Pregnancy brings about incredible changes in a woman’s body, and one common experience is the stretching of abdominal muscles to accommodate the growing baby. According to Ellen Casey, MD, a sports medicine physician, “The abdominal muscles and surrounding tissue have to stretch to accommodate for the growing fetus over the course of pregnancy.” This stretching can sometimes lead to a condition known as diastasis recti, or abdominal separation.
Diastasis recti is often painless, although some women may experience an unusual sensation or discomfort. Dr. Casey notes that some women with this condition might notice a bulge or protrusion in their abdomen, especially after eating or drinking. For many new mothers, addressing diastasis recti becomes a key part of their postpartum recovery journey as they seek ways to rebuild their core strength.
Identifying Diastasis Recti: Recognizing the Signs
One of the most noticeable signs of diastasis recti is a doming or tenting of the abdominal muscles when you engage your core. Anna Ribaudo, PT, DPT, OCS, Capp-OB, a physical therapy specialist, explains that during exercises like crunches, instead of the abdomen staying flat, the muscles of someone with diastasis recti might push outwards, forming a dome-like shape.
If you’re unsure whether you have diastasis recti, performing a simple self-test can help you check for abdominal separation at home.
Performing a Diastasis Recti Self-Test
This straightforward test can be done in the comfort of your own home to help determine if you have diastasis recti:
- Lie Down: Begin by lying on your back. Bend your knees and keep your feet flat on the floor.
- Engage Your Core and Lift Slightly: Gently lift your upper body as if you are starting a crunch.
- Feel for Separation: As you lift, use two fingers to probe gently into the midline of your abdomen. Check just above your belly button, at your belly button, and just below it.
If you can feel a gap that is wider than about two finger-widths between your abdominal muscles, it is likely that you have diastasis recti. For a more precise measurement of the muscle separation, a musculoskeletal ultrasound can be used.
When conducting the self-test, note both the width of the gap (how many fingers fit in the space) and whether you feel any tension from the abdominal muscles against your fingers. Feeling pressure is a positive indicator, suggesting that the muscles still retain some strength. According to Ribaudo, the severity of diastasis recti is determined by the length and width of the separation, as well as the strength of the surrounding abdominal muscles.
Addressing Diastasis Recti: Steps Towards Improvement
It’s important to wait until after childbirth before actively trying to correct diastasis recti. Ribaudo emphasizes, “If you have it during pregnancy, it’s not going to go away.”
Recovering from diastasis recti postpartum involves understanding both what to do and what to avoid. Everyday activities that strain your core, such as straining during bowel movements or holding your breath while lifting your baby, can worsen the separation. Here are some initial steps to aid healing:
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Re-establish Abdominal Muscle Contraction: Start by focusing on reconnecting with your abdominal muscles. Practice drawing your belly button in towards your spine. This action, known as core cinching, enhances stability and reduces strain on the rectus abdominis. Incorporate this exercise throughout your day in various positions, holding the contraction for up to a minute. For instance, practice while squatting, walking, or even sitting. Ribaudo advises, “You can do an abdominal contraction any time. Every single time you do it is one less time you’re pulling on that diastasis.”
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Progress Gradually to Core Exercises: As you regain core control, you can gradually introduce exercises like bicycles and planks, provided you can maintain the abdominal contraction without any doming. Ribaudo cautions, “If your abdominals are protruding, they are not strong enough yet to progress with this exercise.”
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Consider Targeted Exercise Programs: Specific programs designed for diastasis recti can be very beneficial. The Every Mother program, a 12-week video-based program, is one such option. A study led by Dr. Casey and published in the Journal of Women’s Health Physical Therapy in 2021 demonstrated the effectiveness of this program in reducing the separation between the rectus abdominis muscles and alleviating related symptoms like urinary incontinence and lower back pain. The program focuses on the abdominal draw-in maneuver, guiding participants to pull their belly button towards their spine in different body positions.
When to Seek Professional Guidance for Diastasis Recti
If you have been consistently working on healing your diastasis recti, you should expect to see noticeable progress within about six months, according to Ribaudo. She highlights that “The other component of diastasis is the contractibility strength of your core and ability to engage it with activities. So although there still may be a separation, how the muscles function is more important.”
However, it’s important to seek professional help from a healthcare provider specializing in musculoskeletal conditions related to pregnancy and childbirth, such as a physical therapist, if you experience diastasis recti alongside other issues. These may include pelvic floor dysfunction, pain during sexual intercourse, or incontinence that persists four months or more after delivery. Professional diagnosis and guidance can ensure comprehensive care and effective recovery strategies.
