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Diastasis Recti: What You Need to Know

The term “diastasis recti” (DR) often strikes fear and panic among women who have heard of it, or sheer confusion among those who haven’t (even trying to pronounce its name is difficult enough). And it’s no surprise. There is a great deal of mis-information and myths surrounding DR (a separation of the rectus abdominis muscle). We break everything down for you here in a clear and simple fashion — dispelling common myths, and setting the facts straight to hopefully give you some peace of mind and confidence on how to move forward.

What Diastasis Recti Is

In short, diastasis recti (DR) is a separation of the right and left sides of your rectus abdominis (or “6-pack”) muscle due to a thinning and weakening of the connective tissue — called the linea alba — that holds the two sides together. A small separation is normal, but a separation of 2.7 cm (about 2 finger-widths) or greater is considered DR (though there is actually more to the DR assessment than the width of your gap, as we’ll discuss later).

The word “diastasis” means separation, and “recti” refers to the rectus abdominis muscle.  It can manifest as a “torpedo-like” protrusion in the belly during any movement that engages the abdominal muscles, as you see in the images below.

 

Beyond the annoying “pooch-like” appearance, DR may indicate a weak and ineffective core. This can lead to a host of problems including low back pain, pelvic or hip pain, incontinence, constipation, or prolapse. It can also increases the risk of developing a hernia (when internal contents actually protrudes through a weak point in the abdominal cavity).  Hernias may require surgery to address, whereas DR can typically be healed without surgery.

Note: even if you have a hernia, typically the behaviors that cause a hernia are the same as that cause DR, so going through a DR recovery program is still very beneficial, especially to help you avoid further issues in the long-term.

What Causes Diastasis Recti

Simplistically speaking, diastasis recti is caused by a buildup of excess pressure in the core. While it can happen to anyone — men and women alike — it is very common during pregnancy because a growing belly increases pressure in the core. Let’s explain further looking at the images below.

Looking at the image on the left above, all your abdominal muscle layers connect in front at the midline of your body. They are connected by a tissue known as the linea alba. The linea alba has a consistency similar to “silly putty.” It’s strong, but flexible. If consistent and excessive outward pressure is placed on that tissue (like from a growing belly during pregnancy), then it eventually thins and stretches so much that its consistency becomes more like cellophane, and it loses its ability to act as effectively as a connective tissue. When this happens, the outermost muscle layer – the rectus abdominis – begins to drift apart, as in the image on the right.

The important thing to note here is that some degree of Diastasis Recti is actually a normal and natural part of pregnancy. Yes, that’s right. Some abdominal separation is necessary to allow baby room to grow.  In fact, some studies show that 100% of women will experience diastasis recti during their 3rd trimesters So please, do not panic if you feel some separation, especially during your third trimester, and do not attempt to “close the gap.” Your body is doing what it is designed to do.  This natural bit of DR can be healed in the postpartum period, especially with the proper recovery work.

HOWEVER…there are certain activities or behaviors that further exacerbate the pressure in your core — beyond that caused by your growing baby. This is when DR can become an issue — and remain one in the postpartum period.  Let’s discuss what you can do to help mitigate issues with DR.

How to Mitigate Risk of DR Issues

The following tips will help you better manage the pressure within your core as your belly grows, and therefore help you to heal faster in the postpartum period.  If you have DR already, these are excellent tips to begin your healing.

  • Get in Neutral: Neutral Alignment is key to reducing stress on your muscles and soft tissues.  Unfortunately, pregnancy tends to pull your body out of neutral. Look at the image below and note the significant lower back arch (common during pregnancy) and how much added pressure that is putting on her abdominal wall (not to mention her lower back and pelvic floor). Moving in neutral alignment is critical for healing DR in the postpartum period as well because how you move your body throughout the day adds up BIG TIME, especially when your linea alba tissue is trying to heal. So watch this video to help you Get in Neutral

  • Master the #1 Most Effective Core Exercise: This one is HUGE. There are many reasons we refer to 360˚ Breathing as the #1 most effective core exercise of all. One of the many reasons is that breathing in this manner activates the deep core muscles of your “Core Canister” and gets them to work together in harmony to regulate the pressure in your core. The more of a 360˚ Breather you become, the better you will be able to mitigate pressure problems like Diastasis Recti and Pelvic Floor Dysfunction so Learn 360˚ Breathing.
  • STOP these “belly-slimming” behaviors:There are two behaviors you may be tempted to do in order to make your belly smaller (or at least look smaller), especially in the earlier days of your pregnancy when you may not want people to know yet, or in those earlier postpartum days trying to minimize your post-baby belly. These behaviors are sucking in and chronically “engaging your core.” Ironically, these two behaviors actually increase the pressure in your core, and can therefore have the opposite effect. Watch this video to understand why and please STOP these behaviors.
  • Avoid improper core work as your belly grows:  While a focus on deep core training is critical during and after pregnancy, once you develop a belly (and while you are in the earlier stages postpartum), you will need to begin avoiding most traditional core moves that target more of the outer core muscles, as these will place too much pressure on your external abdominal wall. Watch this video for an explanation of the Core Exercises to Avoid during pregnancy and postpartum recovery.
  • Avoid “bearing down” or breath holding during exertion: This is a behavior we sometimes do automatically when lifting really heavy objects or pushing out a difficult bowel movement (envision “bearing down” on the toilet when constipated). Breath-holding upon exertion creates a spike in pressure within the core, which DOES create more power to lift or push, but also has the side effect of worsening DR and pelvic floor issues. So focus on the principle discussed in the 360˚ Breathing video of exhaling on the effort and if you’re experiencing issues with constipation, follow these tips to help reduce constipation.

How to Check for Diastasis Recti

You may notice that torpedo-like protrusion in your belly shown above during any movement that engages your abs. It’s often easiest to see after pregnancy, when the muscles are lax, but you may be able to see it during pregnancy as well. If you do notice this coning in any movement you do, simply stop that movement. That coning is a sign that the movement you are doing is not appropriate for your body at this time.

You can also perform a self-check for Diastasis Recti. We have created a separate post on this because understanding what to actually check for, and how to perform the test to improve accuracy, can get a bit more in-depth. Read this post on How to Check for Diastasis Recti, which includes information on how to take action on your results to begin your healing process.

Want More Information?

Do you already know you have DR and want to focus on recovery? Check out our Self-Guided Training Programs. We offer prenatal training programs that will help you strengthen your core in the most effective way and set you up for a faster postpartum recovery. We also offer an Core Recovery Program and full Postpartum Training Program (which includes the Core Recovery program plus core-safe total body workouts).

Looking for more personalized support? Explore our Online Personal Training (or In-Home Training if you live in New York City).

NOTE: If you are a fitness professional, check out our post on Diastasis Recti: A Guide for Fit Pros