Modifying workouts for Diastasis Recti or fixing it?

[Michele123]

So I have mild Diastasis Recti (four children) and I’ve not been allowed to do things like sit-ups for years. Now I find out the push ups and planks engage the muscles in a bad way for Diastasis Recti too. Before children I used to do 250 various types of crunches each day. It’s killing Mr to be so limited on what I can do to work my core and I’m sick of not being able to do the same exercises as everyone else in class. I’ve asked my doctor but because we live rural, she hasn’t been able to find anyone within driving distance to work with me to fix this. I’ve tried one line programs but none of those work for me either.

So, I’m trying to figure out if there are any tried and true exercises that will close the gap so I can do sit-ups and push-ups and such again. Or, do I just screw the tiptoeing around my Diastasis Recti and do what I used to do and hope for the best? It seems like no one (at least in my neck of the woods) really knows what to do with Diastasis Recti anyway so can I really trust them when they say working my core is bad?

Has anyone else in MA found a way to fix DR or do you simply work around it or ignore it?

 

[Dirty Dog]

Normally, the left and ride abdominal muscles meet in the middle. Diastasis recti occurs when the connective tissue splits. This is most commonly seen in women after giving birth, but it is also seen in men, mostly those who have midline surgical incisions. If the distance between the muscles is less than 3cm, it is considered mild. 3-5cm is moderate. Greater than 5cm is severe. Because of this space, the abdomen bulges and those who have DR will never have a flat tummy.

I have had multiple oncologic surgeries requiring multiple midline incisions, so it isn't surprising that I have a severe DR. It's been there since the first procedure and repairs done during subsequent surgery failed. I'm 6'1" tall and my weight runs 210-220. But I look fat. It's not the end of the world. In a confrontation, it's possible that them seeing an old fat man will lead to underestimating me.

There are ways to exercise around the problem and avoid making it worse, as you know. But these exercises do nothing to repair the actual problem. They can't. Exercise cannot re-connect split connective tissue. The only real fix is surgical. Surgery is relatively uncomplicated since there's no need to enter the abdominal cavity. You can think of it as a variation of a tummy tuck or hernia repair.

Surgical repair can be open or laparoscopic. The success rate is about 85% regardless of technique used, so I'd look for someone to do it laparoscopically, since that will likely result in less scarring. Since one of the main reasons for this procedure is cosmetics, the amount of post-op scarring is a significant factor.

If you want to pursue repair, I'd suggest starting with cosmetic surgeons in your area. If that's not an option, a general surgeon who does laparoscopic hernia repairs would be something to consider.

Since paying for medical care in America is, unfortunately, a real problem (it's one of the top three reasons for bankruptcy), it's worth mentioning that insurance doesn't usually cover cosmetic procedures. However, if the DR is causing physical problems (DR is known to cause abdominal pain, back pain, pain during intercourse, and pelvic pain) then the procedure becomes medically necessary treatment and there's a better chance that insurance will cover it (to whatever extent your insurance covers surgery).

 

[Michele123]

Normally, the left and ride abdominal muscles meet in the middle. Diastasis recti occurs when the connective tissue splits. This is most commonly seen in women after giving birth, but it is also seen in men, mostly those who have midline surgical incisions. If the distance between the muscles is less than 3cm, it is considered mild. 3-5cm is moderate. Greater than 5cm is severe. Because of this space, the abdomen bulges and those who have DR will never have a flat tummy.

I have had multiple oncologic surgeries requiring multiple midline incisions, so it isn't surprising that I have a severe DR. It's been there since the first procedure and repairs done during subsequent surgery failed. I'm 6'1" tall and my weight runs 210-220. But I look fat. It's not the end of the world. In a confrontation, it's possible that them seeing an old fat man will lead to underestimating me.

There are ways to exercise around the problem and avoid making it worse, as you know. But these exercises do nothing to repair the actual problem. They can't. Exercise cannot re-connect split connective tissue. The only real fix is surgical. Surgery is relatively uncomplicated since there's no need to enter the abdominal cavity. You can think of it as a variation of a tummy tuck or hernia repair.

Surgical repair can be open or laparoscopic. The success rate is about 85% regardless of technique used, so I'd look for someone to do it laparoscopically, since that will likely result in less scarring. Since one of the main reasons for this procedure is cosmetics, the amount of post-op scarring is a significant factor.

If you want to pursue repair, I'd suggest starting with cosmetic surgeons in your area. If that's not an option, a general surgeon who does laparoscopic hernia repairs would be something to consider.

Since paying for medical care in America is, unfortunately, a real problem (it's one of the top three reasons for bankruptcy), it's worth mentioning that insurance doesn't usually cover cosmetic procedures. However, if the DR is causing physical problems (DR is known to cause abdominal pain, back pain, pain during intercourse, and pelvic pain) then the procedure becomes medically necessary treatment and there's a better chance that insurance will cover it (to whatever extent your insurance covers surgery).

Thank you. That information is helpful. My doctor said mine is too mild for surgery and that my separation and just barely qualifies as DR, I guess it’s just into the 3cm? She told me that physical therapy could help, but there aren’t the right kind of physical therapists in my small town (I drove almost an hour just for a physical). I feel like I definitely have that pouch and while it isn’t the end of the world, I don’t want it to get worse. However, I just want to do my normal exercises again.
Do you make a lot of adjustments with your workouts? Have you found workouts for the core that don’t make things worse?

 

[Dirty Dog]

Thank you. That information is helpful. My doctor said mine is too mild for surgery and that my separation and just barely qualifies as DR, I guess it’s just into the 3cm?

By definition, the separation between the muscles is less than 3cm. You could still have surgery, but it would be as an elective, cosmetic procedure. You can talk to a cosmetic surgeon to find out what that would cost.

She told me that physical therapy could help, but there aren’t the right kind of physical therapists in my small town (I drove almost an hour just for a physical). I feel like I definitely have that pouch and while it isn’t the end of the world, I don’t want it to get worse. However, I just want to do my normal exercises again.

PT can help you build strength in the muscles around the area in a way that helps reduce the appearance of the DR. But only when you have those muscles tightened. When relaxed, the bulge will return. It's unlikely that you can keep those muscles tight all the time.

Your regular exercises may or may not make it worse. Typically, it's safe to say that the smaller the DR, the lower the chances that something like sit ups will make it worse. But it's still a non-zero chance, and there's no way to predict which individuals will be the ones to get worse. I am not aware of any study that provides any solid numbers on the frequency with which exercise worsens DR.

Do you make a lot of adjustments with your workouts? Have you found workouts for the core that don’t make things worse?

I do not. Mine literally cannot get any worse.