Diastasis recti, often referred to as abdominal separation, is a common condition where the rectus abdominis muscles, or “six-pack” muscles, spread apart. This separation occurs at the linea alba, a connective tissue that runs down the midline of the abdomen. While it frequently arises during pregnancy, it can affect others as well, including men and newborns. Diastasis recti can often be improved, and various approaches exist to help address this muscle separation.
Understanding Diastasis Recti
The condition is prevalent, affecting about 6 in 10 women after childbirth. It can also occur in individuals due to factors like significant weight gain or improper exercise techniques.
The primary cause of diastasis recti in pregnant individuals is the expanding uterus, which puts internal pressure on the abdominal wall. Pregnancy hormones, such as relaxin and estrogen, also contribute by softening the connective tissues, making them more pliable. While abdominal separation is expected during pregnancy, it may not always resolve spontaneously after delivery. Other contributing factors can include being over 35, having multiple pregnancies, carrying a large baby, or engaging in certain strenuous activities.
Individuals with diastasis recti might notice a visible bulge or “pooch” in their belly, particularly above or below the belly button, which can make them appear pregnant even months or years after childbirth. Other signs can include a soft or jelly-like feeling around the belly button, a “coning” or “doming” of the abdomen when contracting muscles, lower back pain, poor posture, and difficulty with everyday tasks like lifting. While the separation itself is not typically painful, associated symptoms like back pain or core weakness can cause discomfort.
Non-Surgical Correction Methods
For many individuals, non-surgical interventions are the most common pathway for improving diastasis recti. These approaches focus on strengthening the deep core muscles and optimizing body mechanics to draw abdominal muscles closer. Targeted core exercises are key, specifically those that engage the transverse abdominis, a deep abdominal muscle that acts like a natural corset.
Exercises such as pelvic tilts and deep belly breathing are recommended to gently activate and strengthen the core without excessive strain. When performing these exercises, emphasize drawing the belly button towards the spine during exhalation, engaging the transverse abdominis. Conversely, exercises that cause the abdomen to bulge outwards, like traditional crunches, sit-ups, or planks, should generally be avoided, especially in initial stages, as they can worsen the separation.
Working with a pelvic floor physical therapist is beneficial, as they provide personalized guidance and proper technique. These specialists assess the degree of separation and develop an exercise program tailored to individual needs, progressing movements safely and effectively. Physical therapy can significantly improve core strength and function, even if the gap does not completely close. Supportive garments or abdominal binders may also be helpful for some women postpartum to provide external support and decrease muscle separation.
Surgical Correction Methods
Surgical intervention for diastasis recti is typically considered when non-surgical methods have not yielded sufficient improvement, or in cases of severe separation or associated complications like an umbilical hernia. This approach directly repairs the abdominal muscle separation by stitching the rectus abdominis muscles back together along the midline. The procedure aims to reduce the abdominal bulge, improve core strength, and alleviate related discomforts like back pain.
The surgical repair is often performed as part of an abdominoplasty (tummy tuck), especially with excess loose abdominal skin. During this procedure, the surgeon makes an incision, usually along the lower abdomen, to access the underlying muscles. The separated muscles are then carefully brought together and secured with sutures. In some instances, minimally invasive techniques like laparoscopic or robotic-assisted surgery may be used, involving smaller incisions.
Recovery from diastasis recti surgery involves a healing period, typically requiring an abdominal support garment for several weeks to support repaired muscles. Strenuous activities and heavy lifting are usually restricted during this time for proper healing. While surgery provides a permanent solution to muscle separation, there is a small risk of recurrence if factors like significant weight gain or subsequent pregnancies occur. Surgeons often recommend waiting at least six to twelve months postpartum before considering surgery to allow for natural healing.
When to Seek Professional Guidance
Recognizing diastasis recti signs is the first step; a simple self-check provides an initial indication. To perform this, lie on your back with knees bent and feet flat on the floor. Place your fingertips horizontally across your midline, just above or below your belly button. Gently lift your head and shoulders slightly, as if doing a mini-crunch, and feel for a gap or separation between your abdominal muscles. If you can fit two or more fingers into this gap, it may suggest diastasis recti.
While a self-check can be informative, a professional diagnosis is important for accurate assessment and to rule out other conditions. Consulting a healthcare provider, like a doctor or pelvic floor physical therapist, is recommended if you suspect you have diastasis recti, especially if the gap is wider than two fingers or if you are experiencing symptoms like pain, core weakness, or incontinence. These professionals can confirm the diagnosis through physical examination, and sometimes imaging like ultrasound may be used for a precise measurement.
Seeking professional guidance ensures a personalized treatment plan tailored to your needs and condition severity. Early intervention and proper guidance are important for achieving the best possible outcomes through targeted exercises, physical therapy, or, in some cases, surgical repair. A physical therapist specializing in postpartum care is particularly well-equipped to assess and treat these issues.