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… in Children

What Is It?

Diastasis Recti (DR): a separation of the abdominal muscles

Functional Core Weakness (FCW): The inability of the muscles of the core to effectively function and support the body for everyday physical demands without pain or dysfunction

Everyone is born with some form of diastasis recti to allow the umbilical cord exit the body.  This separation typically closes in the first few weeks after delivery but can take up to 3-4 years or longer to fully close in some children.  Lack of closure of the diastasis can contribute to functional core weakness, muscle imbalance, intestinal issues and several complications in normal physical development.

 

What Does It Feel Like?

Here’s what living with Functional Core Weakness and Diastasis Recti can feel like for children:
(*not all children have all of these symptoms)

  • A trench or football shaped bulge down the midline of the tummy when they do crunch like movements, cough or cry.
  • Bulging tummy that gets worse with exercise, throughout the day or with eating.
  • Back pain (lower, mid or even upper back)
  • Overall weakness in the core – affecting posture, developmental delays, ability to balance, walk, run, lift, reach.
  • Sluggish intestinal function, bloating, gas, constipation, and the need to bear down to have a bowel movements.
  • Flared rib cage or barrel chest

What Is Causing This?

Chronic Forward Forceful Pressure on the Abdominal Wall.

The core consists of three layers of muscle. The internal-most is the transverse abdominis which functions like a natural corset – designed to elongate the torso and balance the entire body.  In babies and young children this muscle is used primarily for coughing, crying, sitting, crawling, standing, and bowel movements. Typically children with a Diastasis Recti that does not heal  after birth have a condition or habit of chronically inflating and distending this muscle with crying, coughing, moving and bowel movements. This bulging, bracing, straining or inflating of the tummy places excessive intra abdominal pressure on the already weak linea albea keeping the diastasis from closing and actually in some cases making it more pronounced.

(Learn more about the function of the transverse muscle).

Diastasis Recti or Umbilical Hernia or both?

Diastasis Recti: a separation of the abdominals down the midline as the linea albea stretches

Umbilical Hernia: a tear in the connective tissue that allows the umbilicus to pop out.

Detached Umbilicus:  a bulging umbilicus (outie or partially outie belly button) without a tear in the connective tissue.

Diastasis recti often is misdiagnosed as an umbilical hernia in young children but also sometimes can develop into an umbilical hernia or can be present along with an umbilical hernia or detached umbilicus.  Both diastasis recti and umbilical hernias in young children are typically caused by chronic intra abdominal pressure that pushes out on the tummy and keeps the umbilical root from fully retracting and tethering down to create an “innie belly button”.  In both cases, functional core rehab will retrain that compensation pattern and improve these conditions.  If the umbilical area does not tether but instead bulges it can allow the diastasis to be vulnerable to a tear in the connective tissue that often requires surgical repair.

The Tummy Team’s approach to core rehab in children can encourage the diastasis to close, minimize the risk of a tear and even promote the retraction of the umbilicus in some cases.  Even if surgery is recommended, we encourage parents to educate themselves and develop tools to promote the healthy functional strength of their child’s core moving forward.  Surgery will patch the hole but will not retrain the muscle patterns.  All children need a strong core to meet their developmental milestones.

How Do You Fix It?

Diastasis Recti is treatable and should be addressed in young children when it does not appear to be closing on its own.  Typical compensation patterns in children are holding the breath, tensing when straining, bracing the muscles and recruiting upper and lower body muscles to stabilize the core. All of these strategies actually push out on the abdominal wall (even slightly) instead of drawing in and elongating the core. This habitual outward pressure keeps the connective tissue of the abdominal wall (the linea alba) from closing and can make it get bigger, but also can be retrained with the right approach.

The Tummy Team offers a Toddler Course geared to parents of children ages 1-5 years old to help you understand the diastasis and the conditions contributing to it as well as providing tools to help your child close the diastasis and improve their functional core strength.

 

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