Diastasis recti is a common condition involving the separation of the rectus abdominis muscles. While frequently observed during and after pregnancy, it can also affect men and infants. This separation can lead to various physical concerns.
Understanding Diastasis Recti
Diastasis recti occurs when the rectus abdominis muscles, commonly known as the “six-pack” abs, spread apart along the linea alba. This band of connective tissue runs down the midline of the abdomen. During pregnancy, the expanding uterus and hormonal changes stretch this tissue, causing it to thin and widen.
Beyond pregnancy, factors like significant weight gain or improper core exercises can increase intra-abdominal pressure, contributing to diastasis recti. Common symptoms include a visible bulge or “pooch” in the abdomen, especially when engaging core muscles or straining. Individuals may also experience lower back pain, poor posture, a “jelly-like” feeling around the belly button, and in some cases, pelvic floor dysfunction like urinary incontinence.
Targeted Exercises and Physical Therapy
Physical therapy is a primary approach for managing diastasis recti, focusing on restoring abdominal muscle function and improving core stability. A physical therapist can provide a tailored program that emphasizes proper core engagement and breathwork. Diaphragmatic breathing helps activate the transverse abdominis, a deep core muscle, promoting internal support for the abdominal wall.
Specialized exercises target the deep abdominal muscles to help reduce the separation. These often include movements like abdominal bracing, pelvic tilts, heel slides, and toe taps. These exercises are performed with slow, controlled movements and a focus on drawing the belly button towards the spine, which helps strengthen the transverse abdominis and improve the tension in the linea alba. Consistent engagement of these deep muscles helps stabilize the core and can improve symptoms such as back pain and abdominal bulging.
It is important to avoid exercises that can worsen the condition by putting excessive pressure on the abdominal wall. Crunches, sit-ups, planks, and certain yoga poses that cause the abdomen to bulge or “cone” should be avoided. A physical therapist can guide individuals in modifying daily activities and exercises to ensure safe and effective core strengthening.
When Surgery Becomes an Option
Surgical intervention for diastasis recti is generally considered when conservative methods, such as physical therapy and targeted exercises, have not yielded satisfactory results, or in severe cases with significant functional issues. These functional issues might include persistent lower back pain, abdominal wall weakness interfering with daily tasks, or a concomitant hernia. While diastasis recti itself is not painful, its associated symptoms can impact quality of life.
The most common surgical procedure for diastasis recti is often performed as part of an abdominoplasty, also known as a tummy tuck. This procedure involves an incision, typically across the lower abdomen, to access the separated rectus abdominis muscles. The surgeon then sutures these muscles back together along the midline, a process called plication, which reinforces the abdominal wall. Excess skin and fat may also be removed, providing both functional and aesthetic improvements.
Recovery from diastasis recti surgery varies. Patients typically experience some pain and soreness in the abdominal muscles for a few weeks. Light activities can usually be resumed within 2 to 4 weeks, but full recovery, including a return to strenuous exercise and heavy lifting, may take 3 to 6 months. Wearing a supportive compression garment is often recommended during the recovery period to reduce swelling and support healing tissues.
Supporting Recovery and Preventing Recurrence
Maintaining the improvements gained from treatment and preventing recurrence of diastasis recti involves ongoing commitment to certain practices. Good posture is a fundamental element, as it helps align the body and supports core stability. Being mindful of posture during daily activities, such as standing and sitting, can reduce strain on the abdominal muscles.
Proper body mechanics are also important, particularly when lifting objects or performing tasks that engage the core. Individuals should learn to lift with their legs, avoid straining the abdomen, and roll to the side when getting up from a lying position to minimize pressure on the abdominal wall. Continued engagement of the deep core muscles, such as the transverse abdominis, should be integrated into everyday movements.
Nutrition and hydration play supportive roles in the recovery process, aiding tissue repair and overall well-being. A balanced diet provides the necessary nutrients for healing, while adequate hydration supports bodily functions. While not a direct “cure,” these lifestyle elements contribute to an environment conducive to ongoing health and muscle integrity. Consistent adherence to these supportive measures helps maintain core strength and reduces the likelihood of the separation returning.