Diastasis Recti: The 17 Most Common Questions You Need To Know

Approximately two-thirds of pregnant women experience some degree of diastasis recti or abdominal separation after pregnancy. Even though it is a common condition, there’s still a lot of confusion about what it is and how to treat it.

Here are 17 facts about diastasis recti that will help clear things up.

What Is Diastasis Recti, and What Muscles Are Affected?

Diastasis recti is a condition in which the rectus abdominis muscles separate in the midline. The rectus abdominis muscles are the “six-pack” muscles that run down the front of your abdomen and are responsible for flexing your spine.

During pregnancy, the added pressure from the growing uterus weakens the linea alba, the connective tissue that holds the muscle together. The separation usually occurs at the level of the belly button, but it can extend above or below the belly button as well.

What Does Diastasis Recti Feel Like?

The most common symptom associated with diastasis recti is a bulge or protrusion in your abdomen. You might also see a noticeable gap between your rectus muscles, particularly when you strain or flex your abdominal muscles.

How Common Is Diastasis Recti?

Diastasis recti is relatively common in postpartum women. One study of 300 first-time pregnant women found that 60% of women had at least a 2 cm abdominal wall separation by six weeks postpartum.

A smaller study of 84 pregnant women found that 100% had some degree of abdominal muscle separation by late pregnancy. However, the prevalence of diastasis recti decreased to 39% by six months postpartum.

Can You Get Diastasis Recti Without Pregnancy?

Pregnancy is the most common cause of diastasis recti, but it can also occur in nonpregnant women.

Other causes of diastasis recti include:

• Obesity,
• Repetitive strain (such as excessive coughing, vomiting, or heavy lifting),
• Connective tissue disorders (such as people with a history of aneurysms)

Can Diastasis Recti Happen in Men?

Diastasis recti can also occur in men, although it is less common. The most common risk factor for developing diastasis recti in men is obesity due to the increased abdominal pressure caused by visceral fat.

Other risk factors in men are similar to women include repetitive and excessive abdominal straining,

How Do You Know if You Have It?

The simplest way to determine if you have diastasis recti is to perform the modified curl-up test.

First, lie down on your back with your knees bent and place your fingers just above your belly button. Next, gently press into your abdomen and feel for any separation between the muscles. If you do not feel a separation, elevate your head and shoulders off the ground and gently press your fingers into your abdomen again. You can check for rectus muscle separation at the belly button and above and below it.

Another way to detect abnormal abdominal separation is through an imaging study. However, your physician will only order an ultrasound or CT scan if the diagnosis is uncertain.

The most significant benefit of imaging is that it can help rule out other abdominal issues with bulging, such as hernias.

How Wide of a Gap Is Considered Abnormal?

There is some controversy over what is normal abdominal muscle separation. Some experts believe that a gap of more than 2 cm is diagnostic (approximately two finger widths). However, some women might have symptoms with a smaller gap.

What other symptoms can you get with diastasis recti? 

Some women may or may not have any symptoms with diastasis recti. The most common symptom is a bulge or protrusion in the abdomen, particularly when coughing, sneezing, or bearing down.

Another symptom you might experience is lower back pain and a change in your posture due to the abdominal muscles’ weakness.

Can Diastasis Recti Cause a Pooch?

A diastasis recti may give the appearance of a pooch, but the two conditions are not necessarily related. Diastasis is a separation of the abdominal muscles, while a belly pooch is likely due to excess abdominal fat. However, it is possible to have both diastasis rectus and excess abdominal fat.

When Is Diastasis Recti Severe?

There is no accepted definition of severe diastasis recti. Still, some experts believe that a gap of more than 3-4 cm is considered severe. One study of 32 patients classified with either a hernia or severe cases of diastasis recti abdominis had an average separation of 6.7 cm.

Is Diastasis Recti Ever Permanent?

Diastasis recti appears to resolve in some women spontaneously, but some have a persistent separation.

The same study of 84 pregnant women with diastasis recti found that over 60% of women had resolution of their abdominal muscle separation by six months. Similarly, the larger study with 300 women found that half of the women with diastasis recti had resolution by 12 months postpartum.

What Happens if It Goes Untreated?

If you are asymptomatic, you may not need any specific treatment. However, weak stomach muscles might predispose you to other issues, such as lower back pain and postural dysfunctions.

With that said, diastasis recti is not the same as a hernia. A hernia is a protrusion of abdominal contents through a hole in the abdominal wall. It can occur with or without diastasis recti.

It is essential to seek medical follow-up if you have a hernia, as abdominal hernias may cause serious complications.

How Can I Treat Diastasis Recti Naturally?

Diastasis recti is not a true hernia, so it doesn’t have to be surgically corrected. The best way to treat diastasis recti naturally is with exercise.

In general, two types of exercises may be beneficial.

1. Core exercises: Dedicated core training will improve and restore midline strength in the rectus muscles. Doing so may help close the gap and prevent further separation of the ab muscles.

2. Pelvic floor muscle exercises: Pelvic floor exercises improve the function of the muscles that support the bladder, uterus, and rectum. These pelvic floor muscles work together with the transverse abdominis (TVA) to stabilize the trunk and decrease the risk of urinary incontinence and pelvic organ prolapse.

A pelvic floor physical therapist can help you identify the best exercises for your individual needs.

Will Losing Weight Help?

Weight loss may improve the appearance of diastasis recti, but it is not likely to close the gap.

It will most likely help if you have truncal obesity or excess fat around your midline. Obesity and excess weight gain is among the most significant risk factors for rectus muscle separation. Increased visceral fat (fat around your organs) can place a lot of pressure on your abdominal wall.

What Kind of Diastasis Recti Exercises Should You Start?

The best exercises for diastasis recti focus on strengthening the deep abdominal muscles, specifically the transverse abdominis (TVA).

The TVA is a corset-like muscle that wraps around the entire torso and stabilizes the spine and pelvis.

The following core exercises target the TVA and are safe to do postpartum.

Diaphragmatic breathing

Diaphragmatic breathing, also known as belly breathing, is a great way to activate the TVA and gently improve core strength.

To do this exercise:

1. Place both hands on the sides of your stomach, just below the ribs.

2. Inhale slowly, allowing your stomach and the sides of your belly to expand into your hands.

3. Do your best not to let your shoulders rise as you inhale.

4. Begin exhaling slowly and gently contract your abs as you let out the air.

5. Repeat this breathing pattern 8-10 times, allowing your belly to rise and fall with each breath.

Pelvic tilts

Pelvic tilts are another great way to target the TVA while improving poor posture. It is best to do this exercise in the supine (lying down) position.

To do this exercise:

1. Lie on your back with your knees bent and feet flat on the ground.

2. There should be a natural curve in your low back.

4. Tilt your pelvis backward and flatten your back to the ground on the exhale.

5. You should feel your abs engage as you tilt your pelvis.

6. Reverse the movement on the inhale and return to the starting position.

7. Repeat this exercise 8-10 times.

Side planks

Side planks are a great way to target both the TVA and obliques (side abdominal muscles). The side plank is a more advanced exercise, so be sure to listen to your body and modify it.

To do this exercise:

1. Lie on your side with your legs straight and one forearm placed directly under your shoulder.

2. Use your other hand to place it on your hip.

3. Slowly lift your hips and torso off the ground, keeping your body in a straight line from head to toe.

4. Hold this position for 10-30 seconds, then lower back down to the starting position.

5. Repeat on the other side.

If this exercise is too difficult, you can keep your bottom knee on the floor while straightening the upper leg.

You can find a complete list of beginner, intermediate, and advanced diastasis recti exercises here.

How Long Does It Take To Fix?

In general, it might take anywhere from 6 to 12 months after your delivery to heal your diastasis.

However, no two situations are alike, and some women may have more severe separations than others.

If you have not seen any improvement in your abdominal separation after a trial of exercise and weight loss, surgical repair may be an option.

Be sure to speak with your health care provider to see if surgery is right for you.

What Exercises Make Diastasis Recti Worse?

Lastly, it is also essential to avoid any exercise that places excessive stress on the rectus abdominis muscle, as these movements can worsen the separation. You can determine if an exercise is stressing the rectus muscle significantly if you develop coning while performing the movement.

Coning occurs when the connective tissue between your rectus muscles bulges outwards in the middle, giving the appearance of a cone shape.

Common exercises to avoid include sit-ups, crunches, planks, and hanging ab exercises.

Here is a safe diastasis recti workout that only takes 20 minutes a day. 

Conclusion

If you are struggling with diastasis recti, know that you are not alone. This condition is relatively common, and there are conservative measures that may improve the separation. Either way, strengthening your core muscles can help improve your posture, abdominal stability, and quality of life.

This article was produced by The Postpartum Trainer