Diastasis recti, or “abdominal separation,” occurs when the rectus abdominis muscles part ways. This condition involves the stretching and thinning of the linea alba, the connective tissue running down the midline of the abdomen.
Understanding Diastasis Recti
Pregnancy is a common cause, with many pregnant women experiencing some degree of separation as the uterus expands. Multiple pregnancies, large babies, or closely spaced pregnancies can increase this likelihood. It can also affect men and infants, often due to heavy lifting, obesity, or rapid weight changes.
Symptoms often include a visible bulge or “pooch” in the abdomen, or a soft, jelly-like sensation near the belly button. “Doming” or “coning” is a notable sign, where the abdomen protrudes when engaging muscles. Other symptoms include:
Low back pain
Poor posture
Difficulty lifting objects
Constipation
Urinary incontinence
To perform a self-check, lie on your back with knees bent and feet flat. Place one hand behind your head and the other on your abdomen, fingertips across your midline at or just above your belly button. Gently press your fingertips into your abdomen.
Slowly lift your head and shoulders slightly, as if performing a mini-crunch, keeping your gaze towards your belly. As you lift, feel for a gap or softness between the muscle edges. If you can fit two or more fingers into the gap, it suggests diastasis recti.
Exercises to Safely Strengthen Your Core
Targeted exercises strengthen deep core muscles, especially the transverse abdominis, supporting the abdominal wall. Diaphragmatic breathing is a foundational exercise for proper core engagement. To practice, lie on your back with knees bent and feet flat, placing one hand on your chest and the other on your belly. Inhale slowly through your nose, allowing your abdomen to rise as your diaphragm lowers, then exhale gently with a “shhh” or “haa” sound, feeling your belly fall, drawing your navel inward.
Pelvic tilts engage deep abdominal muscles and are a starting point for core rehabilitation. Begin by lying on your back with knees bent and feet flat. Gently press your lower back into the floor by tilting your pelvis upward, bringing your hips and ribs slightly closer together without lifting your buttocks. Hold this engagement for a few seconds, then release, focusing on a slow, controlled movement.
Heel slides strengthen the core, pelvic floor, and hip muscles while maintaining stability. Lie on your back with knees bent and feet flat. Engage your core, then slowly slide one heel along the floor, extending your leg straight while keeping your lower back pressed into the ground. Control the movement as you slide the heel back to the starting position, coordinating with your breath.
Toe taps strengthen abdominal muscles and improve stability. Start by lying on your back with knees bent and feet flat. Lift both legs into a tabletop position, with knees aligned over hips and shins parallel to the floor. While keeping your lower back flattened, slowly lower one foot to tap your toe on the floor, then use your abdominal muscles to bring it back. Alternate legs, ensuring your core remains engaged and your lower back does not arch.
Movements and Exercises to Avoid
Certain movements and exercises worsen diastasis recti by placing outward pressure on the abdominal wall. Avoid activities that cause “doming” or “coning,” where the abdomen visibly protrudes. Traditional abdominal exercises like crunches, sit-ups, and Russian twists should be avoided, as they direct pressure outward on the linea alba, increasing separation.
Full planks and standard push-ups can create intra-abdominal pressure and lead to doming if deep core muscles are not engaged. Double leg lifts, bicycle crunches, and some yoga poses like downward dog can also strain the abdominal midline. Heavy lifting without proper core engagement worsens the condition. High-impact cardio like jumping and running may exert forceful pressure on the abdominals and pelvic floor if core strength is not restored.
When to Consult a Professional
While self-guided exercises are beneficial, professional guidance is sometimes recommended. Consult a professional if there is a significant gap (wider than two finger-widths), or if symptoms like persistent pain, worsening abdominal bulging, or difficulty with daily tasks do not improve. Other signs warranting professional intervention include pelvic floor dysfunction, pain during intercourse, or ongoing urinary incontinence.
A women’s health physical therapist or specialized postpartum fitness professional can provide a personalized assessment and tailor an exercise plan. These specialists determine separation severity, address muscle imbalances, and teach proper core engagement. They offer expert guidance for safe, effective exercises, crucial for recovery and long-term core health.