Diastasis Recti in Children
Did you just learn that your child may have Diastasis Recti and want answers?
You are in the right place. The Tummy Team specializes in the treatment of Diastasis Recti in men, women and children.
What most people do not know is that everyone is actually 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.
First, let’s define Diastasis Recti
Diastasis Recti (DR): a separation of the abdominal muscles caused by excessive stretching of the connective tissue that runs down the midline of the abdominal wall.
What does Diastasis look like?
(*diastasis recti can present differently depending on the age of your child and 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 activity, throughout the day or with eating.
- 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
Diastasis Recti or Umbilical Hernia or both?
Often babies, children and toddlers are diagnosed with both diastasis and an umbilical hernia or there is some confusion between the two. Let’s clarify the difference and help you understand what might be going on with your child. It is possible to have a diastasis and not have a hernia, and have a hernia and not have a diastasis and to have both conditions at once.
What is the difference?
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.
So how did this happen?
When we are born our abdominal wall is slightly separated to allow for the umbilical cord to pass from the placenta into our tummy. After delivery, the cord is cut and gradually retracts into the body and eventually scar tissue tethers the umbilicus and creates an anchor that looks in most cases like and “innie” belly button. In some cases, babies experience chronic forward pressure (intra-abdominal pressure) that presses out on the abdominal wall and keep the umbilical cord from fully retracting and tethering down(detached umbilicus). This pressure keeps the connective tissue from closing and can redirect pressure out on the tummy causing a bulge or trench down the midline (diastasis recti) or creating a tear in the connective tissue that pushes the umbilical cord through the navel (umbilical hernia). Chronic forward pressure on the tummy is most often caused from colic, painful gas, bloating, constipation, straining, respiratory issues, chronic coughing, conditions that cause a lot of vomiting or a muscle tone imbalance.
Diastasis recti can be misdiagnosed as an umbilical hernia in young children. But it is possible to have a diastasis and an umbilical hernia or have a diastasis with a 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, we treat the cause to correct the presenting condition. The Tummy Team uses functional core rehab to retrain that forward pushing compensation pattern and improve both of these conditions.
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. And all children need a strong core to meet their developmental milestones.
How do we fix this?
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. If your child is older or younger than this age range then please reach out to our specialist to see what the best course of action is for you and your child.
