Diastasis Recti: What is it, and what you can do about it

There is a lot of misinformation about diastasis recti (also called ab separation) out there. People refer to this condition as “mummy tummy” or “pooch” because it leaves the belly looking and feeling soft and squishy.

I am bringing you honest and accurate information about diastasis recti in this blog. So let’s deal with facts:

What is diastasis recti, really?

Why does it happen?

What can you do about it?

What is diastasis recti?

There is a pair of muscles that run vertically down each side of the anterior abdominal wall, this muscle is collectively referred to as the rectus abdominis. We call these our “abs”. This is the muscle that people focus on to achieve a flatter stomach.

The two sides of the rectus abdominis are joined by a band of connective tissue called the linea alba. To make room for your growing baby during pregnancy, the two sides of the rectus abdominis separates. This causes the linea alba to stretch out, and results in a separation or a “diastasis”.

Is it common?

Diastasis recti is normal nearly every woman is going to have a mild diastasis of 16 mm near the end of their third trimester. We classify diastasis by both width and tension.  Two finger separation is considered to be a mild case, whereas four or more fingers of separation is considered severe. How much tension a woman creates across the gap indicates how well the connective tissue can transfer load; and provide appropriate support for the internal organs.

 

Until recently, we assumed women who experience diastasis recti had more low back pain and more urine leakage. This would seem to make sense due to reduced stability through their trunk. However, more recent studies have shown that women who have diastasis do NOT have a higher prevalence of lumbopelvic pain at six months postpartum! While this is great news, it also highlights the amount of misinformation out there! A woman with a small gap and poor tension may experience more problematic symptoms than a woman with a large gap and good tension!

How do you reduce your risk of diastasis recti?

This is a difficult question to answer, but one that I get asked all the time. There’s still no clear reason why certain women experience more severe cases of diastasis recti than others.

Currently, medical professionals believe there could be a larger genetic component than previously thought. Some also argue that women who exercise regularly have a reduced risk of severe diastasis recti. It is possible that this is the case, as exercise would make the muscles stronger and more likely to handle the pressure from a growing uterus.  She likely has more developed brain pathways to her core muscles contributing to the ability to create good tension in the abdomen even where there is a gap. Though, this isn’t for certain –  there are plenty of women who work out and still experience more severe cases of diastasis recti. Due to the poor quality of available literature, we can’t suggest that any specific exercises may or may not help to prevent or reduce diastasis during antenatal and postnatal periods.

How do you manage diastasis recti?

In general, diastasis recti is not a contraindication for exercise; however, when a woman’s diastasis is severe (in width, softness, or lack of tension), she should work with her pelvic floor physiotherapist to determine how to modify her training program.

 

A small diastasis with good tension can be managed by a fitness professional with a pre and postnatal coaching designation. It is important to avoid exercises that cause bulging or doming in the abdomen at the linea alba. This includes planks and sit-ups; but, the only way to know for sure is to closely monitor the abdomen for these symptoms during various exercises. Your trainer can check to see if the linea alba creates better tension with different cues and different positions.

 

For a smaller diastasis and good tension, begin with isolated core muscle contractions immediately. This helps you ascertain what muscles develop tension in the linea alba. By doing so,  you work on developing the pathways from the brain, to those deeper core muscles through repetition. Working on the connection-breath helps your pelvic floor–and–core work together. Inhale and relax the pelvic floor and core musculature, exhale and contract the core while lifting the pelvic floor. Letting go, and relaxing the pelvic floor is just as important as being able to contract!

Listen to your body.

Once you are able to engage and relax your core on cue, you are ready to move on to co-recruitment exercises. In other words, you can integrate core activation into functional movements. Always monitor what’s happening in the abdomen during each movement to determine which exercises are going to work for you! Never do more than you can manage and always listen to your body. If you have urine leaks, pain, or the feeling of excessive pressure on the pelvic floor or on the abdominal wall make sure to consult with a professional.

Be easy on yourself.

Remember that it takes time for your body to recover from pregnancy and giving birth. Give yourself permission for this to be a journey with ups and downs. With time and hard work, you will regain functional use of your muscles, and even make them stronger than before.

 

Struggling with diastasis recti and need personal support? Let me help you create an exercise routine and plan geared specifically to you and your needs!