Post-Baby Pooch: What You Need to Know About Diastasis Recti and Abdominal Separation

Diastasis recti, or stretching and separating muscles in the abdominal area, is a common issue during and after pregnancy. Learn more about this condition.

Published Date: Jan 4, 2024
women-stretching-with-her-baby-below-her

Post-Baby Pooch: What You Need to Know About Diastasis Recti and Abdominal Separation

Diastasis recti, or stretching and separating muscles in the abdominal area, is a common issue during and after pregnancy. Learn more about this condition.

Published Date: Jan 4, 2024
women-stretching-with-her-baby-below-her

Post-Baby Pooch: What You Need to Know About Diastasis Recti and Abdominal Separation

Diastasis recti, or stretching and separating muscles in the abdominal area, is a common issue during and after pregnancy. Learn more about this condition.

Published Date: Jan 4, 2024
women-stretching-with-her-baby-below-her

Post-Baby Pooch: What You Need to Know About Diastasis Recti and Abdominal Separation

Diastasis recti, or stretching and separating muscles in the abdominal area, is a common issue during and after pregnancy. Learn more about this condition.

Published Date: Jan 4, 2024
women-stretching-with-her-baby-below-her
Table of Contents

Lower back pain, stretch marks, a constant need to pee. These make the top of the what-to-expect-when-you’re-expecting symptom list. Further down on the list: an often overlooked  — and yet super common — issue. It’s called diastasis recti (or diastasis recti abdominis), which means separation of the abdominal muscles. What happens is just as it sounds: as your uterus expands to accommodate your growing baby, the core muscles that run vertically along the front of your abdomen can separate, creating a gap down the middle. It’s usually not painful, and it can resolve on its own after delivery. But for about two-thirds of women, the condition persists for weeks or months postpartum — leading to that post-baby pooch, among other effects.  The good news: With time and the right exercises, most cases of diastasis recti will heal. Read on to learn about the symptoms of diastasis recti and how exercise and physical therapy can help treat it.

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Our Hinge Health Experts

Kandis Daroski, PT, DPT
Pelvic Health Physical Therapist and Clinical Reviewer
Dr. Daroski is a pelvic health physical therapist who provides clinical expertise for the Hinge Health Women's Pelvic Health Program.
Tamara Grisales, MD
Expert Physician in Urogynecology and Medical Reviewer
Dr. Grisales is a board-certified urogynecologist and surgeon and oversees the Women's Pelvic Health program at Hinge Health.

What Is Diastasis Recti?

The rectus abdominis muscles — or six-pack ab muscles — run parallel down the front of your stomach, from your ribs to your pelvis. They are divided into left and right sides and connected by a band of tissue at your midline called the linea alba. As your uterus expands during pregnancy, your ab muscles stretch and that band of tissue thins and widens as it’s pushed outward. Hormonal changes in pregnancy that loosen connective tissue also play a role.

Once you give birth, the linea alba can bounce back into place like a rubber band. But when the tissue loses its elasticity from being overstretched, the gap in your ab muscles will not close as much as it should. That’s diastasis recti.

While this issue is most common in pregnant and postpartum women, it can also affect men, infants, and children.

Symptoms of Diastasis Recti

Most people have diastasis recti during pregnancy but don’t notice symptoms until after delivery. The most obvious sign is a visible bulge or “pooch” that protrudes just above or below your belly button.

Other symptoms may include:

  • Doming or coning when you contract your ab muscles

  • Softness and a jelly-like feeling around your belly button

  • Weakness in your ab muscles

  • Lower back pain

  • Pelvic or hip pain

  • Difficulty lifting objects, walking, or doing everyday activities

  • Posture issues

  • Leaking urine (urinary incontinence)

Diastasis Recti Risk Factors

Pregnant women are more likely to develop diastasis recti if they: 

  • Are pregnant with twins, triplets, or multiples

  • Are petite or have a small stature

  • Are pregnant later in life

  • Have had more than one pregnancy

  • Have had diastasis recti with a previous pregnancy

  • Have weakened abdominal muscles

  • Have other conditions like umbilical hernia or pelvic instability

Physical Therapy to Help Heal Diastasis Recti

Exercise is often the first step to treating diastasis recti. It can help lessen the separation between ab muscles and ease symptoms. “Current research shows that the most important factor in healing diastasis recti is creating tension through the gap,” says Kandis Daroski, PT, DPT, a Hinge Health pelvic floor physical therapist (PT). “That means focusing on exercises that strengthen and coordinate deep core muscles to better support the area of the ab separation.”   Healing your diastasis recti after childbirth is as much about knowing what not to do as what to do. Certain exercises (like sit-ups or planks) that put pressure on your abdominal muscles before they’re fully healed can make your abdominal separation worse. Similarly, performing everyday movements— such as lifting your baby or getting in and out of bed —  while holding your breath or with poor ergonomics can delay healing. 

“It’s important to focus on exercises that strengthen and coordinate your abdominal muscles after delivery before moving on to more challenging core exercises like sit-ups or crunches,” Dr. Daroski says. A pelvic floor physical therapist can recommend a postnatal exercise program for your specific needs and teach you how to use proper body mechanics to engage deep core muscles when lifting and pushing to help promote healing. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit. Rarely, severe diastasis recti doesn’t improve with exercise and physical therapy and your healthcare provider may recommend surgery to repair your abdominal muscles.

Exercises for Diastasis Recti

Get 100+ similar exercises for free

  • Diaphragmatic Breathing
  • Abdominal Bracing With Heel Slide
  • Child’s Pose With Side Bend
  • Seated Kegel With Thigh Squeeze
  • Kneeling Hip Flexor Stretch With Overhead Reach

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Your PT Partner in Healing

“There’s no one-exercise-fits-all cure for diastasis recti,” says Dr. Daroski. “To most effectively engage your core to decrease symptoms, a physical therapist will need to create a customized and comprehensive program to help you feel better, faster. Improving diastasis recti is a journey — with a PT as your guide.”

Learn More About Hinge Health for Pelvic Symptom Relief

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Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

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This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

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References

  1. Diastasis Recti (Abdominal Separation): Symptoms & Treatment. (2022, February 8). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22346-diastasis-recti

  2. Hall, H., & Sanjaghsaz, H. (2022). Diastasis Recti Rehabilitation. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK573063/

  3. Sharma, G., Lobo, T., & Keller, L. (2014). Postnatal Exercise Can Reverse Diastasis Recti. Obstetrics & Gynecology, 123, 171S. doi: 10.1097/01.aog.0000447180.36758.7a

  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. doi:10.1136/bjsports-2016-096065

  5. Thabet, A. A., & Alshehri, M. A. (2019). Efficacy of deep core stability exercise program in postpartum women with diastasis recti abdominis: a randomised controlled trial. Journal of Musculoskeletal & Neuronal Interactions, 19(1), 62–68. https://pubmed.ncbi.nlm.nih.gov/30839304/