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Understanding Diastasis Recti (Abdominal Separation)

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Post-baby pooch. Mummy tummy. Diastasis rectus abdominus (DRA).

These are all ways to describe a separation in the rectus abdominis (also known as abs or “six-pack”) muscles that is common in pregnancy and the postpartum period. As your abdominal wall stretches to accommodate your growing uterus and baby, it pulls on the tissue connecting the right and left sides of the abdominal muscles and creates a gap in the middle. This is called diastasis recti. While this issue is most common during and after pregnancy, it can affect people of any age or sex, including infants, men, and older women.

Going through pregnancy-related body changes isn’t easy, but remember that your body is meant to deal with this. Just as your body adjusts to the demands of a developing baby, it has the capacity to heal from diastasis recti. With the right exercises, care, and time, most cases of diastasis recti will heal.

Could I Have Diastasis Recti?

DRA looks and feels different from person to person. You may have:

  • “Doming” around the belly button when using your abdominal muscles (e.g., doing crunches)

  • A separation in your abdominal area, which can be visible and felt by touching your stomach

  • Softness and difficulty creating muscle tension in the area near your belly button

  • Significant weakness in your abdominal muscles

  • Low back, hip, or pelvic pain

What Are the Risk Factors for Diastasis Recti?

Diastasis recti is pretty common, with studies indicating that it affects about 60% of people. Most have it during pregnancy, but you may not realize it until you’re postpartum. It’s more common if you:

  • Are pregnant with multiples

  • Are petite or have a small stature

  • Are pregnant later in life

  • Have had more than one pregnancy

  • Had DRA with a previous pregnancy

  • Have weakened abdominal muscles

  • Have other conditions like umbilical hernia or pelvic instability

How Can I Heal?

Most cases of DRA resolve within a couple of months postpartum. The following tips can help your healing. Talk to your Hinge Health physical therapist if you have questions about posture or how to properly engage your abdominal and core muscles during daily activities.

  • Keep your core muscles strong. Exercise them regularly, especially before, during, and after pregnancy.

  • Use proper body mechanics with lifting and pushing. Engage your core when performing strenuous activities, or when you get in and out of bed.

  • Watch your posture. Engage your core throughout your day. Don’t sit or stand with a “belly out” or “arched back” posture.

  • Practice your belly breathing. Also known as diaphragmatic breathing, this technique can help decrease excess pressure within your abdomen that may contribute to diastasis recti. Ask your Hinge Health coach or physical therapist for our Diaphragmatic Breathing resource.

In severe situations that don’t improve with exercise and physical therapy, your doctor may recommend surgery to repair your abdominal muscles.

How Does Physical Therapy Help?

Your Hinge Health physical therapist can help develop an exercise plan for your specific needs. Many people with diastasis recti have other pregnancy and postpartum issues that benefit from pelvic floor, core, hip, and low back exercises (such as incontinence, constipation, pelvic and low back pain, and prolapse). Focusing only on core-strengthening moves may not address all of your symptoms.

Key Takeaways

  1. Diastasis recti is a common condition (particularly in pregnant and postpartum women) that occurs when the abdominal muscles separate from being stretched during pregnancy.

  2. The most obvious sign of DRA is a bulge in the belly that doesn’t go away after pregnancy.

  3. Most cases of DRA resolve on their own. Physical therapy, proper body mechanics, and diaphragmatic breathing can also help resolve your symptoms.

References

  1. Diastasis Recti (Abdominal Separation): Symptoms & Treatment. (n.d.). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22346-diastasis-recti

  2. Diastasis recti abdominis. (n.d.). Physiopedia. https://www.physio-pedia.com/Diastasis_recti_abdominis

  3. Guide | Physical Therapy Guide to Diastasis Rectus Abdominis. (2021, August 26). Choose PT. https://www.choosept.com/guide/physical-therapy-guide-diastasis-rectus-abdominis

  4. Sperstad, J. B., Tennfjord, M. K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine, 50(17), 1092–1096. https://doi.org/10.1136/bjsports-2016-096065

  5. Fei, H., Liu, Y., Li, M. et al. (2021). The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study. BMC Women's Health 21, 68. https://doi.org/10.1186/s12905-021-01194-8