Diastasis recti is a separation of the abdominal muscles. While not always painful, it can cause discomfort and a range of physical symptoms. This article explains why diastasis recti can cause pain, its other manifestations, and how to address them.
What Diastasis Recti Is
Diastasis recti occurs when the rectus abdominis muscles, or “six-pack” muscles, separate. This separation is not a tear, but a stretching and thinning of the linea alba, the connective tissue joining these parallel muscle bands down the abdomen’s midline.
During pregnancy, the expanding uterus and hormonal changes soften connective tissues, causing the linea alba to stretch and widen. Vaginal delivery can further exacerbate this. While pregnancy is the primary cause, diastasis recti can also develop in men and newborns due to factors like significant weight fluctuations, improper core exercise techniques, or underdeveloped abdominal muscles.
Understanding Pain and Discomfort
Diastasis recti causes pain because weakened abdominal muscles provide less trunk support. This lack of core stability strains other muscle groups, leading to localized discomfort as the body overworks surrounding muscles to compensate.
Common pain types include persistent lower back, pelvic, and hip pain. The compromised abdominal wall can also cause generalized abdominal discomfort or soreness, as internal organs lack support. Activities increasing intra-abdominal pressure, such as lifting, twisting, prolonged standing, coughing, or sneezing, can intensify these sensations. Certain exercises like crunches and sit-ups, which push abdominal muscles outward, can worsen pain and the separation.
Other Physical Manifestations
Beyond pain, diastasis recti presents other physical signs. A visible “doming” or “pooching” of the abdomen, especially when engaging core muscles during activities like sitting up or coughing, is a common indicator. This occurs because the weakened linea alba allows abdominal contents to bulge outward.
Diminished core strength from muscle separation can lead to poor posture and difficulty with everyday movements like getting out of bed or lifting objects. Diastasis recti is also associated with pelvic floor dysfunction, including urinary incontinence or a sensation of pelvic organ prolapse. Some individuals report digestive problems like bloating or constipation due to weakened abdominal support affecting bowel function.
Addressing Diastasis Recti and Associated Symptoms
Diastasis recti can be identified through a self-check: lie on your back, lift your head slightly, and feel for a gap between abdominal muscles along the midline. A gap wider than two finger-widths (approximately two centimeters) indicates diastasis recti. For precise diagnosis, a healthcare provider may use physical assessment, ultrasound, or calipers.
Management typically begins with conservative measures, focusing on targeted physical therapy. This involves specific exercises to strengthen deep core muscles, particularly the transverse abdominis, without straining the separated rectus abdominis. Examples include diaphragmatic breathing, pelvic tilts, and gentle abdominal bracing. Avoid movements like traditional crunches or planks that can worsen the condition.
Learning proper body mechanics for daily activities, such as rolling to the side when getting out of bed, also helps reduce pressure on the abdominal wall. In severe cases, surgical intervention, often part of an abdominoplasty, may be considered to stitch muscles together, alleviating pain and improving core function.