The women left with excruciating back pain for YEARS after pregnancy

After giving birth to her son Cailean, Wilma MacDonald expected a few short-term pains.

But as time went on, she got low back pain that was so painful that even getting out of an armchair was a huge struggle.

But when Wilma, then 38, a nutritionist, was referred by her GP to an NHS physiotherapist, she was told it was a routine after-effect of labor pains and that she would soon be normal again.

Only the pain got worse. In fact, Wilma endured nearly three years of discomfort before she was finally diagnosed with diastasis recti (DR), a condition in which the left and right sides of the large muscles on the front of the abdomen separate – due to uterine expansion – during pregnancy and fail. to reunite after birth.

After giving birth to her son Cailean, Wilma MacDonald expected a few short-term pains.  But as time went on, she suffered low back pain that was so painful that even getting out of an armchair was a huge struggle.

After giving birth to her son Cailean, Wilma MacDonald expected a few short-term pains. But as time went on, she suffered low back pain that was so painful that even getting out of an armchair was a huge struggle.

In addition to being painful, it causes a “doming” effect on the abdomen, meaning that some women still look pregnant long after giving birth – a source of anxiety for many. A 2016 survey of 300 first-time pregnant women conducted by Norwegian doctors showed that 45 percent still had diastasis recti six months after giving birth to their child, and 32 percent had problems after 12 months.

Despite the fact that the problem affects about a third of women during pregnancy, many say they struggle to get a diagnosis, let alone be warned of the risks while expecting their baby.

Author and publisher Caitlin Moran recently revealed that undiagnosed diastasis recti was the hidden cause of her prolonged back pain. Caitlin, who has since undergone surgery to correct the problem, wrote: ‘Some days just getting out of bed made me cry. I feel 1,000 years old. ‘

In addition to painful back pain – as a result of the abdominal muscles, which were supposed to support the back, not functioning properly – it can cause constipation, urine leakage and poor posture.

It can also lead to a hernia – in which tissue is torn to pieces, leading to organs that puncture through the opening – in the intestine and sharp pain, explains Shirin Irani, a consulting gynecologist in Birmingham. She says: ‘Although there are no physical symptoms, it can have a huge emotional impact due to bulging. Many patients are asked if they are pregnant, even though they have had their child aged before. It’s disturbing. ‘

Dr. Aishah Iqbal, a general practitioner in Leicester, suffered from DR after the birth of her daughter 11 months ago. She says separate abdominal muscles should return to normal within eight weeks of birth, adding: ‘During pregnancy, the growing uterus causes the abdominal muscles to separate to allow the baby to grow’.

When Wilma, then 38, a nutritionist, was referred by her doctor to an NHS physiotherapist, she was told it was a routine after-effect of labor pains and she would soon be normal again.  Only the pain got worse

When Wilma, then 38, a nutritionist, was referred by her doctor to an NHS physiotherapist, she was told it was a routine after-effect of labor pains and she would soon be normal again. Only the pain got worse

Factors such as weight and fitness – and thus muscle strength – can affect how severe a diastase can be, as can pregnancy hormones such as estrogen, which relax abdominal muscles and soften connective tissue.

Although there is no standard classification of DR, the most accepted definition is a gap of 2.7 cm (approximately two finger widths) between the long abdominal muscles that run down from the ribs to the pubic bone. Dr. Iqbal, who suspected she had the disease, sought help from a private physiotherapist.

“There’s a big problem with women not realizing or being educated that diastasis recti is one thing,” she says. ‘In addition to being a general practitioner, I work as a weight loss coach and often meet women who think it’s belly fat that makes them look pregnant. They never consider it to be weak abdominal muscles. ‘

And what they are not aware of is that weight loss will not tackle the bulge if it is caused by DR.

Elaine Farquharson, a sports physiotherapist from Weymouth, Dorset, who has also experienced DR, says she has often treated women whose condition was overlooked and caused problems. ‘I see countless women who have, for example, shoulder problems or pelvic adjustment problems because they have DR and do not use their muscles properly.

‘Nobody checks after that. It is not seen as important by some doctors, so women are left to fend for themselves. Still, it has a massive impact on mental health because it makes women feel terrible. ‘

The irony is that the problem is very easy to diagnose – by careful sensation of the abdomen to look for a gap between the muscles.

For Wilma MacDonald, her pregnancy in 2017 was a textbook – although her 7kg boy only arrived after she had been in labor for 36 hours. She says: ‘I had no pain relief except gas and air.

‘I had my partner, sister and parents all waiting to help. I felt that everything was fine. ‘

Still, the 5-foot-1-inch new mother quickly began to feel that something was not right. As her back pain got worse, Wilma, who lives in Edinburgh with her partner Andrew Ness, 42, and Cailean lost strength in her core muscles (abdominal muscles), which stabilize and control the pelvis and spine.

“When I tried to get out of bed, there was no tension in my back,” she says. ‘I could not tense my muscles or bend them, and my stomach had a kind of “dome” if I sat up or leaned in a certain way.

‘I felt a dull back pain all the time and I had to try to compensate for the way I wore Cailean. I knew I had just had a baby, but I expected to start getting better after a few months. However, it did not go away.

‘If I went, I would get a sore back after 45 minutes. And getting up from a chair was really hard as I could not put any pressure on the middle section which is the bit you use to do this.

“Meanwhile, I had some urine leakage, my back curved more, and my posture was really bad, so my lower back protruded. I looked at myself in the mirror and tried to straighten up, but just could not do it. ‘

When Wilma finally came to an NHS physiotherapist after six weeks of waiting, it was only to be told that ‘feeling like I did was normal after giving birth. I was fired after less than 20 minutes and was told to do Pilates to strengthen my muscles. It was only when Caelian was three years old and after more fruitless trips to the GP that Wilma – still in pain – sought out a physiotherapist privately.

She says: ‘After examining me, feeling my stomach and testing me with certain exercises – such as gentle sit-ups – she found that I had a large split in my abdominal muscles. I was completely shocked. I had no idea about this. And I was deeply disappointed that it was only diagnosed after all that time and only by paying privately. ‘

The condition is most often treated with tailored physiotherapy to strengthen the muscles and help them knit together again.

A central part of this is the work of maintaining posture when moving and lifting.

This involves deep abdominal strength work and pelvic floor muscle exercises to support linea alba – the fibrous structure that keeps the abdominal muscles in a certain proximity to each other, explains Ruth Smith, from London-based Complete Pilates physiotherapy.

This gradually brings the muscles back together. Sometimes physiotherapy is not enough and a tummy tuck surgery may be necessary to bring the separated muscles back together.

However, the three-hour operation, under general anesthesia, is classified as cosmetic surgery and is not routinely available on the NHS. Wilma was prescribed a large number of exercises to be done at least three times a week.

She explains: ‘It was quite uncomfortable at first, but I was really working on it. Within six weeks, I noticed the difference – I could lift the baby and I could just feel the strength coming back into my core. There was no doming on my stomach when I did certain exercises.

“I’m now four years behind, and most of the time I’m okay – I do a lot of exercise, including Pilates, and use a rowing machine.

‘What frustrates me is that I never got proper advice. Unless you can afford to pay for the help, the support is just not there. It’s been a long journey, but I’m on my way. It will not be the same for women who just do not get the help they need. ‘

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