Hernias are common in individuals with Diastasis recti, not because Diastasis causes hernias, but because both are impacted by your underlying pressure management system.

When thinking about hernia Diastasis recti symptoms, it’s crucial to understand the relationship between these conditions. While Diastasis recti and hernias are distinct, they often coexist due to the underlying issue of weak connective tissue. Let’s explore what hernias are, their causes, symptoms, and how to manage them effectively, especially if you have Diastasis recti.​

Diastasis recti versus a Hernia

What is a Hernia?

A hernia occurs when an internal part of the body, such as the intestine, protrudes through a weak spot in the abdominal wall. This results in a noticeable bulge or an “outie” belly button. Hernias can be tender or painless and often become more apparent when straining, lifting, or coughing. The most common type of hernia affecting women during or after pregnancy is an umbilical hernia, which appears around the belly button.

What is Diastasis recti?

Diastasis recti is a condition where the rectus abdominis muscles (the “six-pack” muscles) separate along the midline of the abdomen. This separation occurs due to the stretching of the connective tissue (linea alba) that holds these muscles together, often as a result of pregnancy. By 35 weeks of pregnancy, nearly all women will have some degree of Diastasis recti. While many women’s bodies recover naturally postpartum, some, continue to experience a significant gap, leading to various symptoms and complications. It’s important to note that men can also suffer from Diastasis recti, often resulting from rapid weight changes, repetitive strain, or incorrect abdominal exercises.

Symptoms

Symptoms of Hernias to look out for:

  • Bulge or Outie Belly Button: This may appear where you used to have an innie or as a thumb-shaped protrusion.
  • Tenderness: The area may feel tender to touch or show no pain but visibly bulge when you strain, lift, or cough.
  • Visible Bulge: This becomes more apparent if you strain, lift objects, or cough.
  • Pain or Discomfort: You may experience discomfort or pain, especially during physical activities.

Symptoms of Diastasis recti
If you have DR, symptoms may include:

  • Doming or Coning: When performing activities like sitting up from a lying position, or reaching overhead you abdomen may form a cone-like shape.
  • Lower Back Pain: You may experience lower back pain that persists postpartum, signaling weakened core muscles.
  • Weak Core Muscles: Your core may feel weaker and “squishier” than before pregnancy or earlier in life.
  • Pelvic Floor Dysfunction: If your abdominal muscles are stretched, you may also experience issues with your pelvic floor.
What causes a hernia?

A hernia, along with Diastasis recti or prolapse, is caused by excessive intra abdominal pressure. This refers to extra pressure located inside your abdomen and pelvis.

If you don’t reduce and realign that extra pressure that caused the problem, you may have a re-occurance of the hernia or develop another pressure related issues.

Increased abdominal pressure can be due to various factors, including straining (lifting, constipation, coughing etc), bad posture (hunched upper body, a pelvic tilt (both an anterior and posterior), obesity, and multiple pregnancies.

Adjusting your whole body alignment and increasing your core strength allows your body to function optimally. This reduces the pressure and helps minimize the risk and effects of a hernia.

What exercises can I do with a hernia?

Unless you’ve been told otherwise by your doctor, it’s fine to do many exercises with a hernia, BUT you want to avoid exerting pressure on the muscle around it.

​For example, with an umbilical hernia, crunches are a NO/NO even if you don’t have Diastasis recti!

Those of you with Diastasis recti (which, if you’re reading this you probably do) should already know not to do crunches or sit-ups. Instead, should be doing Diastasis-safe core work like the FREE beginners program available HERE, which are also safe for those with a hernia.

General considerations with exercising with a hernia:

1) Keep weights light when lifting (especially initially). If you find you are holding your breath they are too heavy – holding your breath is an indication that you are putting pressure on your abdominal wall. Also, make sure you maintain correct posture with a neutral spine and avoid hunching.

2) Avoid movements that cause you to bend backwards to an extreme (these should be avoided with Diastasis recti as well). For example, back extensions or “superman” exercises may need to be monitored. If you keep the movement small, you should be okay, but pay attention to how your body responds. 

3) STOP if you feel pain in the affecter area OR you see it bulging out more.

I am often asked “what does Diastasis recti pain feel like?” In general pain isn’t a DR symptom, so if you are feeling pain (other than when pressing against the thinning connective tissue I would get checked by a Doctor to make sure there isn’t a hernia present. 

Managing Hernias and Diastasis recti

Non-Surgical activities to help or prevent hernias

Fix Your Posture: Proper body alignment reduces abdominal pressure. Resources for improving posture are available on my Facebook page, Core Fitness for Moms.

Strengthen Your Core: Your core consists of your transverse abdominis, pelvic floor, back muscles, and diaphragm. These muscles work together to help you stand straight and perform everyday movements safely. Start with the free beginner programs or other programs available here on my site.

Avoid Straining: Refrain from activities that increase abdominal pressure, like improper lifting or heavy lifting without core activation. It’s crucial to avoid straining durin gactivities such as lifting, dealing with constipation, and when managing chronic coughs.

Surgery to fix a hernia

You may need surgery to fix your hernia, although a doctor may not recommend it if your hernia is not causing your any pain or not getting any bigger.

This is a decision for you to make with your doctor.

However, if you haven’t reduced your gap, gained function, and fixed the underlying problem with your abdominal pressure, you run the risk of the hernia recurring.

There are a few reasons for this, but let me give you two:

1) If you haven’t realigned yourself to reduce the pressure on the abdominal wall that pressure will affect the surgery fix, pushing against it with the pressure building up behind the fix, looking for a weaken spot to break through. This may not be in the same place but in another weaker spot. 

2) If you haven’t regained a functional core and reduced your gap to a “normal” level, then if you are open above or below the fix (which say was for an umbilical hernia), potentially causing those stitches to come loose OR making your belly misshapen because, like a balloon, if you squeeze the middle, the pressure goes to either end.

Surgery to repair a hernia is common (I had my umbilical hernia repaired before I knew about Diastasis recti, and they had a lot of issues with the gap and the repair!)

During the surgery, the surgeon basically pushes the protruding part back where it belongs and sutures the muscles there, or if it is very big, they may place a piece of surgical mesh to reinforce the hole and prevent another herniation.

You can find many articles about it on the web or talk to your doctor/surgeon about it.

Tips for Preventing and Managing Diastasis recti and Hernias

  1. Maintain a Healthy Weight: Avoid excessive weight gain.
  2. Proper posture: Pay attention to your standing and sitting posture. Engage your lower abdominal muscles to avoid flaring your ribs and arching your back excessively.
  3. Deep breathing: Practice expanding your ribcage with inhalation and breathing out slowly through your pursed lips. This helps maintain mobility in the ribcage, which is essential to create more space for your organs.
  4. Safe abdominal exercises: You should continue working on strengthening your abdominal muscles; however, choosing appropriate core exercises is essential. Avoid sit-ups and crunches, as these increase intr-abdominal pressure.
  5. Don’t strain while lifting: Gently blow out as you lift things and squat down. When carrying, try to keep the load close to your body. This will also help take the strain off the abdominals. When bending, avoid rounding your back. Instead, keep your spine in a neutral position and bend at the hips.
  6. Stay Active: Moving and exercising are essential parts of pregnancy, so don’t stop.
  7. Support Belts and K-Tape: Wearing a support belt or using k-tape is helpful to provide support around the hernia.
  8. Regularly Re-Assess Movements: Regularly reassess your daily movements and exercises and modify them if needed to prevent strain on your abdominal muscles.
Diastasis OR Hernia in the upper belly

Upper belly Diastasis is common, especially if your rib cage is still wide. This can cause your upper belly to bulge and even look like a possible hernia.

The only fool proof way to know if it is a hernia would be with a scan, but normally if you have DR above the belly button, and there is no “burning” pain it is more likely to be Diastasis recti causing the bulge.

Always check with your doctor to confirm. If you do have upper belly Daistasis you can check out my Upper Belly Blaster program here >>>

Understanding the connection between Diastasis recti and hernias, recognizing symptoms, and knowing when to seek medical advice are crucial for effective management and recovery. If you suspect you have either condition, consult a healthcare professional for an accurate diagnosis and treatment plan. By addressing these issues comprehensively, you can improve your quality of life and reduce the risk of recurrence.

My online programs, the Pelvic Floor Freedom program and the  8-week progression program for Diastasis recti, are designed to teach you how to manage your intra-abdominal pressure correctly, move well, correct your alignment and strengthen both your core and your whole body. This is essential for both hernias and Diastasis recti.

 

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