The sensation of your stomach feeling “split in two horizontally” can be concerning, but it often points to a common physical change rather than a problem with internal organs. This visible separation in the abdominal area is frequently associated with diastasis recti abdominis. This article explains its causes, identification, and management.
Understanding the “Split” Sensation
The perceived “split” in the abdominal area is not a division of an organ, but a separation of the outermost abdominal muscles. These muscles, the rectus abdominis (or “six-pack abs”), run vertically and are divided by the linea alba. This fibrous band of connective tissue extends from the breastbone to the pubic bone, acting as a central seam that stabilizes the abdominal wall.
Diastasis recti abdominis (DRA) occurs when the linea alba stretches and widens, creating an increased gap between the left and right rectus abdominis muscles. When these muscles contract, the separation can become more noticeable, sometimes appearing as a ridge or bulge down the belly’s midline. While DRA is typically not painful, weakened core support can lead to other discomforts. The linea alba’s elasticity allows it to stretch and retract, but excessive stretching can cause it to lose its original tension, leaving a persistent gap.
Common Causes of Abdominal Separation
Several factors contribute to the stretching and weakening of the linea alba, leading to diastasis recti. Pregnancy is the most frequent cause, affecting a significant number of women, with estimates suggesting it impacts up to 60% of women during or after pregnancy. The expanding uterus exerts considerable pressure on the abdominal wall. Hormonal changes during pregnancy also soften connective tissues, making the linea alba more prone to stretching. The issue arises when the connective tissue is damaged and the separation does not resolve postpartum.
Beyond pregnancy, other factors can also lead to diastasis recti. Conditions that increase consistent intra-abdominal pressure contribute to the separation, including significant weight gain or obesity. Improper core exercises, particularly those that cause the abdomen to bulge outwards like traditional crunches or sit-ups, can worsen or even cause DRA. Chronic straining from issues such as persistent constipation or a chronic cough can also exert enough repetitive force to stretch the connective tissue. In some instances, DRA can even be present from birth in newborns, especially premature infants, due to underdeveloped abdominal muscles.
Identifying Abdominal Separation
You can perform a simple self-test to check for diastasis recti:
- Lie on your back with your knees bent and your feet flat on the floor.
- Place one hand behind your head for support.
- Position the fingers of your other hand, palm down, on your midline just above your belly button.
- Gently lift your head and shoulders slightly off the ground, as if performing a mini-crunch, ensuring your neck remains relaxed.
- As you lift, feel for a gap or separation between the left and right sides of your abdominal muscles.
Assess both the width and depth of any felt separation. Diastasis recti is indicated if you can fit two or more fingers into the gap between the muscles. The depth of the separation also provides insight into the linea alba’s integrity; a shallow, taut gap is less concerning than a deep, soft one. Besides the visible gap, common symptoms include a persistent “pooch” or bulge in the abdomen, lower back pain, poor posture, and pelvic floor dysfunction, such as urinary incontinence.
Managing Abdominal Separation
Managing diastasis recti often begins with non-surgical approaches, focusing on strengthening the deep core muscles and improving body mechanics. Targeted physical therapy exercises are a primary method, emphasizing activation of the transverse abdominis, a deep abdominal muscle that acts like a natural corset. Exercises like abdominal bracing, pelvic tilts, heel slides, and toe taps can help engage and strengthen this muscle without putting undue pressure on the separated rectus abdominis. Avoid exercises that can worsen the separation, such as traditional crunches, sit-ups, and full planks, as these can increase intra-abdominal pressure and cause the abdomen to bulge.
Proper breathing techniques, such as diaphragmatic breathing, are also crucial for engaging the deep core and reducing abdominal pressure during movement. Supportive garments or belly binders can offer temporary external support and may help reduce symptoms, especially during physical activity. However, these are not long-term solutions and should be used in conjunction with a comprehensive exercise program.
For more severe cases where non-surgical methods do not yield sufficient improvement, surgical options may be considered. These procedures, often performed as part of an abdominoplasty or “tummy tuck,” involve stitching the separated muscles back together to repair the abdominal wall. This surgical repair can significantly improve core strength, reduce abdominal bulging, and enhance posture.
When to Consult a Doctor
While many cases of diastasis recti can be managed with conservative measures, it is advisable to consult a healthcare professional if you suspect you have the condition. An accurate diagnosis can be made by a doctor or physical therapist, who can assess the extent of the separation and rule out other potential issues, such as a hernia. Seeking professional guidance is particularly important if you experience persistent discomfort, pain, or functional problems like chronic lower back pain, difficulty performing daily tasks, or pelvic floor dysfunction.
A physical therapist specializing in core rehabilitation or pelvic floor health can provide a personalized exercise plan and ensure you are performing movements correctly to avoid further strain. They can also help address associated symptoms like poor posture or incontinence. If conservative treatments do not provide satisfactory results after several months, or if the separation is severe, your doctor may discuss surgical options. Waiting at least 6 to 12 months postpartum for the body to naturally heal is often recommended before considering surgery. A medical evaluation ensures you receive the most appropriate treatment for your specific situation.