According to Google, this is a question many people are asking.
As awareness of Diastasis Recti has grown, so too has the degree of confusion and misinformation on the topic. Our goal is to demystify Diastasis Recti (DR) with evidence-based, easy-to-understand information that empowers you to move (and heal) your body with confidence.
In this post, we’d like to address the question of whether Diastasis Recti can be “fixed” (or healed or repaired) — even years later.
The short answer is YES. You can absolutely heal your Diastasis Recti at any point — even if you’ve had it for years — because the core tissues that were stressed during pregnancy will respond to the type of inputs you give it. This means that with the right training, you can strengthen your deep core so that it functions at a very high level, allowing you to do the activities that you love.
Now, the CAVEAT.
The more nuanced answer to this question depends on how you define “fixed” (or healed), which we will discuss below. But first, let’s briefly recap what Diastasis Recti is and how to (more accurately) check yourself for it.
What Diastasis Recti Is
DR is a “wider than usual” separation between the left and right sides of the rectus abdominis (or “6 pack” muscle). One commonly used definition is a separation of 2.7 cm (about 2 finger-widths) or greater at the umbilicus (Rath et a., 1996). The word “diastasis” means separation, and “recti” refers to the rectus abdominis muscle. You can see a visual of how this might look below.
DR can often present as a “torpedo-like” protrusion in the belly. It is often easiest to see it during any movement that engages the abdominal muscles, such as in the image below.
What Causes DR
The primary cause of DR is consistent and excessive intra-abdominal pressure (IAP). There are several factors that can lead to elevated IAP, which is why DR can occur in anyone — male and female alike. However, one (completely normal and necessary) cause of DR is the growing belly during pregnancy. As the belly grows, it thins and stretches the connective tissue that runs down the midline of the body, called the linea alba. This weakens the linea alba, which causes the distance between the left and right sides of the rectus abdominis (“6-pack” muscle) to widen.
Because DR is a natural part of pregnancy, everyone will have at least some degree of DR in the immediate aftermath of labor. Healing rates vary widely by individual based on several factors. This is what we’ll get into now.
How to Check Yourself for DR
Before you begin working to heal your DR, it’s important to have an accurate picture of your starting point. The DR assessment is an imperfect one, with many factors that can influence the results. If you have not done so already, follow one of the posts below to ensure you are performing the DR check in a manner that gives you the most accurate results. NOTE: We recommend waiting until you are at least 6 weeks postpartum to perform this assessment since everyone will have at least some degree of DR in the weeks following delivery.
Notice how both articles stress the importance of checking for width and depth — and emphasize that the depth assessment is actually the most telling indicator of DR severity.
Once you understand your starting point, you’re ready to begin your healing journey.
What Does it Mean to “Fix” or “Heal” DR?
Most often today, when people talk about healing DR, they’re thinking about “closing the gap.” However, there are a couple of significant problems with that line of thinking.
1. You don’t know what your pre-pregnancy “gap” was.
From an anatomical standpoint, there has always existed a “gap” between the left and right sides of your rectus abdominis. We are not born fused together but, rather, we are designed to be pliable and move in three dimensions. However, you likely became aware of this width after already learning that yours has increased during pregnancy. As a result, you don’t have any point of comparison for the newer width because you don’t know what your baseline was. So, trying to “close the gap” is not an accurate or measurable objective.
2. The “gap” isn’t the ONLY important characteristic that defines DR.
As discussed in the articles linked above on how to check for DR, newer research shows that how much tension you can generate in the linea alba (or the “depth” of your gap) is a more telling indicator of the severity of your DR than the width of your gap. Put simply, if your core is strong and functional, and you don’t have pain, then the width of your gap matters very little. As an illustration of this, look at the quick video demo below. In this case, you can see the gap width quite clearly. However, this individual can generate great “tension” in her linea alba tissue, and has no pain. Therefore, this is not a problematic case of DR.
So, you can see that “fixing” DR is a matter of perspective and nuance.
The Bottom Line: the goal is to develop a strong and capable body that will support the activities that matter to you. That could be anything from picking up your child out of the car seat without pain or chasing after your grandkids at the park. Successful healing is marked by satisfaction with your quality of life, not by achieving a certain number on a relatively subjective assessment.
Factors that Influence DR Healing
Now that we have outlined what defines successful healing, let’s take a look at the several factors that impact the rate and degree of healing. These include:
- Alignment The positions in which you orient and move your body will directly impact the function of your deep core. During pregnancy, the forces acting on the body often result in altered alignment, which can often persist into the postpartum period. These alignment changes can result in altered core recruitment strategies, which can disrupt the way your deep core fires. The more you can learn to position, and move, your body in neutral alignment, the faster your linea alba tissue will heal.
- Breathing Style: It may be surprising to learn that the way you breathe impacts the strength and effectiveness of your core. Often, the alignment changes and weight gain of pregnancy impact breathing patterns, which can alter the way, and amount, that the core works. Learning to breath with 360° Breathing mechanics is one of the most significant factors that can expedite healing.
- Amount of Physical Activity: The degree to which you are active will play a large role in how quickly your core regains its control and strength. Typically, the more active you are, the quicker the deep core structures will recover their capabilities.
- Degree of Core Recovery Work: Strengthening your deep core from the inside-out with deliberate postpartum recovery work will heal your core structures much more quickly than if your core doesn’t get fed that type of progressive and specific work. If you haven’t embarked on core recovery yet, don’t fret. Below, you will find resources that will help you begin healing and strengthening your deep core — regardless of how long ago you gave birth.
- Age: Recall that the linea alba tissue is made up of collagen. However, after age 25, collagen production begins to decline, and continues to decline as one ages, especially after age 40. Therefore, the older you are, the longer the healing process could take.
- Genetics: The characteristics of your soft tissues, like your collagen and skin, are influenced by your genetics. So, the degree to which you inherited “looser” or “tauter” tissue will impact your recovery speed.
- Diet: Collagen (which is what the linea alba tissue is primarily composed of) is a substance found in food. Therefore, your dietary choices directly impact how much collagen you consume. Eating collagen-rich foods can improve the healing and function of your connective tissues, including the linea alba. Contrarily, eating a diet higher in processed foods can increase inflammation and slow the body’s healing efforts.
- Pregnancy Weight Gain: The more weight that was gained, the more the tissues have been stretched and stressed, which impacts the degree and speed of recovery.
Resources to Help You Heal DR (at any age)
While some of the factors listed above may be out of your control (i.e. age) there is plenty you can do to facilitate healing at any point postpartum. Here are some resources to help you with that:
- Postpartum Core Recovery Article: This article will teach you movement strategies and a few powerful exercises that will help kickstart your healing journey so you develop a stronger and more resilient body (FREE article).
- 8-Week Core Recovery Program: This is a self-guided program delivered on the ProNatal Fitness app. Each day, you’ll receive a 5 – 8 minute core recovery routine. Your routines progress each day to gradually take you through the entire ProNatal Core Recovery protocol and help you rebuild your core from the inside out. The program includes lifetime access so you can stop or restart any time ($79).
- Become a ProNatal Certified Coach: If you are a health and fitness professional interested in learning how to train pre & postnatal clients, explore our industry-leading Pre/Postnatal Fitness Specialist Certification. In this in-depth course, you will learn the details behind the ProNatal Core Recovery Protocol and how to utilize it on all types of clients to heal DR and build a truly strong and functional core ($699 – $799).
Sources:
Rath, A.M., Attali, P., Dumas, J.L., Goldlust, D., Zhang, J., Chevrel, J.P. (1996). The abdominal linea alba: an anatomo-radiologic and biomechanical study. Surgical and Radiology Anatomy. 18, 281-288.
Spitznagle, T. M., Leong, F. C., & Van Dillen, L. R. (2007). Prevalence of diastasis recti abdominis in a urogynecological patient population. International urogynecology journal, 18(3), 321-328.
