Abdominal separation (Diastasis Recti) and hernia

[sarah00001]

Hi, I went to my GP yesterday and was told that following the birth of my child my abdominal muscles have separated and I have a hernia above my belly button where my bowel is poking through. The GP just told me to do some sit ups and it would heal. I'm not happy with this and would like more help, possibly physio, so am going to see a different GP today and ask for a referral to physio as I have private medical cover.

I have a very large baby who weighed 9 pounds 10 and delivered her via c-section 2 and a half weeks ago and I think these factors have lead to the problems with my abdomen. I'm in a lot of discomfort but the worst bit is I am really struggling to hold my baby as I have no strength in my abdomen at all and it'll only get worse as she gets bigger. As I live alone and have little support, this really worries me.

I wondered if there was anyone else who has suffered from this and if so, what was the treatment if any?

Thank you

Sarah

Oh gosh no, I haven't got much advice but sit ups will do HARM in this situation - I just have to tell you that. Please don't do this.

Physio sounds like a great idea - can you get a referral? Otherwise pilates can help but I don't know much about it.

Congratulations on your baby your strength will improve naturally with time, it is VERY early days - honestly it will.

NO NO NO!!!! I can't believe the GP said sit-ups, WTF?! That's probably the worst thing you should do. I have just finished 9+ months work with a physio (on the NHS) to try and help real my diastasis recti and she was adamant that I shouldn't even think about a sit up. There are a lot of resources online and some videos on YouTube that will take you through a gentle series of exercises designed to help you strengthen your core. One of the the most important things you can do now are pelvic floor exercises. A strong pelvic floor and transverse ("corset" muscles) will eventually help pull the connective tissue (fascia) that is currently separated closer together. It takes time and a lot of work - currently making myself do my exercises 3x a day.

I'll dig out the link for the videos and post in a minute

Thanks Strella, it's really upset me to be honest as from what I've read online, it's not something that has a quick fix and may even require surgery. I'm very upset my GP was so dismissive of it yesterday and hope the doctor I see today is more helpful, although they are a locum so this may be the only time I see them. My GP's attitude yesterday was basically 'ok you've had a baby, it's normal for your body to be damaged after childbirth and you just need to get on with it'.

I'll take your advice and avoid the sit ups, I'm pretty sure I couldn't manage it anyway. I've also suffered from really bad constipation since my c-section which apparently can happen with a hernia and I get a lot of painful bowel cramps. I've been on laxatives for over 2 weeks now and can't open my bowels without them. I feel very run down in general and just want to start feeling like my old self again x

Ok in the light of no one else answering yet I've come back

I had this too despite vaginal births. I still have a little gap and the hernia hasn't gone away, though I wonder if it would with the right physio or exercises. I haven't had time yet as I live on my own too and ds3 is still a toddler.

I've been told I can have surgery to fix the hernia, which is only small, but I am putting it off as you can't lift for a while afterwards and I don't have any help either - toddlers are a lot heavier than babies too - so I am waiting till he is big enough not to need lifting and then I might go for it.

My strength has been Ok - I was very weak after he was born but it has gradually restored itself - I believe walking rather than driving will get it back quickest, my stomach was far better sooner after my other two than this one, and I didn't drive so much then, and walked more.

So don't give up hope. You will feel like a wreck for a little while, it's normal but it DOES improve massively - my stomach is nearly flat now, and getting flatter slowly all the time, which I didn't think it would this time.

Please ignore your GP's advice - doing sit ups is a very bad idea when you have a separation, unless it is very small indeed. You need core strength and as far as I know, pilates, Yoga, certain other exercises and so on can really help with this.

I'm not sure how you go about getting this sorted out, your GP might agree to refer you for physio, otherwise it can be had privately but at a cost.

Sorry not to be more helpful. I hope you get some more advice from more knowledgeable people soon x

ah x posts!!

Thanks Mudpiesfortea, can I ask how you got to see a physiotherapist, was it through a referral from your GP? Also did you see a general physiotherapist or one who specialised? x

Here you go:

This is VERY informative
m.youtube.com/watch?v=Ys7mb_PPuqA

Depending on your level of fitness you could also look at this. I'm currently doing the 12 week programme 3x per week as part of my ab routine and then the exercises in the video 3x per day. I've had friends who have managed to heal their diastasis by doing the exercises 3x per day for 3 months. One now has a washboard tummy
breakingmuscle.com/mommy/mommy-workout-diastasis-recti-recovery-week-1

You poor thing. I think tbh the hernia, (how big is it?) is unlikely to be causing your bowel issues. I have never had any problems with mine in that regard. It could be to do with the CS or with the drugs you have had during/after that (anything opiate has that effect - codeine, morphine etc)

I know it feels insurmountable and depressing but that will not last for long. Try not to think about your physical shape - pretend it isn't there, if you like, that's what I did - and wear supportive clothes too, you can buy a belly band type thing, like a support band, it looks a bit granny but it will help your muscles know where they're supposed to be and make you feel better wearing clothes.

I am never without my long, fitted breastfeeding vest even now - it just makes me feel more unified iykwim!

Wow Mud thank you for the links, I might use those too if I may!

I went to the GP and said I want a referral to a physio .

Yes, yes to walking. And remember to use your core in EVERYTHING you do. Baby wearing is also good.

The other thing you can try is wearing a splint or belly band. Mixed opinions on this as some people say if you've got the support you're less likely to properly engage your core but I find it helpful because it reminds me to keep tight and the pressure is something to pull away from if you see why I mean.

I post lots of core strengthening stuff on my Instagram if you're interested - @surrey_gymrat

Agree dont do situps! Certainly dont do anything until you C-section scar has healed - at least 6 weeks.

Regarding the diastasis, it will get better on its own to a certain extent, then you should see a specialist physio, but often they wont start work until ~6 months post birth. It is very unlikely you will need surgery for the diastasis.

With regards the hernia, it depends on the size. It wont heal no matter what you do, but it is not necessarily dangerous. If it is painless and small and does not contain bowel it can be left alone, however if there is bowel gurgling in and out then it should be operated on to prevent the bowel getting stuck. Get someone who knows what they are doing to look at it.

Def physio. My muscles didn't knit together after the birth of my first and I only found out about 4 years later!
I had physio to sort it. Sit ups are not where you start. They are fine once the muscles are knitted but IIRC I started with lying down and sort of tilting the pelvis. (Doesn't sound much but it was hard enough!)
You need physio now or you may end up like me with back problems down the line.

Oh and one more tip: watch what you eat. Any extra intraabdominal pressure is going to make it worse so make sure you're eating plenty of green leafy veg, fresh fruit, quality carbs (eg brown rice, sweet potato, etc) and steer clear of sugar and anything that you know causes you to bloat (eg I can't go anywhere near legumes )

Thank you all so much for your advice and sharing your experiences. Mudpies, thank you for the links, I'm sure they'll be really helpful.

I saw the locum doctor today who was pretty useless. She felt my tummy and said I definitely had abdominal separation but she didn't think the hard lump was a hernia and when I asked her what it could be she said she didn't know. I asked if she could refer me to a physio and she said it was far too soon for that and that I should just wait and see if it sorts itself out. I explained I wanted to start physio asap and that I was struggling to carry my baby. She said my abdominal muscles shouldn't affect my ability to carry my baby (which I disagree with) and reluctantly agreed to write a referral letter.

I'm going to try to see a different GP about the hard lump which may or may not be a hernia. If it is a hernia, I'd prefer to have an op to sort it out rather than leave it, but not until my baby is at least 6 months old. The problem is with the useless GPs at my surgery, I can't see that having an op will be possible.

I'm still so weak and its getting harder to hold my baby, so the sooner I can start physio the better. xxx

Hi Sarah,

a hernia is not normally hard - that's one of the things that indicate it could be strangulated so you would be in trouble if it was one, iyswim?

It would be a soft bulge in the tissue.
I am glad if you don't have one, I wouldn't poke around or worry too much until you have seen the physio who will probably know exactly what it is and reassure you that it can be sorted out.

Meanwhile go easy and I hope you get on Ok while you wait to see someone. Did the locum know how long you might have to wait?

It is very difficult being on your own with a baby, lots of us have been there, thoughts are with you xx

Thanks SophiesDog. I was contacted by my health insurance today. They said they received the referral letter from the locum doctor and whilst she referred me to physio, she wrote that in her medical opinion she didn't think it was necessary. This means my insurance won't cover it and I'm gutted and really peed off with the doctor, I'll have to try to see if I can get another doctor to write a referral letter. I feel pretty deflated at the moment.

Bloody hell, so many clueless GPs.

Diastasis recti DOESN'T heal by itself, and sit ups are the single worst thing you can do.

I have a DR (they're measured in finger widths and mine is a 3) and I've just started seeing a women's health physio. You need a referral to a women's health physio rather than a regular one, because when your core muscles are wean, your pelvic floor most likely is as well, so you really need a specialist physio.

It's important to get yourself healed as well, because a weak core and pelvic floor can cause problems in later life with back pain and pelvic organ prolapse.

That locum is an arse. Why the hell does it matter to them if you get a referral or not? It's not like they're paying for it

Complain to the practice manager. See another GP and insist on a referral.

Also, if you have the money you can sign up to Mutu System, which is an online programme which you can do at home to help close a DR. It's not cheap - I bought mine when they had a sale recently.

There's a programme with core exercises, more high impact exercises, diet, etc. There's also a cheaper version with just the core stuff, so you could consider that.

Thanks Sealove, the locum was a total idiot and didn't have a clue what she was doing and I am definitely going to complain to the practice manager.

There is a lovely locum doctor who comes in occasionally and is due to be there next week. I'm going to try to get an emergency appointment with him in the hope he will write me a referral letter. This will be the third time I will have to go to the surgery about the same issue, which should have been dealt with properly at the first appointment.

I will ask to see a women's health physio as you suggested. Thank you.

Wow your GPs are useless. I'd be tempted to complain. Sit are not just useless they are harmful and must be avoided. DR can be corrected through appropriate exercise, there are two decent systems you can buy Mutu and Tupler, although neither has an 100% success rate. On the other hand the operation is complicated and not always successful,so well worth trying the exercise regime first.

I want to start either Mutu or Tupler in September but I haven't decided on which one yet. My DR is 4:5:3, any decent doctor should be able to feel the gap and tell you how wide it is.

I've got this as well and even after 2.5 years my gp won't accept that it's anything other than just an expected change in body shape. So frustrating especially when there is so much conflicting advice so I've ended up doing nothing about it.
I've started yoga which I feel has strengthened me overall but hasn't made any difference to my belly as there are a lot of moves you shouldn't do so the benefits are limited.
I'll also check the links above - I don't really want to spend the rest of my life looking as though I'm 3 months pregnant!

What terrible advice! Echo what others have said and can also recommend MuTu, have just started it for the second time after DD2 ruined my abs again. Binders or splints aren't recommended by MuTu as they move all the pressure onto your pelvic floor instead. I can't even begin to imagine the number of women out there doing sit ups to try and fix their tummys

Don't do sit ups and you need to see a women's health physio.

Hey! I know this was years ago now but how did it work out?