Diastasis Recti

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Diastasis Recti

So what really is a diastasis recti?

A diastasis recti is the separation of your rectus abdominis muscle at your linea alba, or your “6-pack muscle”. It is a common occurrence during pregnancy, but in most women this separation will return to normal within the first 6-12 weeks after having the baby. During pregnancy the transverse abdominis (TA) is stretched and weakened; the rectus abdominis (RA) is lengthened, creating a gap between the linea alba.

In many cases this separation will remain unclosed, creating increased strain on your back, pelvic floor, and abdominal muscles. When this happens the core muscles cannot strengthen properly and there is an increased risk of back pain, injury with exercise, and pelvic floor dysfunction, such as urinary incontinence or pelvic organ prolapse.

Diastasis RectiDiastasis Recti

Why does the gap remain open?

The transverse abdominis and pelvic floor (usually) are weak and the abdominal canister is unable to maintain the pressure that it is designed to maintain. At N2 Physical Therapy, a physical therapist will evaluate and assess the specific functional strength and integration of the abdominal and pelvic muscles.

How do you check for diastasis recti?

Diastasis Recti

  1. Lay on your back with your knees bent and your feet flat.
  2. Make sure you are completely relaxed and place 4 fingers horizontally across your belly button. Push them into your belly slightly.
  3. Lift your head as if you are doing an abdominal crunch.
  4. Feel the edges of your rectus abdominis (“6-pack muscle”) come onto either side of your fingers.
  5. The gap is measured by the amount of fingers that fit between the muscle.
    1. If you feel the muscle come together under your fingers and they cannot fit between the gap then you do not have a diastasis recti.
    2. A measurement of 1 finger or more is considered a diastasis recti, or “gap”.

How do you fix it?

In a nut shell (and for lack of being able to assess each person individually, which I think is incredibly important!):

  • Perform a basic transverse abdominis  (TA) strengthening program
  • STOP doing crunches or “core exercises” that exacerbate the injury
  • Change all body patterns that cause an increase in intra-abdominal pressure (constipation, bearing down throughout the day, etc)
  • Improve posture to improve TA engagement
  • Learn to engage TA with all functional tasks, stop using the RA and obliques to substitute for TA weakness
  • Perform regular low impact cardio exercise (such as walking, elliptical) to enhance TA engagement
  • Sometimes a brace helps (the jury is still out on this one but I find that people like it when using it in moderation)
  • See a physical therapist who is trained to treat this condition!

What about your pooch?

Patients often confuse their “pooch” for a diastasis recti. You can have both, but they can be independent of each other. A “pooch” can be both adipose (fat) tissue and loose skin following pregnancy. Your body distributes adipose tissue to areas of your body during pregnancy to support your growing infant. Losing fat is losing fat. (If I had the secret to this I’d be writing from my mountain house…) We all know that to lose fat takes diet and exercise modification. (Also see excerpt above regarding fitness professionals…. Fat tissue is not my specialty!)  Can specific exercises help?  Possibly! But again, this is not the same thing as a diastasis recti.

If you are interested in joining a class “Closing your Diastasis Recti”. Or call any of our locations for a physical therapy evaluation!

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About the Author:

Amie Nangle, PT, DPT