Diastasis Recti: What Is It and What You Can Do

Diastasis Recti after Pregnancy
Image © Ekaterina Shelest / Adobe Stock

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 that 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 till 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 or 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 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.

Do You Have Diastasis Recti?

Abdominal separation is very easy to check. Follow the steps below to learn if you have it:

  1. 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.
  2. Keep your abdominal muscles relaxed as you lift your head off the ground and place one hand on 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.
  3. Next, place your other hand above the belly button and 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 till your pubic bone as the separation can happen anywhere.
  4. Can you feel it? Now, how many fingers fit in the space between the muscles? One, two, three, more than three? If it’s one finger, you’re fine. Two to three fingers indicate mild diastasis recti, while four, five and more mean that your abdominal separation is severe.
Types of Diastasis Recti
Image © Asya / Adobe Stock

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:

  1. Do exercises and 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.
  2. Practice core-strengthening yoga poses such as the Sunbird Pose.
  3. 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.
  4. 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.
  5. 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 lay onto your side with the help of your hands.
  6. 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. 
  7. 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:

  1. 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.
  2. 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. 
  3. Avoid Reverse Triangle or similar yoga poses or exercises that require spinal twists.
  4. 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.
  5. 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 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.

Let’s Talk!

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.

There are 5 comments

  1. Anya

    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.

    1. Karina

      Hello Anya, sorry to hear that it’s still bothering you, and thanks for trusting me to provide that advice.

      Planks are one of the exercises that can help build core strength and train your core muscles to provide the support necessary to ensure that your body does not create pressure on the connective tissues. However, I would advise using a combination of exercises for more holistic healing so that your muscles get to learn how to respond in a variety of situations. Mix in isometric poses/ exercises that require static hold and isotonic ones that involve repetitive movement. For the latter, exercises such as dead bugs and yoga poses like sunbird can be beneficial. Also try hip dips, hip twists, twisting planks, rocking forward and back in plans (You can Google all of them if you are unsure of what they are). Make sure that your tailbone and ribs are tucked in and you don’t sag your hips. Vary your exercises so that your muscles don’t get used to them over time.

      Regardless of what you choose to practice, I would advise doing that consistently. Meaning that you shouldn’t do them and stop. And your muscles weaken, so will the support. Connective tissues don’t regain elasticity in the same way that muscles do, so there needs to be consistent muscle support to ensure that, wherever there is pressure, your muscles are there to prevent that from hurting you. Your aim should be training your muscles to close in like a corset rather than bulge out when you engage them.

      Also, always focus on form rather than the number of reps or length of hold. So, focus on doing them right rather than more or for longer. Going past the ability to properly do them can result in improper form and can cause injury and/or teach your muscles to engage incorrectly. Modify if necessary, for instance, hold inclined planks or drop your bottom knee in side planks.

      If your case is severe, I would advise seeing a professional -a physical therapist or someone specializing in corrective exercise who could offer a more personalized program.

      Other than that, hope this is helpful and let me know if you have any further questions.

  2. 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?

    1. Karina

      Hello Scott,

      Sorry to hear you are going through this. Diastasis recti is, in general, more common with females because of pregnancies and hormone-related changes that affect muscle and ligament tome. However, it is absolutely possible in men, just not nearly as frequently.

      If your umbilical hernia is recurring, this would indicate that there is an underlying issue or issues that have not been addressed. The surgery seems to patch the issue up, but something keeps pushing those internal organs out through the connective tissues. DA (Diastasis recti) develops when there is increased intraabdominal pressure, i.e., excess pressure in the abdominal cavity. For women, this would be the baby. Once it is out, the pressure is gone. So, the treatment options and exercises you may need could differ from what postpartum women may need.

      In men, DA could be due to excess weight, incorrect or excessive exercising, heavy lifting, swelling in the abdominal cavity, genetic predisposition. Once the separation has already developed, you can potentially make it worse if you keep increasing pressure in the abdominal cavity with any of the above. So, first, I would make sure that you eliminate any possible contributing factors that may worsen it, such as excess weight. If you exercise or lift weights, stop altogether, modify, reduce in the intensity, or review the form. It’s possible though that none of these apply to you. However, they are important to address if they do.

      Next, you should work on building (if you do not exercise) or rebuilding (if you exercise) core strength from the inside out. So, instead of focusing on the external abdominal muscles such as the six-pack muscles or obliques, focus on strengthening the deep core muscles and making sure that they are working together. If there is a lack of strength or imbalance in the strength of the deep core muscles, something may give/ be weak or something else will overcompensate. The external abdominal muscles can’t provide that stability as their functions in the body are different.

      These deep core muscles are your diaphragm at the top, transverse abdominis, deep abdominal muscle in the front, pelvic floor at the bottom, and multifidus, deep spinal muscle at the back.

      DA would indicate a weak transverse abdominis, the deep core muscle at the front. However, all of these muscles work together. So, if one of the other muscles is weak or overcompensating (which is likely), you will have issues such as shallow breathing, postural issues, slouching, anterior or posterior pelvic tilt, that may be altering your posture, lower back pain, issues with bowel movements. If any of these apply, you would need to work on the entire deep core, not just the frontal muscle.

      It is hard to give any suggestions without actually seeing you. Yet, if I were to start somewhere, I would do the following:

      – Make sure that I am not worsening the DA (as described above).
      – Assess and correct the posture, make sure you maintain optimal posture while walking and sitting.
      – Practicing deep belly breathing (diaphragmatic breathing or yogic breath) laying down with a neutral back. It helps all these deep core muscles to relearn how to work together.
      – Core engagement. Lay down on your back with knees bent and feet on the floor. As you exhale, draw abdominals toward the spine. Hold it there for about 30 seconds or 5 breaths. You should keep breathing while the core is engaged. Repeat 8-10 times. As you feel stronger and more stable. You can add extra movements here like extending one leg at a time or one leg and one arm at a time, making sire abdominals are hugging in.
      – Simple exercises to retrain the deep core muscle strength. Your aim is to teach your deep core muscles to close providing support for the connective tissues in the middle. Some exercises include: pelvic clocks, dead bugs, Sunbird pose in yoga, Cat-Cows in yoga, toe taps laying on your back, modified plank (with knees on the floor making sure abs are closing in). I would Google each of these for more in-depth instructions or tutorials.

      These exercises are rather simple, but that is the point. You should be starting with gentle training to help the core muscles relearn their natural movement patterns. Be patient as the progress will be slow. It will take a few weeks for the brain to start learning that as a natural reaction and 3-5 months to start seeing progress.

      If possible, I would also look into exercise routines like hypopressives (this routine helps improve core and pelvic muscle functionality) and perhaps see a physical therapist to rule out any other possible issues that could contribute to balance problems.

      Working on improving flexibility (hamstrings and chest are where men normally tend to have more tightness), could be helpful, too. If you feel stiff or lack flexibility, this could contribute to postural and balance issues.

      General strengthening such as stronger glute muscles could also bring more balance. But that would be easier to determine having a movement specialist or a physical therapist see you.

      It’s a rather lengthy reply. Hope that is helpful and, if you have any further questions, please let me know.

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