The vertical bulge that appears down the center of the abdomen during activities like a sit-up is the most visible sign of diastasis recti (DR). DR is the separation of the rectus abdominis muscles, commonly known as the “six-pack” muscles, which run vertically along the front of the stomach. This separation occurs because the connective tissue joining these muscles has stretched and weakened. A noticeable gap in the midline of the abdomen often appears when the core is strained.
Understanding Diastasis Recti
The two bands of the rectus abdominis muscles are normally connected by a strip of collagenous tissue called the linea alba. This midline structure acts as a supportive bridge, helping to maintain intra-abdominal pressure and core stability. When the rectus muscles separate, the linea alba stretches and thins, resulting in a wider gap between the muscle halves.
The vertical bulge, often described as “doming” or “coning,” occurs because the weakened linea alba can no longer contain the internal abdominal contents when pressure increases. Activities like a crunch or sit-up push the underlying organs and tissue forward through the gap, creating the ridge. A separation is considered diastasis recti if the gap measures more than two finger-widths or about two centimeters.
While most commonly associated with pregnancy due to the expanding uterus and hormonal changes, DR is not exclusive to postpartum women. Other factors that significantly increase intra-abdominal pressure can also cause the separation. Risk factors include improper lifting techniques, strenuous core exercises, obesity, multiple pregnancies, or a history of rapid weight changes.
Identifying the Separation and Associated Symptoms
The most straightforward way to check for diastasis recti involves a simple self-test that makes the separation visible or palpable. Begin by lying on your back with your knees bent and your feet flat on the floor. Place your fingertips perpendicular to your torso, right in the midline of your abdomen, either at, above, or below your belly button.
Gently lift your head and shoulders, as if starting a mini sit-up, while keeping your hands in place. As you engage your abdominal muscles, feel for the space between the two muscle bellies. Measure the width of the gap by noting how many fingertips fit into the separation. If the gap is two or more finger-widths wide, it suggests the presence of diastasis recti.
Beyond the visible doming, a separated abdomen can cause several functional symptoms. Individuals often report chronic lower back pain because the weakened core musculature fails to support the spine. Poor posture and difficulty engaging the core muscles effectively are common complaints. The instability caused by DR can extend to the pelvic floor, potentially leading to urinary incontinence or pelvic/hip pain. Digestive concerns like persistent bloating or constipation may also be associated with the condition.
Safe Core Management and Movement
Managing diastasis recti involves focusing on movements that strengthen the deep core muscles without causing the abdominal wall to bulge outward. Avoid exercises that involve spinal flexion or rotation, such as sit-ups, crunches, and full planks, as these increase pressure on the linea alba. Any exercise that causes the visible “coning” or doming of the stomach should be modified or temporarily discontinued.
In daily life, minimizing strain is important, which includes rolling to the side before getting out of bed or standing up from a chair. Heavy lifting, especially without conscious core bracing, should be avoided until the deep abdominal muscles are stronger. The focus should shift to gentle, restorative exercises that activate the transverse abdominis, the deepest abdominal muscle, which acts like a natural corset.
A fundamental technique is abdominal bracing, which involves consciously exhaling while drawing the belly button toward the spine to stabilize the trunk. Specialized physical therapy, particularly with a women’s health physical therapist, is often the most effective way to learn these techniques and create a recovery plan. A therapist can assess the severity of the separation and guide a progression of exercises, focusing on core and pelvic floor strength. If you experience persistent pain, a large separation, or suspect a hernia, seeking professional medical advice is necessary.