RAD: Getting Your Body Back After Birth

Rectus Abdominis Diastasis (RAD) can be quite common after giving birth. So, what exactly is RAD? How do I know if I have it? I hear many of my patients say “I have a gap of 2 fingers when I prod my tummy, I don’t really know what I am feeling for or what it even means.”

RAD is caused by the hormone relaxin, which I wrote about in my previous blog. The hormone relaxes your ligaments and soft tissue to make room for the growing uterus. It allows the abdominal muscles to stretch, permitting the uterus to move out into the abdominal space. The outer most abdominal muscle is called the rectus abdominis. It has two halves and is joined at the midline by a connective sheath called the linea alba. The two bands of recti muscle lay parallel but during pregnancy they can stretch away from the midline, and it is this separation that is called RAD. A significant RAD is a gap greater than 2 fingers in width, three days post-delivery.

Overall, 66% of pregnancies leave the mother with RAD at the end.  Scenarios in which RAD is most common include:    

• ·         If you have gained excess weight
• ·         If you are an older mother
• ·         If you have a larger baby (classified as above 4kg)
• ·         It is a multiple birth
• ·         It is your third, fourth etc. pregnancy
• ·         You have had pregnancies close together
• ·         You have carried out inappropriate exercise during pregnancy.

Are there any symptoms?

There are no obvious symptoms from RAD, which may leave you wondering why my patients should care about how many fingers worth of a gap they have.  In fact, although there are no obvious symptoms, it can alter your posture and contribute towards lower back and pelvic instability which in turn can lead to pain. It can also simply prevent you from gaining back your old figure.

What can I do about it?

Sit ups, which are a well-known exercise for toning your abdominal muscles, would be counterproductive for any patient that has RAD and should be avoided. Instead, focus on exercises that isolate the correct muscles. For instance, going on all fours or on your back doing posterior pelvic tilts would be more suitable.

It should only take one visit to your physiotherapist to measure RAD properly and show you how to do it yourself in future. They will also show you what exercises you should be doing at that stage, and advise you how to progress your exercises program. You cannot measure correctly simply by lying on your back prodding your tummy. The correct method, that should be demonstrated first, is lying on your back with your knees bent, drawing in your abdominal muscles, tilting your pelvis back, raising your head and shoulders off the floor and feeling 2cm below the umbilicus.

If you suspect you have RAD and would like to book an appointment, please contact me on 0544485086 or by email to tamaramay.physio@gmail.com.  I can arrange to see you in Bishvilaych Women’s Comprehensive Medical Centre in Givat Shaul, Jerusalem or at your home if you live in Gush Etzion.