Diastasis Recti: What Is It and What You Can Do?
A common for expecting mothers to hear is that “babies ruin bodies,” you’ll get a mommy tummy, never fit into your old jeans, and similar “encouraging” phrases. Much of that is due to a condition called diastasis recti.
What Is Diastasis Recti?
Diastasis recti is the complete or partial separation of the rectus abdominis or the six-pack muscles, which causes the connective tissues in the middle to widen and thin.
Let’s take a closer look at what your abdominal muscles consist of to understand this better. There are four layers of abdominal muscles:
- The deepest one is transverse abdominis (TVA), which is important for good posture, stability, breathing, and keeping abdominal organs in place.
- Above the TVA, lie two groups of obliques – internal and external ones. These muscles are responsible for turning your torso.
- The most superficial muscle layer is rectus abdominis which contracts the torso. These are the muscles that you probably know as the six-pack.
Your rectus abdominis muscles consist of two halves that are held together by line alba, a string of connective tissue. Linea alba consists mostly of collagen and, unlike the muscles in your body, is not flexible. So, once it stretches, it can no longer go back to its original state.
What Causes Diastasis Recti?
The simple answer is: increased inner-abdominal pressure.
Before pregnancy, your uterus is roughly about the size of an orange and sits deep in your pelvis. As your baby grows bigger, the uterus gradually expands to the size of a watermelon to accommodate it, reaching your ribcage, pushing internal organs from their original locations, and pressing against your abdominal wall.
In the meantime, your body also produces a hormone called relaxin, which softens the connective tissues so that your pelvis becomes wider and makes it easier for the little one to come out. Since the body can’t isolate the connective tissues in the pelvis alone, relaxin affects the entire body, including your linea alba.
Diastasis recti can also occur or worsen while you’re pushing during labor.
However, diastasis recti does not only happen in pregnancy. It can also affect men, women who’ve never been pregnant, as well as premature babies. Excess weight, rapid weight changes, certain types of exercise with incorrect engagement, as well as temporary swelling within the abdominal cavity can also result in diastasis recti.
Moreover, certain factors such as age, weak muscle tone, consistently incorrect posture, and genetics can increase the risk of diastasis recti or make it worse.
Why Is It Bad?
Apart from the fact that your tummy may not go back to its original shape and your pre-pregnancy clothes may no longer fit, diastasis recti weakens your lower belly and overall functional abdominal strength. As a result, it puts additional pressure on your lumbar spine.
Decreased abdominal muscle strength can cause or aggravate lower back pain, destabilize your pelvic floor, or even lead to an injury. With diastasis recti, you also have a much higher risk of developing an umbilical hernia with diastasis recti.
Will You Get Diastasis Recti?
Abdominal separation during pregnancy is quite common and affects about two thirds of expecting women. Unfortunately, there is no way of telling whether you’ll develop it or not.
However, diastasis recti is more likely to happen if you have more than one pregnancy, are over 35 years of age, are carrying a heavy baby, twins or more babies, gain excessive weight, or have poor abdominal muscle tone.
How Can You Know If You Have Diastasis Recti?
Abdominal separation is very easy to check. Follow the steps below to learn if you have it:
- Lay down on the floor or any other firm and flat surface with your knees bent. If you are pregnant or recovering and your muscle tone is still weak, lay onto your side first and then roll onto your back to protect your abs.
- Keep your abdominal muscles relaxed as you lift your head off the ground. Place one hand at the back of your head to prop it up. Without engaging your abdominal muscles, use the hand behind your head to roll your shoulders up and move your ribcage toward your pelvis.
- Next, place the fingers of your other hand above the belly button. Your fingertips should be facing your knees. Feel for the ridges of your abdominal muscles and the gap between their two halves. Move your fingers all the way up from the sternum to your pubic bone as the separation can happen anywhere.
Can you feel it?
The Severity of Diastasis Recti
Now, how many fingers fit in the space between the muscles? One, two, three, more than three?
- If it’s one finger, you are most likely fine. You may have “functional diastasis,” which means that you have a little bit of separation, but you can engage your deep core muscles and generate the tension necessary along the linea alba.
- Two to three fingers indicate mild diastasis recti.
- Meanwhile, four, five, or more mean that your abdominal separation is severe.
It’s Not Just the Width but Also the Depth
When assessing the severity of diastasis recti, you also need to pay attention to its depth. This will indicate how compromised your connective tissues are.
If it’s firm similar to how your neck feels, the integrity of linea alba is not severely compromised. If, however, it feels softer such as your cheek, and your fingers sink in deeper, your line alba is more compromised. In this case, you may need more time to heal.
What You Can Do to Prevent Diastasis Recti from Developing or Getting Worse
Even though the line alba won’t go back to its original shape, you can strengthen and “teach” your muscles to close, making the gap between them smaller.
Here are a few things you can do to prevent diastasis recti from developing or getting worse:
- Do exercises that activate the TVA and pull the muscles together rather than cause them to bulge, such as core compression or baby hugs, standing or reclining push-ups, single-leg raises, squats against the wall, or toe taps while lying on your back.
- Practice core-strengthening yoga poses such as the Sunbird Pose.
- Be mindful of how you engage your abdominal muscles. Instead of allowing them to bulge out into a cone, slightly tuck your pelvis in and pull your belly button toward the spine. You will notice that it will make core exercises and yoga poses much harder, so aim for correct engagement rather than more reps or longer hold times. You may be worsening your condition if you do more with incorrect engagement.
- Maintain good posture. A proper posture during pregnancy (as well as prior and beyond it) not only protects your lower back, but also engages the abdominal muscles and helps maintain good muscle tone.
- When you get up from bed, roll onto your side and push yourself up with your hands into a sitting position instead of crunching your abs. To lay down, sit on the side of the bed and lie on your side with the help of your hands.
- Watch your diet and weight. Gain weight within the recommended range for your BMI, as the rapid excess weight gain is going to put even more strain on your abdomen.
- Support your belly when coughing or sneezing by placing your hands or arms.
What to Avoid?
And here are some things you should be avoiding:
- Exercises that contract your midsection, especially both sides of the rectus abdominis, at once. When you start showing, avoid crunches, sit-ups, planks, bicycles, oblique curls, double leg lifts, or any other exercises, as well as yoga poses such as Navasana. They can put stress on your midsection and cause your belly to bulge outward.
- Skip or go easy on backbends, such as Upward Dog, Wheel Pose, and Camel Pose, or any spinal extensions that stretch and open the abdominal muscles.
- Avoid Reverse Triangle or similar yoga poses or exercises that require spinal twists.
- Eat for two. You absolutely need more calories, but your baby definitely doesn’t require an additional share of every meal you have. You only need extra 300-350 calories a day per each baby you’re carrying starting from the second trimester till about 400-500 additional calories in your third trimester. Make sure these extra calories come from healthy, nutritious food.
- Lift or carry very heavy objects. If you lift weights or do other forms of strength training, you can continue doing so. However, you should lift lighter weights, lower the intensity, and engage your abs correctly.
Can I Get Rid Of Diastasis Recti?
I have great news for you! It is possible to treat and heal abdominal separation with specific exercises. Moreover, it’s recommended to do so before you have another pregnancy, as a weakened abdominal wall has a greater risk of resulting in more severe diastasis recti and a weaker back and pelvic floor.
Even if you don’t plan to have any more babies, working on closing the diastasis recti gap can improve your posture and support your abdominal muscles, reduce the risk of lower back pain, and more.
Do consult your physician before you engage in any sort of exercise to make sure your body has properly recovered and is ready for a fitness routine.
Have you noticed that you have diastasis recti? How severe is it? Let me know if you have any questions that I have not answered.
Scott C. Miller
Hi. I am a male (born that way), so no pregnancy. I have been told by a Doctor that I have Diastasis Recti. I do have poor balance and have a difficult time standing and going up (or down) stairs. I often loose my balance without cause. I had an umbilical hernia at 2 (which I was told was repaired, it was repaired again in 2011 . In 2013 I began to have balance issues which progressed. A surgeon noticed it was open and a mesh was added in 2017. What can you recommend to correct it or should I just reduce the gap and strengthen the muscles?
Scott C. Miller
Thank you Karina. Your post was not too lengthy. I will try your suggestions and will give it 3-5 months to see progress. Thank you.
Slot of internal pressure was put inside my abdomen. I felt my abdominals stretch out so much it was painful, and still doesn't feel right. Planks helped me before, should I try it again? Even now I can still feel pain in my upper and now I just touched it.