Diastasis Recti (Abdominal Muscle Separation) Q&A

Diastasis Recti Repair Program

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.

mummy tummy

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:

Diastasis Recti Collage

Diastasis Recti Repair Program

Sources

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002569
http://www.ncbi.nlm.nih.gov/pubmed/9583506
http://www.scielo.br/pdf/rbfis/v13n4/en_aop035_09.pdf
http://www.mayoclinic.com/health/diastasis-recti/AN02153
http://www.wcpt.org/abstracts2007/Abstracts/39-14.htm
http://www.ohbaby.co.nz/family/for-mum/health-and-wellbeing/mind-the-gap
http://www.wcpt.org/abstracts2007/Abstracts/39-14.htm
http://journals.lww.com/jwhpt/Abstract/2005/29010/The_Effects_of_an_Exercise_Program_on_Diastasis
http://www.ncbi.nlm.nih.gov/pubmed/16868659

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  1. Sarah says

    I am about to embark on the journey of surgery to fix my separated stomach. It looks just like those pictures you’ve shown above. Two 10pd babies! A petite 5’5″, this has shattered my self confidence. Ridiculous as it may seem but in my eyes, it is the only way. I love your blog x

  2. says

    HI IM JACKIE RECENTLY DIVORCED WITH THREE BOYS AGED 28-30-36
    Weighed 9.5 & two boys at 10.3 each. I am 5.1″.
    I LEFT MY HUSBAND AFTER 32YRS. 3 BOYS, 4 MISCARRIAGES & A COMPLETE ANIMAL OF MY DAD. BETWEEN THE BIRTHS,MISCARRIAGES,
    & MY DAD BEATING ME TOO A PULP AS A CHILD/ TEENAGER I NOW HAS
    ABOUT A EIGHT INCH IN LENGTH SPLIT UNDER MY ABDOMINAL WALL.
    IF I LAY OUT FLAT YOU DONT SEE IT, BUT IF I PULL MY HEAD FORWARD
    I HAVE A REALLY WEIRD SHAPE APPEAR ( I CALL IT MY ALIEN) ITS VERY
    UNCOMFORTABLE, MY STOMACH ITS SELF IS LIKE A ROCK, I EVEN LOOK
    LIKE IM PREGNANT. MY DAD WAS A BARE KNUCKLE BOXER AND WOULD
    ON A REGULAR BASIS BEAT ME TO APULP. ONCE SO BAD HE HIT ME IN THE STOMACH LIFING ME HIGH IN THE AIR AND THROUGH A GLASS PANE DOOR. I HAVE WEAKNESS OF THE BLADDER, WEIGHT PROBLEM
    AS IN WHEELCHAIR FROM DAD, CANT EXERCISE TAKE 720mg OF
    MORPHINE TABLETS AND LIQUID ORAMORPH FOR BREAK THROUGH PAIN. I HAVE BEEN LIKE THIS YEARS ONLY NOW I CANT BEND FORWARD
    WITHOUT PAIN, STOMACH SO TIGHT ITS LIKE A DRUM. AND ITS ONLY A
    FLUKE I WANDERED ONTO THIS SITE TONIGHT. NOW IVE FOUND OTHERS
    HAVE ALIENS WHAT DO I DO NOW!!!!!!!!!!!!!!!!! Jackie.

    • says

      Hi Jackie. It sounds like you have had a rough couple years. I’m so sorry. But out of the ashes beauty may rise. I would encourage you to speak with your doctor as it sounds like you have a multitude of issues. I know it’s hard (and sometimes feels embarrassing) but that’s what they are there for. A women’s health physiotherapist is another option for treatment. Diastasis recti is usually a symptom of a larger issue which physiotherapists are great at treating. Good luck. I hope you find peace with your past some day.

  3. Alissa says

    Wow, you have great information on here! I too have a severe case of diastasis recti more than 5 fingers (surgeon took a measurement of 9cm). Either way PT has helped , but won’t fix this separation:( I have met with several surgeons and found one I am really happy with. I’ll be going in at the end of April and while I am so scared of the pain I’m trying to think of the outcome and a flat tummy again!! I wish I had been more informed prior to having babies. This is something doctors should discuss could happen after having a baby. Has anyone had any luck with insurance covering any part of the surgery? Especially if a doctor calls it a severe case? I’m sure they won’t, which seems ridiculous to me, but wanted to ask…. Thanks for any info you can provide on having a tummy tuck or success with insurance:)

    • says

      Hi Alissa. I’m not sure where you live or what type of insurance you have. I’ve spoken with women who are facing this surgery in the US, Canada, and Australia. Some women are having all, none, or a percentage covered by an insurance company. The insurance companies seem to have their own specific policies when it comes to diastasis recti repair and/or abdominoplasty. Sometimes it’s a measurement of the amount of loose skin. Sometimes it’s the width of the separation. Sometimes it’s whether the separation is above or below your belly button. Sometimes it’s a “requirement” that you’ve had to have prior caesarians to be covered!! (How unfair is that?) You’ll have to contact your insurance company to find out the terms. It sounds to me like the onus is on you to “prove” it is not a cosmetic procedure.

  4. kristina says

    Hi

    I am 28 nearly 29 weeks pregnant and have been told i have Diastasis recti, witch has just been diagnosed as i have had it since i had my daughter 7 years ago, all though i never new what this was i had the back pain and leaking urnine as well when sneeze etc. I am under a phsio i have worked on my pefic floor and is much better now however i still leak when laugh, cough, sneeze etc sometimes quite a lot comes out. I am in a lot of pain when i walk in my stomache, back, bum and legs and sitting or lying is very painful after a few minutes i all so completly stiffen up over night. My main question is can i give birth naturally with Diastasis recti. ? I really want to thank you x

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