Diastasis Recti - STRONGMom

You might have heard about “Diastasis recti” (DR) or “abdominal weakness/ separation”. This is a condition that can occur not only during pregnancy but also if there is too much strain and pressure on the abdominal muscle wall.
So what is diastasis recti and why does it occur? It’s a natural process during the pregnancy as the belly stretches out when the baby grows. To make space for the baby the belly has to expand and that puts stress on the abdominal muscle wall. The linea alba is the connective tissue that connects the muscles and that stretches out and an unnatural distance between the left and right halves of rectus abdominis occur. The linea alba runs from the sternum to the pubic bone. DR is more likely to occur around the belly button then below or above. The symptoms of DR can be the feeling of lost core muscle control, bulging belly and/or lower back pain.
Something that’s really important to remember as you read this article, if you have diagnosed with DR and you feel worried and anxious, always remember, you are NOT broken! You might have weaker abdominal muscles and not as well functional core as before but there is help to get and with well planned strategy you can improve well. We recommend you seek professional help that can help you guide through this process.
Most, if not all women experience DR especially in the third trimester and after giving birth. Most women will heal slowly without any specific treatments but there are some that even after 12 months still have a “gap” between the abdominal muscles. There is no clear explanation why some women are more affected than others. There is also a lot of misleading information regarding DR out there and the lack of research can result in a lot of fear and confusion regarding this condition. I do feel confident that this is a growing area of research and more information and clearity will open up more information and guidelines.
Assess diastasis recti
It’s not unusual to feel weak in the core after giving birth and many women feel that it is hard to “connect and activate “ the core muscles. While doing core exercises or specific movement the belly “doming” or they feel “hollow”. If you have concerns or feel unsure about your condition please contact your doctor or someone that can help you assess your DR. Usually a pre/postnatal fitness professional has training in this and can help you. You can also do it yourself, (see instructions below), even though it’s sometimes easier to have someone help you assess.
The best and most accurate way to assess DR is to use ultrasound but the most common is to use finger-width measurements. If you use the finger-width method, lie on your back, lift your head and shoulders slightly off the ground (in to a slight sit- up position). While you hold this position, palpate the linea alba with your fingers and measure the gap between the rectus abdominis. Observe both the width and the depth, both above and below the belly button. I also like to palpate the abdominals to feel any pain or discomfort. Also observe the breathing during this position and exhale as you go in to the position. You can also palpate the abdominal while it is in a relaxed state to observe any discomfort or pain. It is important to not only observe the gap between the muscles but also the tension of the linea alba. Does the linea alba “give” or is it “hard”? You want to measure both the distance between the rectus abdominis as well as the tension in the linea alba. One- to two finger-widths is normal; three (3 centimeters) or more could be a sign of diastasis recti. Some women don’t have any discomfort or complications even with a 3 centimeters gap.
If you have been diagnosed with DR the goal is to build your abdominal strength and function up slowly to avoid any injuries or discomfort. As the strength and functionality build up, the gap can get smaller, but it is also possible to have a strong, functional core with a small DR. Another thing that is also important is to be able to control is the intra-abdominal pressure (IAP) and tension in the core. The breathing patterns can help regulate the pressure in the core and help restore the deep core muscle connection. Right after labor you need to recover and start the healing progress before doing any intense workouts or core exercises that puts too much tension on the abdominal muscles. The retraining and restoration of the deep core muscles are priority. In our app you can find gentle yet effective exercises (After pregnancy, level 1) that are appropriate soon after pregnancy to retrain the deep core muscles.
Are there exercises or movements that you should avoid if you have been diagnosed with DR? In the early stage of DR, I would recommend not to do too intense core exercises like crunches or the plank, or any core exercise that can put too much stress on the linea alba. If the belly is doming or bulging and can’t control the pressure. I also recommend to avoid plyometrics like jumping/running and too intense exercise in general before the DR is under control.
Diastasis recti affects most if not all women during and after the pregnancy. Most women “heal” after a few weeks/months without any specific treatment but sometimes the deep core muscles need a little more attention and care. With care from a health professional, a carefully selected rehab program and support from your surrounding you can recover and build a strong foundation, feel strong and self confident!