Diastasis Recti is an issue that many women know all too well.
Unfortunately, it is something that occurs primarily due to pregnancy, leading not just to a saggy tummy but can also cause pelvic floor dysfunction and the many negative side effects which accompany that.
However, all women (regardless of having a baby or not), men and children are at risk of having a diastasis. Many people have diastasis recti but may be unaware of it, since checking for a diastasis is not part of routine medical or fitness evaluations.
During pregnancy, a woman’s body changes significantly in order to accommodate the growing life within them. One of the resulting changes is stretching of the abdominal musculature, which can often remain stretched after the baby leaves the womb.
Apart from the visually undesired change to the abdominal region, this issue can also be related to pelvic floor dysfunction, which can cause problems extending much further than any purely aesthetic ones.
In this article, I’ll discuss what Diastasis Recti is, the issues which often accompany it and what you can do to begin repairing your abdominal musculature after pregnancy in order to recover from this condition.
What is Diastasis Recti?
Before jumping into this discussion, we must first understand the anatomy of the abdominal region, in order to fully understand how this issue occurs and then eventually understand how to fix it.
The word diastasis means separation; the recti muscles are the outer abdominal muscles, hence the term Diastasis Recti refers to a separation of the outermost abdominal muscles.
For brevity’s sake, we’ll discuss the two different abdominal tissues, which are most relevant here.
The two tissues most tightly involved with the condition known as diastasis recti are the linea alba, a thin, fibrous band of connective tissue, which connects to two sides of what is known as the rectus abdominis.
To paint a little clearer image, the rectus abdominis includes the protruding “ab” muscles, which would make up what you know as a six-pack. The linea alba, however, is the thin band of connective tissue, which holds these two sides together.
It’s obvious that, as the baby grows in the womb, the the trunk region will stretch as the pregnancy progresses. A consequence of pressure pushing outwards results in a “stretching” of the linea alba connective tissue, creating a void between the two sides of the rectus abdominis to accommodate the growing baby.
Unfortunately, after many months of this constant stretching, the mother is often left with a widened abdominal region where the linea alba remains stretched, once the baby has been born (1).
This can also result in what is sometimes referred to as a “post-baby pooch,” or a protrusion of the abdominal musculature, giving the appearance of early pregnancy or weight gain.
Studies have indicated that up to 66% of women who give birth end up with some form of Diastasis Recti. So, although it may be of little comfort if you have this issue, you can rest assured that it is a very common one (2).
What Issues Are Caused By Diastasis Recti?
Some of the most common issues related to diastasis recti are low back pain and a weak pelvic floor (3, 4, 5).
The second of the two above issues is likely the most prevalent and debilitating due to potential urinary and bowel incontinence, or the inability to control excretion of urine and feces. This is in addition to a potential prolapse of the pelvic region organs such as the uterus and bladder.
It’s no wonder why this is actually a serious and worrying condition. A weak pelvic floor as a result of diastasis recti is also likely to cause urinary and digestive problems and even potential pain and discomfort, due to the rearranged abdominal tissue.
How To Treat Diastasis Recti
Diastasis recti is a tricky issue in that it literally changes your abdominal region by significantly stretching the linea alba connective tissue, which holds together the rectus abdominis.
Unfortunately, many of the current procedures to help fix it include surgery. My personal view is that surgery should only be undertaken after all other methods have been investigated.
When considering fixing this issue through core strengthening exercises, it’s important to wait 6 weeks after the birth (slightly longer after a C-section) and of equal importance is the avoidance of traditional “isolation” abdominal exercises, since specifically contracting the ab musculature could make the issue worse.
Certainly after a period of time strengthening this region, direct abdominal work may be acceptable or necessary, but for the time immediately after pregnancy, you should avoid the following exercises until your core is strong enough:
- Traditional Crunches
- Decline Sit-ups
- Weighted Sit-ups
- Cable Crunches
- Abdominal Crunching Machines
- Oblique twists
These exercises also include just about any other exercises that directly “crunch” or flex the spine and the ab region.
When attempting to improve symptoms of Diastasis Recti it’s firstly important to recognize the condition you are in. Surely you can eventually progress over time (as you should), but doing too much, too soon may exacerbate the issue.
At first, you’ll want to attempt to work on stabilizing core musculature and ensuring proper function. Doing so will allow for a new base of strength and stability, allowing for control of the core region.
Improving core stability at this stage includes the following:
- Lying Glute Bridges
- Wall Sits
- On Elbow Planks
- Side Planks
- Bird Dog
- Lying on Back, Knee Abduction (with resistance band if possible).
The reason for using these forms of exercise is quite simple. These movements indirectly work the abdominal region but require bracing and contraction, without actually “crunching” or “twisting” the abdominal region.
After a couple of weeks using exercises such as the above, you can begin to incorporate other indirect activators of the ab region, without actually “crunching” your abs. Some of those exercises may include:
- Kettle Bell Movements
- Bodyweight Squats
- Light Deadlifts (with Dumbbells and kettle bells)
- Farmer’s Walks
- All previous exercises.
Incorporating light exercises that require dynamic movements will allow for generating core bracing and stability, while not overly activating the abdominal region.
Diastasis Recti is a literal stretching of connective tissue, which holds together the two sides of the rectus abdominis musculature (six-pack). Unfortunately, many women who give birth experience this debilitating issue.
Not only can it be visually undesirable, but it can also cause health issues like the inability to control one’s pelvic floor. Pelvic floor weakness can result in serious conditions such as urinary and bowel incontinence and even pelvic region organ prolapse.
While many seek surgery, there are different exercises that you can perform to begin rebuilding core strength and stability, while eventually allowing the abdominal muscles to “close the gap,” so to speak.
However, caution must be practiced, since traditional “crunch” type exercises are not recommended, as they can worsen the issue.
Using these movements and information consistently and regularly should allow you to take back control of your body, saying goodbye to that unsightly “pooch.”
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- Hsia, M., & Jones, S. (2000). Natural resolution of rectus abdominis diastasis. Two single case studies. Australian Journal of Physiotherapy, 46(4), 301-307.
- Boissonnault, J. S., & Blaschak, M. J. (1988). Incidence of diastasis recti abdominis during the childbearing year. Physical therapy, 68(7), 1082-1086.
- Nahas, F. X., Ferreira, L. M., & de Arimatéia Mendes, J. (2004). An efficient way to correct recurrent rectus diastasis. Aesthetic plastic surgery, 28(4), 189-196.
- Spitznagle, T. M., Leong, F. C., & Van Dillen, L. R. (2007). Prevalence of diastasis recti abdominis in a urogynecological patient population. International Urogynecology Journal, 18(3), 321-328.
- Parker, M. A., Millar, L. A., & Dugan, S. A. (2009). Diastasis Rectus Abdominis and Lumbo‐Pelvic Pain and Dysfunction‐Are They Related?. Journal of Women’s Health Physical Therapy, 33(2), 15-22.