Diastasis Recti: What is it and what to do about it
Do you have a gap between your abdominals?
Do you have a gap between your abdominals, a momma pooch, bulging abdominals, pelvic floor or low back pain? Do you pee a little when you cough or have a prolapse. If the answer is yes, it’s possible you may have diastasis recti (DR)!
Men and women can both have diastasis recti… however, it is more common in women during or after a pregnancy. For most, it goes away within a few months after giving birth, but for some, it can last months to years! Diastasis recti can also re-occur, even if you have not had another baby.
YES, your body has changed from having children, but NO, you do not have to live with those pains and discomforts just because you’re a mom. According to Kaiser Permanente Division of Research, one in three women have some form of pelvic floor and core dysfunction and even that is too many. There are exercises you can do to get your body working properly again.
My experience with diastasis recti
Before, during and after both of my pregnancies, I worked on my pelvic floor and core intently to help strengthen the areas and encourage healing. This helped me avoid a large, abnormal diastasis recti.
However, at about 13 months postpartum with my second child, my abdominals separated slightly, about 1/2 a finger width. My sons reflux and strong willed nature at that time, called for standing and holding him as he whipped around for 3-4 hours in the middle of each night. It was when nursing didn’t calm him down anymore and standing was the only thing that got him to relax for 4-5 minutes, to get some burps out.
I took the stress on my body for months until I kept feeling a stabbing pain in my abdominals, my pelvic floor started hurting again and my back and arms where shot. So I put my husband on night time duty and at 17-18 months postpartum, I was working on healing that small little split. It only took about a month using the exercises from my Momma Pelvic Core Rehab Program, and now I am always extra cautious of my core and floor and remembering to engage it when I need to… even while holding my children.
What is diastasis recti?
So you have this connective tissue band that runs from the xiphoid process of the sternum (bottom of the rib cage) all the way down to your pubic symphysis (front tip of pubic bone). It’s called the linea alba (meaning white line). It’s what separates the right and left rectus abdominis muscles.
The linea alba holds our abdominal muscles in close proximity and it’s job is to remain firm or to soften and widen. This is a good thing! We want this tissue to be flexible and taut at different points in our life.
During pregnancy is one of those points when we want the linea alba to soften and widen… which allows a separation to occur in the rectus abdominis. This is called diastasis recti. Diastasis means separation. Recti is referring to the straight rectus abdominis muscles.
The connective tissue is there for a reason; to provide the give necessary, when pregnant, for our babies to grow and for our organs to not get completely smushed and to still be able to do their jobs.
Usually this separation will close on its own within a few months after having a baby. However, sometimes it doesn’t.
When the separation is NOT good
The real issue with diastasis recti occurs when the separation doesn’t close on its own. When you can put more than two fingers between your rectus abdominis muscles… and your baby is more than 3 months old. This can lead to abdominal, pelvic and back pain/problems, incontinence, painful intercourse…among other things.
And visually, it’s that frustrating post-baby pooch that doesn’t go away when the baby weight does. The thing that keeps your jeans fitting incorrectly, even when you’re the same weight pre-pregnancy.
(*picture from web- unknown)
What caused a large diastasis recti
There are many things that can cause a larger then wanted diastasis recti.
- The inner pelvic core system not firing correctly.
- Weaker abdominals before and during pregnancy can cause a larger split.
- Extreme stress or strain to the abdominal and pelvic floor area during your pregnancy or right after giving birth (which is easy to do, when you have older toddlers you’re tending to).
- Genetics come into play with the differences in the composition of the connective tissue.
- Carrying multiple babies or having successive pregnancies within a short period of time.
- Excessive weight gain during pregnancy.
- Having overdeveloped obliques and underdeveloped transverse and rectus abdominal muscles because the strong obliques pull the rectus abdominis open further.
- Having weaker hip rotator muscles, which are fascially connected to the pelvic floor and supports the whole abdominal region. (It’s amazing how everything is so connected, isn’t it!)
How to check for diastasis recti:
- Lie on your back with your knees bent and your feet on the floor.
- Bring your chin to your chest. Carefully lift your head and shoulders off the ground and engage your pelvic floor (i.e. your pelvic floor, rectus and transverse abdominal muscles). Note that your mid/lower back should stay on the ground.
- Place your fingertips at the top of your abdominals near the bottom of your ribcage (your xiphoid process). Walk your fingertips all the way down past your belly button and down to your pubic bone.
- Feel with your fingers if there is any gap between your recuts abdominis muscles. Normally the largest gap would be around the belly button.
- *If you are pregnant, your stomach will peak and form a ridge up the center. This is normal to some extent, due to the stretch of the linea alba to make room for your growing baby. However, it could also be indicative of a larger separation then normal . Your belly button will more likely poke out if you have a greater separation. (In men and women who are NOT pregnant but overweight, with most of the weight in their mid-section… the stomach may form a ridge in the center as well, if they have diastasis recti. Yes, it is possible in men too!)
*If you’re not sure you have it…double check with a professional because sometimes the test done wrong, without an adequate contraction, can cause a false positive for diastasis recti.
- If tested and you have more than 2.5 finger widths between your rectus abdominals, your child is older than 3 months, and you have bulging, pelvic floor pain, low back pain, etc., you may want to consult your doctor to make sure you have nothing else major going on. If at any time you see a round, hard, or painful bulge protruding from your belly button area, or along your mid line, consult your doctor or OBGYN.
So what do I need to do now?
Well … you need to allow the rectus abdominals heal. I know, I hate hearing that advice too! But it is important.
In order to do this, realistically (being a mom), you would need to avoid all activities that places stress on the midline, that stretches or overly expands the abdominal wall.
Do not be afraid to move… movement is good, just be conscious of your movements and in making sure your pelvic floor and transverse abdominal muscles are engaged when picking objects or baby up, exercising, etc.
Plus, all the surrounding muscles need to be strong to be able to support your body when you move… which is what you will learn in my Full Momma Pelvic Core Rehab Program.
Movements you may want to AVOID with diastasis recti:
- Carrying your babe on one hip or in a ONE shoulder sling. Doing so places a lot of strain on the abdominal area, which can actually increase your diastasis. It’s better to hold your baby in the center of your body with both hands (if possible) or in a carrier that goes over both shoulders and is centered with the midline of your body.
- Running with a stroller and pushing with one hand. This causes one side of your body to have to engage more, which is not good for healing up diastasis. Plus it does not allow your shoulders and core to move, which is important, down the chain of muscles which stabilize the entire body. If you must, at least, make sure you push with both hands with soft elbows, to keep your core working equally and to allow your shoulders to move freely. Or just avoid running with a stroller for a month or so, until your abdominals become stronger and you learn to engage the right muscles.
- Excessive twisting exercises…ones where the core really has to strain or work.
- Extending backwards, such as lying backwards over a ball or backbends.
- Certain Yoga / Pilates work. Such as cat dog, upper body flexion, single and double leg extensions, 100’s, rolling like a ball, teaser, ab series, etc. A lot of Yoga and Pilates work is not diastasis safe, so be careful and avoid until after your DR is completely healed. Then take it from there and listen to your body. If you are doing private sessions with a diastasis recti experienced yoga instructor, then I’m sure they we lead you through movements that are ok for your body to do, at each phase in your recovery/ rebuilding.
- Abdominal exercises that flex the upper spine off the floor such as: crunches, oblique crunches, bicycles, sit ups, hollow body positions where your head and legs are raised.
- Burpees, ab wheel, roll-ups, dragon fly’s, seated/kneeling machine or cable crunch…
- Intense coughing without abdominal support (if you have a cold and can’t stop coughing, wear a belly band or brace your abdominals while having long coughing attacks. Also make sure you engage your pelvic floor when you cough… kegel cough!).
- Any exercise that causes intra-abdominal pressure or where you notice your abs bulging out upon exertion. This can generate a lot of abdominal strain and can cause a spit/ re-split in the linea alba. Plus it produces a lot of pressure on the pelvic floor, allowing it not to be a support either.
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- When lifting heavier or carrying a heavy load. Make sure you breathe properly through it. Breathe OUT on the hardest part of the movement and breathe IN on the easiest part. But do avoid for until your DR is completely closed.
- Crunches or movements that flex the upper body can cause a lot of intra-abdominal pressure as well, plus strain the linea alba. So avoid until transverse abdominals and pelvic floor muscles are strong enough to engage naturally during all movements.
- Lifting and carrying very heavy objects… realistically, try NOT to carry heavy objects off to one side. If you have to carry them, carry them in the center and engage your pelvic tilt and lift properly with your legs. (This includes your child 😉.)
- Lower body and upper body exercises without adequate abdominal support/ engagement.
- Single leg exercises where you are off balance. Just until transverse abdominals and pelvic floor are strong enough and your diastasis recti has closed.
Exercises you CAN DO:
We need to get that inner pelvic core system firing and not strain it along the way.
So the only exercises you would want to do right now, if your diastasis is more then 2.5 fingers wide, would be:
- 360 breathing (More on this here!)
- Posture alignment work
- Pelvic tilts (More on this here!)
- Kegels
- Transverse abdominal hugs… (Brief descriptions of the transverse abdominal hugs and kegels are here, in my Momma Core Rehab Jump-Start blog post.
⭐️ ⭐️ Full descriptions and 3 months of progressions and complete pelvic core rebuilding is here, in my full Momma Pelvic Core Rehab Program ~ Diastasis Recti: Healing the “momma pooch” and Recovering the Core and Pelvic Floor!
As that area gets stronger and you feel like the gap is starting to close, then you can slowly add more and more exercises in. But give it at least a month… depending on how bad your DR is.
Side Note: If some of you splint/brace your abdominals or use belly bands to support that region right after giving birth, go for it. Just please do not leave them on all day or for long periods of time. Splinting is great to help your organs and body heal and move back into place after giving birth to about 3-4 months postpartum, however it does not help the abdominal and pelvic floor muscles recover and re-strengthen. You’d be surprised how much you use your core throughout the day with just normal daily life movements. And your core needs those little movements to gain strength back from being stretched to the max for so long. Splinting can actually make the diastasis recti worse if used TOO much.
Need More?
If your Diastasis is more than 2 fingers wide or you recently had a baby, I would highly suggest looking into my full Momma Pelvic Core Rehab Program. It will provide you important education and all the steps you need to heal your diastasis and re-strengthen your core and pelvic floor.
Goals of Momma Pelvic Core Rehab – Diastasis Recti: Healing the “Momma Pooch” and Recovering the Core and Pelvic Floor
- Education. Knowledge is power and will help you understand why it takes time to rebuild.
- Fix breathing- not shallow, not all belly, but 360. The diaphragm is the top of the true core.
- Fix posture to decrease the load on the abdominals, which could be a large contributor to diastasis recti.
- Perform exercises to “wake up” the pelvic floor and transverse abdominal muscles, aka the inner pelvic core.
- Perform exercises that support alignment and proper pelvic core function. Strong glutes, adductors, rotators, core and pelvic floor.
- Perform exercises to support and re-gain muscle balance. Balance between external obliques, rectus and transverse abdominals. Not overworking one area, but incorporating them all together.
- A more comfortable, confident and stronger you!