What is Diastasis Recti?
First, an anatomy overview. The rectus abdominis muscles are the abdominal muscles running down the center of our bellies. The left and right side of these muscles are joined together by connective tissue, called the linea alba.
Diastasis recti, or abdominal muscle separation, is the separation of the left and right sides of the abdominal muscles. Many women call this condition “mummy tummy.”
Who’s at Risk for Diastasis Recti?
It’s common for babies to be born with diastasis recti, especially premature babies. Usually no intervention is required and the gap will close gradually as the baby grows. Later in life the risk of developing diastasis recti increases for adults who:
1. are overweight in the abdominal area;
2. lift heavy weights incorrectly;
3. perform excessive and inappropriate abdominal muscle exercises;
4. are pregnant.
How Common is Diastasis Recti in Pregnancy?
Every woman’s abdominal muscles widen and stretch during pregnancy. This is what the muscles were designed to do. The condition diastasis recti occurs when the abdominal muscles separate or do not close after pregnancy. Health professionals may use different methods of diagnosing diastasis recti. Some consider any gap width diastasis recti and others may look for a gap wider than 1 – 3 cm. Studies have shown that between 35 – 62% of women have diastasis recti postpartum.
There are many websites reporting that 90% of women are experiencing diastasis recti during pregnancy. This is simply not the case and there is no research to support this. As stated, the stretching of the abdominal muscles during pregnancy is a perfectly natural occurrence. The gap will usually close naturally 6-8 weeks postpartum. If it does not, this is when you need to consider treatment.
What Increases the Risk of Developing Diastasis Recti in Pregnancy?
Diastasis recti usually develops in the second or third trimester of pregnancy. This is a pressure related condition, from the force of your uterus pushing up against the back of your abdominal wall. Factors that increase a pregnant woman’s risk of abdominal muscle separation are:
1. excessive weight gain during pregnancy,
2. older maternal age (over 35),
3. multiple pregnancies,
4. close successive pregnancies (within one year),
5. pregnancies with multiples,
6. anterior pelvic tilt.
What are the Health Implications of Having Diastasis Recti?
A diastasis recti of more than 2.5 cm can cause health implications. This may include lower back pain, hernia, and incontinence issues (because of the relationship between the abdominal wall and pelvic floor). A mild diastasis is mostly a cosmetic issue for postpartum women – hence the “mummy tummy” term, which is a bulging of a woman’s abdomen that diet and exercise cannot fix.
How can I Reduce My Risk of Developing Diastasis Recti in Pregnancy or Repair it Afterwards?
Prevention is always better (and less time consuming) than having to treat diastasis recti afterwards. Try these tips for prevention and treatment of minor diastasis recti:
1. Exercise! Several studies have shown that women with no or mild diastasis recti were more likely to be exercising regularly than women with moderate or severe diastasis. One study in the Women’s Health Journal of Physical Therapy reported that 90% of non-exercising women had diastasis recti while only 12.5% of exercising women had the condition. Wow!
2. Avoid gaining excessive amounts of weight while pregnant. A woman with a normal BMI should should strive for a 25-35 pound weight gain in her pregnancy.
3. Check your alignment. Alignment is a huge component in any pressure related body ailment, including diastasis recti. This is especially important when lifting heavy objects, such as older children or when strength training. A tilted pelvis will push your uterus against your abdominal wall, creating even more pressure.
4. Avoid exercises that exacerbate diastasis recti after the first trimester and immediately postpartum. This includes sit-ups, crunch movements, oblique twists, and plank-position exercises.
5. Performing transverse abdominal (TVA) focused exercises while pregnant will reduce your risk of diastasis recti postpartum. Studies have shown a significant difference in diastasis recti incidence between pregnant women who are active in TVA engagement and pregnant women who are sedentary. TVA training postpartum will help to close or minimize a gap.
How do I Check for Diastasis Recti?
This is a great video for learning how to check for diastasis recti, as well as a corrective exercise, the pelvic tilt. Warning: there are many videos on YouTube about this subject, but not all can be trusted!! The one below was recommended to me by a women’s health physiotherapist.
How is Diastasis Recti Related to Pelvic Floor Muscles?
Your abdominal muscles and pelvic floor muscles work together. What goes up must come down, what goes in must go out – so to speak. Diastasis recti affects the pelvic floor and vice-versa. In a U.S. study of women with diastasis recti, 66% also presented pelvic floor dysfunction symptoms. This includes urinary incontinence, faecal incontinence or pelvic organ prolapse symptoms. Learn more about how your delivery method may affect your risk of developing pelvic floor dysfunction.
Can I Close my Diastasis Recti Gap Years After Childbirth?
Yes! Women’s Health physiotherapists and pre and post-natal trainers are having great success treating diastasis recti at any age, no matter how long it’s been since you had your children. You can close or significantly reduce your abdominal muscle gap through rehab exercise. Severe diastasis recti that does not improve with physical therapy may need to be surgically repaired.
My Gap Isn’t Closing… Now What?
If you’ve been trying to close your abdominal muscle gap on your own and are having no success, there are online programs guided by professionals or you could see a women’s health physiotherapist for further treatment. If you’ve been seeing a physiotherapist for this issue you may be a candidate for abdominoplasty. Talk with your physiotherapist and your doctor.
What Does Diastasis Recti Look Like?
Diastasis recti affects babies, men and women. It effects the healthy and unhealthy, fit and unfit. Here are some pictures of what diastasis recti may look like: