Diastasis recti (DR) is a common condition involving the separation of the rectus abdominis muscles, commonly known as the “six-pack.” This separation occurs at the linea alba, the thin line of connective tissue running down the center of the abdomen. While often associated with pregnancy and the postpartum period, men and individuals who have experienced significant weight fluctuations or improper abdominal straining can also develop it. Many traditional core movements can worsen the condition, making safe and informed recovery important.
Understanding Diastasis Recti and Self-Assessment
Diastasis recti is essentially a stretching and thinning of the linea alba, the collagen-rich tissue connecting the two halves of the rectus abdominis muscle. The condition is a natural consequence of pregnancy, as the expanding uterus exerts significant outward pressure on the abdominal wall. This strain causes the connective tissue to widen, resulting in a gap between the muscles. Other causes include excessive abdominal strain from improper lifting or chronic, forceful coughing.
You can perform a simple check at home to determine if you have DR. Lie on your back with your knees bent and feet flat on the floor. Place your fingertips horizontally across your midline, pointing toward your feet, either above, on, or below your belly button. Gently lift your head and shoulders just enough to feel the abdominal muscles contract, as if starting a mini-crunch.
As the muscles contract, you should feel the edges of the rectus abdominis muscles hug your fingers. If you feel a gap or depression into which your fingers sink, this indicates a separation. The width of the gap is measured by the number of fingers that can comfortably fit between the muscle edges. A separation of two finger-widths or more is typically considered diastasis recti, though the tension of the tissue is often more important than the width alone.
The Mechanism of Harm Caused by Sit-ups
The answer to whether you can do sit-ups with diastasis recti is generally no, because these movements increase intra-abdominal pressure (IAP). IAP is the force exerted by internal contents onto the abdominal wall, and sit-ups dramatically spike this pressure. When the deep core muscles are compromised, this force pushes outward against the weakened linea alba. This repeated outward pressure can further stretch the already thinned connective tissue, potentially widening the gap and worsening the separation.
A visual warning sign that an exercise is generating too much IAP is “doming” or “coning,” where a ridge appears down the center of the abdomen during the movement. This indicates the internal contents are bulging through the compromised midline. Traditional exercises like crunches, full sit-ups, planks, and leg raises must be avoided in the initial stages of recovery. Continuing these movements reinforces a dysfunctional core pattern and prevents the deeper stabilization muscles from engaging properly.
Safe Core Strengthening and Rehabilitation Exercises
Safe rehabilitation focuses on activating the deep stabilizing muscles, primarily the Transverse Abdominis (TVA), which acts like a natural corset. The TVA is the deepest layer of the abdominal wall and its contraction helps create tension across the linea alba. The goal is to restore the ability of the abdominal wall to manage IAP, rather than just forcing the gap to close.
One foundational exercise is diaphragmatic breathing, which coordinates the deep core and pelvic floor. Lying on your back, focus on breathing deeply into your ribs and belly on the inhale, and gently drawing your belly button toward your spine on the exhale to engage the TVA. Another gentle, effective movement is the pelvic tilt, performed by flattening your lower back against the floor by slightly rotating your pelvis backward. Heel slides are a progressive exercise that builds on TVA engagement, requiring you to slowly slide one heel along the floor while maintaining a gentle abdominal brace.
When to Seek Professional Guidance
While self-help exercises are a good starting point, professional guidance is necessary if your abdominal separation is persistent or remains larger than two to three finger-widths. If you continue to see coning during gentle exercises, a specialist assessment is recommended. A Women’s Health Physical Therapist, also known as a Pelvic Floor Physical Therapist, is the most qualified professional to address DR.
These specialists provide an accurate measurement of the separation and assess the tension and functionality of the surrounding core muscles. Indicators that suggest a need for professional intervention include persistent symptoms such as low back pain, pelvic pain, or any degree of urinary incontinence. A physical therapist will create a tailored, progressive exercise plan and can teach you to activate your deep core muscles correctly.