Diastasis recti, a common condition involving the separation of abdominal muscles, can contribute to back pain. This separation affects core stability, potentially leading to discomfort and various other symptoms.
Understanding Diastasis Recti
Diastasis recti occurs when the rectus abdominis muscles, or “six-pack” abs, separate along the midline. These two vertical bands are joined by the linea alba, a connective tissue. When this tissue stretches and thins, a gap forms between the muscle halves.
This condition is most frequently associated with pregnancy and childbirth. The expanding uterus and hormones like relaxin stretch the linea alba. While some separation is expected during pregnancy, it can persist postpartum. Diastasis recti also affects men and individuals experiencing rapid weight changes, obesity, or those who exert excessive intra-abdominal pressure through improper lifting or certain exercises.
How Diastasis Recti Leads to Back Pain
The connection between diastasis recti and back pain stems from compromised core integrity. Abdominal muscles, particularly deep core muscles like the transverse abdominis, provide spinal stability. When the rectus abdominis muscles separate, this core support system weakens.
A weakened abdominal wall forces the spine and back muscles to work harder to maintain posture and stability. This increased strain can lead to lower back discomfort. Altered abdominal mechanics also affect posture and spinal alignment, further contributing to back pain. The stretched and damaged connective tissue cannot properly support the trunk and lumbar spine, placing additional demand on these areas. Over time, this lack of support can even contribute to spinal joint degeneration.
Other Signs of Diastasis Recti
Beyond back pain, diastasis recti often presents with other signs. A visible bulge or “pooch” in the mid-abdomen, particularly above or below the belly button, is a common indicator. This bulge may become more prominent when straining, such as coughing or sitting up. Individuals might also experience a soft or jelly-like feeling around the belly button, or coning/doming when contracting abdominal muscles.
Other symptoms include general core weakness. Poor posture, constipation, bloating, pelvic pain, hip pain, urinary incontinence, or pain during sexual intercourse can also be associated with diastasis recti due to the interconnectedness of the core and pelvic floor.
Strategies for Managing Diastasis Recti
Managing diastasis recti involves conservative approaches focused on strengthening deep core muscles and improving body mechanics. Targeted exercises are crucial. Diaphragmatic breathing, which emphasizes deep breaths that engage the diaphragm and transverse abdominis, is a foundational exercise. Exercises like abdominal compressions, heel slides, pelvic tilts, and bridges with a belly scoop help activate and strengthen the core without exacerbating the separation. These movements focus on drawing the navel towards the spine and engaging the deep core.
Proper posture and body mechanics are also important; being mindful of how one moves, such as rolling to the side when getting out of bed, can reduce strain. Avoid exercises like traditional crunches, sit-ups, planks, and heavy lifting, as they can increase intra-abdominal pressure and worsen the condition. Consulting a physical therapist specializing in postpartum care can provide a tailored exercise program and guidance.
When to Consult a Professional
Consult a professional if diastasis recti symptoms persist or impact daily life. A healthcare provider can diagnose and assess the separation’s severity, often measured in finger widths. A gap wider than two fingers, or significant pain, warrants evaluation.
A physical therapist, particularly one specializing in women’s health or postpartum recovery, can assess core strength and function to develop a personalized treatment plan. They address abdominal separation and related issues like pelvic floor dysfunction or persistent back pain. If conservative treatments do not provide sufficient improvement after several months, or if symptoms are severe, surgical options with a qualified plastic surgeon may be considered.