If you are a female, either with babies or planning to have babies, you likely have heard of diastasis recti.
It is a common term used, but maybe not often explained well or understood.
This blog is going to explain everything you need to know about diastasis recti – from who it effects, how common it is and more.
I want you to feel prepared if you are pregnant or postpartum, because I know the 6 week clearance exam is not very hands on or helpful.
And you should feel confident getting back into exercise/life that you aren’t going to cause more damage to your body.
So, let’s get into it.
The full definition is “separation of the muscles along the midline of the abdomen, typically as seen in women during and after pregnancy.”
Let’s get into a little bit of anatomy.
The core is made up several muscles/muscle groups, but there are 3 main ones.
The transverse abdominis, the external obliques and the rectus abdominis. For more information on the anatomy and function during pregnancy, check out this blog post.
There is also connective tissue down the very center of your core/abdomen called the linea alba.
This connective tissue is what holds the ab muscles together, and what expands and shrinks during and after pregnancy.
In order to make room for a growing belly, the linea alba stretches and the rectus abdominis moves to the sides of the belly, with the help of relaxin and estrogen hormones.
Once you give birth, the stomach then starts to shrink back down, and the linea alba starts to return to its original position.
But it doesn’t always return back to where it was.
If the tissue is not healed or strengthened, a gap between the rectus abdominis may remain wider than we wish and therefore the core contraction is not as strong.
We will get into all of the details later in the blog, but the general idea is that diastasis recti (DR) is a separation of the abdominal muscles that did not close after pregnancy.
This can usually be rehabbed and will return back to how it was, but only with proper training and exercise, with a coach and/or a pelvic floor physical therapist.
We know that every females belly stretches during pregnancy to make room for a growing baby.
The internal organs shift, muscles shift, the hips start to get wider…a whole lot is happening during those 9 months.
Females bodies are made for birthing, but it doesn’t mean it isn’t a traumatic experience.
Not to mention, you aren’t really told much about what our body is doing, you just get ultrasounds to make sure the baby is growing and doing well.
No one teaches you how breathing patterns change, how to get up from a lying position, how to avoid dramatic pressure changes etc.
These small things during pregnancy no one tells you about are usually what can cause damage postpartum.
Diastasis recti is caused by excessive intra abdominal pressure or dysregulation.
This means that the pressure pushing out into the muscles/connective tissue of the belly is so much and for so long that the linea alba stretches even further.
After having the baby, the muscles go back to where they belong, but if you aren’t working on core connection and breathing patterns, that gap may not close and the muscles may not reconnect like before pregnancy.
This separation is diastasis recti.
That “mom pooch”, weak core, protruding bulge when doing certain activities is because the intra-abdominal pressure is not being managed and therefore the gap cannot close.
This is why it is so important to get into a reputable postpartum program and/or seek out a pelvic floor physical therapist.
Because this gap can close, and you can have a strong and functional core again after babies.
Hopefully you understand that females who are pregnant or postpartum can get diastasis recti.
But they aren’t the only ones.
Men and women who have not carried a child can also get diastasis recti.
That is because the biggest cause is dysregulated pressure within in the abdomen.
This pressure against the stomach from the inside (over time), can create a separation. This separation then allows what is under the ab muscles, like your organs and tissue, to push through that separation and create a bulge along the midline.
Other potential causes of diastasis recti, or ab separation, include:
• frequent/rapid changes in weight
• swelling within the belly due to medical conditions
• weightlifting without proper form and contraction
• abdominal exercises that are not performed correctly
This photo shows “breadloafing”. Which is not keeping correct pressure/contraction and therefore it is pushing out against my abdominals.
If you have not been pregnant, typically diastasis recti occurs from doing something incorrectly over and over again.
So if you are doing sit ups in every workout, but you aren’t regulating pressure within the abdomen and breathing correctly (meaning you are doing them incorrectly), overtime it can cause diastasis recti instead of a 6 pack.
How you do things MATTERS.
Risk of DR can also increase if:
• you have more than 1 child, especially close together with minimal time to recover/heal
• having multiples (twins, triplets)
• having a big/heavy baby for your size/frame
A lot of these you cannot control, but you can make sure that after delivery you do everything you can to make sure you heal and have a fully functioning core again.
Diastasis recti is extremely common in those that are pregnant.
About 60% of women get diastatsis while pregnant, and many heal and close up on their own after delivery.
They say about 40% off those still have DR sixth months after delivery (because postpartum care in the US is nonexistent and many women don’t know what they should be doing to recover).
You can get checked for Diastasis recti by someone who is trained to identify it, or a physical therapist.
You can also do a self assessment on yourself first and then go for a second opinion if you think you have it.
I will walk you through a brief self assessment you can try out now.
Start out laying on your back with your knees bent and feet flat on the floor.
Don’t press your low back into the floor or anything, just remain in a neutral and comfortable position.
Take 2-3 fingers and place them at your belly button.
You want your fingers to be wide along your stomach right and left, not up and down.
Take your fingers and feel your abdomen. Press down and see if it feels taught, spongy. Can you feel a separation (you should be able to feel the edges of your rectus abodminis). Can you tell how wide it is, 1 finger, 2 fingers, 3 fingers?
Once you checked at your belly button, do the same thing about 3 inches above your belly button, and then 3 inches below.
If the gap feels larger than 2 inches, or if the tissue is very spongy and you don’t feel either side of the abdominals, you could have diastasis recti and I recommend seeking out a pelvic health physical therapist for further assessment and evaluation.
If you have diastasis recti, you want to avoid anything that is going to cause you to lose pressure within the core.
That could be lifting heavy things off the floor or overhead.
It could be crunches, planks, sit ups and certain core exercises.
It could be sitting up in bed or getting up off the couch.
All of these can cause bulging or pressure against your abdomen if you are not strong enough to maintain pressure.
But this does not mean you should stop doing these things forever.
It is important to work on closing the gap so that you can have a strong and functional core.
Because if you don’t, it could lead to low back pain, constipation, pelvic pain, incontinence, painful sex and more.
While I know it seems like time and not doing certain things will fix the issue, but it won’t.
The best way to close the gap is to get involved in a postpartum fitness program from someone who is certified to coach it, and/or see a pelvic floor physical therapist.
This will allow you to connect with your pelvic floor, learn proper core contraction, fix your breathing patterns and more.
We know that doing improper exercises or activities can make things worse, so it is better to spend the time relearning and fix it, rather than ignore it.
I hope you found this blog helpful and learned all you needed to about diastasis recti.
While it is very prominent, it is not normal to just live life with this separation.
You do not have to just “deal with mom things” such as leaking when you jump or sneeze.
Again, while common, it is not normal.
Please share this blog on social media or with your fellow postpartum moms.