Why Diastasis Recti Experts Disagree (Preview)

Why Diastasis Recti Experts Disagree: Preview
The following is from the essay Why Diastasis Recti Experts Disagree.


Dear Reader (that’s you),

Are you wondering what the heck happened to your belly?

Are you overwhelmed by voluminous, yet conflicting internet advice?

Can you distinguish an expert from a fauxpert?

Are you ready to give up, wear a mumu, and stuff your face with ice cream; or, are you spending hours trying to crunch, plank, and transverse abdominis pulse your way to awesome abs?

Are you sick of all my questions?

Point taken.

I wrote this for you, which means I wrote this for me because I am you. Not in a weird sci-fi sort of way, but in an OMG WTF happened to my belly kind of way.

Before getting pregnant with the first of my three lovely (and large) children, I had annoyingly rhapsodized about pregnancy’s charm, about how I would love gaining weight, about how rotundity might be a nice change of pace.

Ugh. I would like to get in a time machine and laugh heartedly at my pre-partum naïveté. I didn’t realize that gaining weight during pregnancy would mean replacing my tiny belly with a ballistic missile. Even as my belly grew and grew and GREW, I thought our bodies were magical beings that knew how to spring back into position once the baby blissfully and easily exited our primal forms.

Silly Meredith of the past. After my missile launched, I looked downward and thought “Huh, that doesn’t look like my belly.” I was sure Mother Nature just needed more time to shrink me. A few months later, I thought “Why won’t it go back to the way it was before?!” A few months after that, I thought “I will fix this!”

Thus, an obsession was born. The obsession has evolved over the years as I’ve worked on my body image in concert with my body; however, although diverted, the obsession remains—a search for perfection replaced by a search for information. Therefore, Dear Reader, let me take you on an esoteric journey into the heart of your diastasis recti.

Ever your humble guide,

Meredith

Introduction

Why Write this Essay?

The internet is a torrent of postpartum belly advice, and “diastasis recti” has become the en vogue buzzword. In 2010 when I had my first child, I had to poke around the interwebs to figure out what was going on with my mushy, bloated, gaped, alien belly, but now any new mom can easily find the term and pinpoint it as the cause of her “mummy tummy.” She’ll also be offered half a dozen programs for fixing her belly, some of which are actually quite good, and some (ahem) that aren’t. I know because I tried them all.

The diastasis recti and postnatal fitness world can be summed up in one word: Overconfidence.

“Gods of the gaps” is a particularly apt (and punny) explanation. The phrase refers to a type of logical fallacy, but it also applies to the women’s health world; in the absence of good evidence, many self-proclaimed experts make up their own theories. This is because the theories about closing diastasis recti (DRAM) are not backed by a lot of concrete evidence. No advice giver can be faulted for skimpy evidence. But, they can be faulted for cloaking their evidentiary blind spots. Keep in mind, not all the theories are bad, but some are more plausible than others.

Practitioner overconfidence can lead women down the wrong path or oversell expected results. In extreme cases, overconfidence may also prevent women seeking appropriate specialists, or, in milder cases, may encourage unnecessary physical restrictions.

We know more about diastasis recti every day, but we don’t have any good studies proving the efficacy of any particular approach or exercise routine. Additionally, even those at the research forefront have a theory to defend, money to be made, a horse in the race. This doesn’t disqualify, but it should embed a bit of skepticism in your brain.

As a result, many of the well known DRAM experts disagree with each other. This is confusing for us moms. They are confident in their correctness. But, logically, they shouldn’t all be.

This essay differs from other diastasis recti resources because it is a modality review from the perspective of a semi-educated and always skeptical patient. I offer suggestions on how to narrow a diastasis recti, but I try my hardest not to oversell the solutions. We like halcyon answers and precise paths, which means a DRAM essay will never out sell a DRAM “program.” I’m okay with that. Ambiguity isn’t sexy, but it’s honest.

Why Should You Listen to Me?

Good question. I’m not a physical therapist. I have a personal training certification from the American College of Sports Medicine, but that means squat about my knowledge of diastasis recti. I also have a graduate degree in English Literature, which tells you I wear glasses and read a lot, but not much else. I did narrow my gap and strengthen my abdominals, but not by following a specific program. Plus, you shouldn’t rely too much on any one person’s experience. Take my qualifications for what they are.

Ultimately, I am a slightly obsessive mom who has been trying to navigate this confusing terrain. I’ve tried the programs. I’ve read the experts. I’ve read many of the studies. And I’ve parsed and arranged the evidence into a clear(ish) guide.

I don’t advocate or dismiss a branded program. Therefore, I do not mention the programs by name. Instead, I describe schools of thought and things to look for when evaluating diastasis recti advice. Occasionally, I link to motherfigure.com blog posts that address some of the topics in more detail. Program names may be mentioned in those posts, but I refrain in the essay.

What are your goals?

I also make some assumptions about my reader, about you. I assume you want to close your gap and flatten your belly. Before we go any further, I must announce a gap isn’t a big deal absent functional problems, and DRAM doesn’t prohibit a flat belly. Conversely, a closed gap doesn’t guarantee a trim midsection. Your diastasis recti may close. It may not. You may get a flat belly by narrowing the gap. You may not.

For example, a study in the journal Plastic and Reconstructive Surgery looked at 92 abdominoplasty patients and found “contrary to current thought, abdominal wall protrusions are caused by the stretching of the entire abdominal wall and not only the linea alba. Thus, significant abdominal wall protrusions may occur without diastasis and flat abdomens may exhibit a diastasis.”[1]

Be careful not to interpret this as saying your DRAM has no effect. It probably does. But, sometimes you can sufficiently strengthen your muscles and reduce adipose tissue (a.k.a. fat) to get measurable aesthetic improvement without fully closing the gap.

As a result, we should reframe the goal. The goal isn’t closing DRAM (possible for some, but not for all). The goal is a stronger core that stabilizes what needs to be stabilized, that moves what needs to be moved, and that doesn’t balloon out in the process.

I wrote this primer for my 2010 self. I can’t go back in time and read it, but hopefully I can help some of you evaluate the advice you have received or will receive about getting rid of your “mummy tummy.” Let’s start.

This was an excerpt from the 14,000 word essay “Why Diastasis Recti Experts Disagree.” Find out more about the essay HERE…


  1. Daniel Brauman, “Diastasis Recti: Clinical Anatomy,” Plastic and Reconstructive Surgery, November 2008, Volume 122, Issue 5.  ↩

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