repeating the situation in subsequent pregnancies.

Therefore, it is important to tell your doctor about this problem if it occurs.

During an ultrasound examination, the specialist will pay attention not only to the condition of the fetus and uterus, but also to the pelvic bones. If there is a high probability of relapse, a caesarean section is recommended.

Women should give birth using a similar method after surgery performed on the pelvic bone tissue.

When do the pelvic bones diverge during pregnancy?

In the interval between 17 and 20 weeks of pregnancy, the body increases the rate of production of the hormone relaxin in order to soften and relax the naturally inelastic cartilages of the pubic and sacral joints. These changes in themselves cause particular discomfort for the expectant mother.

In this case, the pelvic bones normally hardly diverge, but if the distance between them increases by more than 0.5 cm, the painful sensations will increase significantly. In addition, excessive mobility of the pelvic bones limits the freedom of movement of the expectant mother - the woman’s gait resembles that of a duck, and it seems to her that her legs are about to move apart in different directions. Adapting to such changes, the pregnant woman has to involuntarily stick her stomach forward.

In fact, it is not possible to say exactly at what stage of pregnancy the pelvic bones diverge. Physiological changes in the skeleton can occur both in the early stages of pregnancy and shortly before childbirth - the timing and degree of softening of cartilage is individual. In order not to miss the development of complications, the expectant mother should tell the doctor about all her worries and ailments.

Preventive measures during pregnancy

It is very important for every woman who is carrying a child under her heart to adhere to the following rules to prevent all risks of endoprosthesis failure:

eat a balanced diet, if necessary, take complex vitamin preparations, vitamin D and calcium (vitamins and minerals are prescribed strictly by the doctor!);
control body weight, avoid pathological excess weight (in case of an abnormally high BMI, urgently seek help from a doctor to prescribe a diet);
regularly perform an adequate set of physical exercises prescribed by the doctor (note, swimming is an excellent way to unload the joints and back, and it also perfectly maintains the muscle corset in good tone);
undergo all follow-up examinations with an orthopedist-tramatologist and strictly follow his medical instructions;
if a specialist insists on carrying a child in a hospital setting, there is nothing to think about, be sure to go to the hospital at the appointed time;
do not overcool and avoid drafts, protect the implanted joint from hypothermia;
avoid staying in a monotonous position for a long time, taking long steps to the side and making sudden body movements, throwing one leg over the other, or uneven load on the limbs when standing;
sleep on an orthopedic mattress with moderate hardness, and during rest you can place bolsters or a pillow under your feet to restore blood circulation and lymphatic drainage;
It is rational to alternate periods of physical activity with rest (if you feel tired and heavy in your legs, you need to lie down, and if you are far from home, then at least sit on a bench);
from the 20th week onwards, it is recommended to use a special prenatal bandage to relieve stress from the spine, pelvis, and limbs.
Immediately notify the doctor about the occurrence of pain, swelling, redness, hyperthermia in the area where the endoprosthesis is located, including urgently seeking help in case of blue discoloration, deformation and swelling of the leg, or an increase in general body temperature.

Treatment

Do the pelvic bones converge after childbirth? Yes. If the pubic symphysis diverges, surgical intervention is not required. If the distance between the bones is small, immediately after childbirth the doctor recommends reducing physical activity. During pregnancy and after, it is important to wear a bandage that will keep the symphysis together with the abdominal muscles strong. In addition, it is better to purchase an orthopedic mattress so that the spinal column is unloaded and does not cause unnecessary back pain. Among measures aimed at strengthening muscles and ligaments, it is worth choosing potassium, magnesium, and calcium for bones. It will not be superfluous to take B vitamins and sunbathing, which will help absorb microelements.

If the distance between the pubic bones exceeds 1 cm, then you should think about how to reduce the pelvis after childbirth. Firstly, you need to bring the bones closer together, and secondly, keep them in this position. Bed rest meets the objectives; how long does it take for different women to reconcile the pelvic bones after childbirth? After all, not every mother can lie in bed for 2 to 6 weeks; you can’t not only walk, but also get up. In addition, the pelvis should be tightly bandaged, after which a bandage is put on.

Exercises for the pelvis can be avoided if, immediately after childbirth, ice is applied to the symphysis area and a course of physiotherapeutic procedures is performed. Supportive treatment will include taking vitamins, calcium supplements and, if necessary, painkillers. It happens that symphysitis is diagnosed along with the discrepancy, then it is necessary to add antibacterial drugs to the treatment. A woman’s diet itself should be rich in calcium, magnesium and potassium.

After the above procedures, X-ray control is required, on the basis of which a bandage is selected. But when wearing it, you will be able to get up and feed the baby. But heavy loads will still be prohibited at first. It is recommended to wear a corset for up to six months.

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