Diastasis Recti: Treatment and Prevention

postpartum belly
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Pregnancy and childbirth changes people's bodies in significant ways. After all, there’s a lot of growing and stretching that has to happen for you to gestate and birth your sweet baby. Many are able to heal and return to normal—or a “new normal”—after childbirth, though it often takes many months (or years) to get there. 

Some women end up with a separation in their abdominal muscles after childbirth which leaves bellies looking stretched out long after pregnancy. This stretching is known as diastasis recti or, colloquially, “mummy tummy."

But it’s not just appearance that’s the concern here—diastasis recti can cause back pain, “mommy bladder,” and other discomforts. Many cases of diastasis recti are linked to uterine, rectal, and bladder prolapse.

Let’s take a look at what diastasis recti is, how to know if you have it—and most importantly, how to treat it so you can live a strong and healthy life.

What Is Diastasis Recti?

Diastasis recti is defined as the separation of the rectus abdominis, a pair of muscles that run vertically down the front of your abdomen.

Separation of these muscles can happen to anyone, at anytime in their life. Newborn babies often have a diastasis recti, though this usually resolves on its own.

People who have jobs that require heavy lifting are prone to diastasis recti, as are people who lift weights incorrectly. Any repeated strain on the abdominal muscles can cause diastasis recti.

Diastasis recti is very common among pregnant and postpartum women. During pregnancy, as your abdominal muscles stretch to accommodate your baby, you may notice a faint white line that runs vertically down your abdomen where your belly button is. This line is called a linea alba and is a sign your abdominal muscles have separated.

Statistics

According to a study published in the British Journal of Sports Medicine, about one-third of all pregnant women will develop diastasis recti by their 21st week of pregnancy.

After giving birth, at six weeks postpartum, up to 60% of women will have diastasis recti. Some of those cases resolve on their own. Furthermore, by six months postpartum, 45.4% of women still develop diastasis recti and by 12 months postpartum, 32.6% do.

According to the National Federation of Professional Trainers, you are more susceptible to developing diastasis recti if you have a baby over the age of 35, if your baby had a high birth weight, if you have had more than one pregnancy, or if you birthed twins or multiples.

Identifying Diastasis Recti

Now comes the question you’ve been waiting on an answer to: How do you know if you have diastasis recti?

Ask a Doctor

As a first step, you can ask your midwife or doctor to check for diastasis recti at your postpartum check up.

These days, more healthcare providers are realizing how important this assessment is and, while at your appointment, feel free to bring up next steps with your care provider.

How to Check For Diastasis Recti

You can also check for diastasis recti in the comfort of your own home. Here’s how to do it:

  1. Get comfortable on a flat surface like a firm bed or yoga mat
  2. Lie on your back with your knees bent and your feet on the surface below
  3. Place two fingers in the space directly above your belly button
  4. Gently exhale and then lift your head
  5. If you have a separation in abdominal muscles, you will be able to fit your fingers into the space between your abdominal muscles as you inhale and lift
  6. Repeat this assessment in the space right below your belly button

If you don’t feel any open space between your abdominal muscles as you lift your head, you may not have diastasis recti.

In general, experts says that if you're able to fit two or more more fingers in that space, you have diastasis recti. Don’t be surprised if you can fit several fingers into that space—wide diastasis recti is also common.

Symptoms

Besides a gap in your abdominal muscles, there are several other symptoms that may accompany diastasis recti:

  • Back pain
  • Urine leakage
  • Bladder, rectal, or uterine prolapse
  • Poor posture
  • Bloating
  • Constipation
  • General core weakness

Treatment

Here's some good news! Although diastasis recti is quite uncomfortable, it is curable.

Although some severe cases may require surgery, most cases of diastasis recti can be treated with specific, correctly performed exercises that target the deep core abdominal muscles and pelvic floor.

Also, keep in mind that there is no deadline for treating your diastasis recti. Women successfully close their gap a year or two after childbirth, or even longer.

Postpartum Exercise

Your first stop on your path toward healing is to discuss the matter with your healthcare provider. They will be able to clear you for any postpartum exercises you may want to try, and they can give you advice about programs that might be helpful.

They may also refer you to a pelvic floor specialist or physical therapist who can give you specific exercises tailored to your body and whatever other postpartum issues you may be facing, such as prolapse or pelvic floor weakness.

As you embark on an exercise program aimed at closing the gap in your abdominal muscles, it is imperative that you choose one geared specifically toward diastasis recti.

Focus on Your Core

Core-centered exercise programs alone—especially ones that emphasize crunches or other more traditional ab exercises—may not be appropriate for diastasis recti. Some of these exercises can actually make the condition worse.

If you are working with a pelvic floor specialist, they will likely give you exercises to do both in their office and at home. You can also find several different online and in-person exercise programs that target diastasis recti specifically.

Exercise Dos and Don’ts

Exercises that correctly engage your deep core muscles have been shown to be the most effective at closing a diastasis recti. These corrective exercises are performed by pulling your abdominal muscles in rather than bulging them out, and require you to breathe properly in order to do this. In general, you want to exhale anytime you engage your core.

Below are some diastasis recti-safe exercises to try and some to avoid. In general you'll want to avoid any exercise that bulges your abs when you perform the exercise, as this will not engage your deep core muscles, and might cause further abdominal separation.

Exercises to Try
  • Planks

  • Upright pushups

  • Squatting against a wall

  • Pelvic floor tilts

Exercises to Avoid
  • Crunches

  • Double-leg lifts

  • Yoga poses that stretch the abdominals (e.g. back bends)

Prevention

You may not be able to fully prevent diastasis recti, especially in pregnancy, but there are things you can do to minimize the separation and prevent it from getting worse once you have it. Here are some things to consider:

  • Practice good posture
  • Learn how to properly engage your abdominal muscles, not just while sitting, but in everyday movement
  • Avoid carrying your baby on one side only. Many of us carry our babies on our hips, but this can create misalignment and put too much pressure one side of your body. Alternate hips periodically or use an ergonomic baby carrier that distributes your baby’s weight evenly
  • Make sure you learn how to properly lift heavy objects such as your baby’s car seat and stroller
  • Practice core-friendly breathing, which is where you exhale when engaging your core
  • Avoid “belly breathing” and breath holding. Try to avoid holding your breath when you lift your baby

A Word From Verywell

The changes that happen to our bodies after we have babies can be distressing. But it’s important to remember that these changes are expected and inevitable—they are part of the miracle of bringing new life into this world. 

The idea that a woman’s body would stay the same, or bounce back within weeks of giving birth, is a myth—and believing these things can be damaging to your self-esteem and self-image. Your postpartum body is beautiful and amazing.

At the same time that we want to practice as much self-love and acceptance as we can about our postpartum bodies, we also don’t want to neglect our health. While diastasis recti is a condition experienced by the majority of women who have given birth—and many times heals on its own without intervention—if your diastasis is causing you any discomfort, you owe it to yourself to work on closing the gap and strengthening your core.

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Article Sources
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  1. Sperstad JB, Tennfjord MK, Hilde G, Ellström-Engh M, Bø K. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic painBr J Sports Med. 2016;50(17):1092-1096. doi:10.1136/bjsports-2016-096065

  2. Brancato D. Diastasis recti: not just for new borns and pregnant women. National Federation of Professional Trainers website. Published August 28, 2015.

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