Understanding Diastasis Recti: What It Is and How to Manage It
Diastasis recti has gained significant attention in the pregnancy, postpartum, and fitness communities. As a pelvic floor and sports physical therapist, I often see female athletes expressing fear over this condition during pregnancy—often without fully understanding what it is (and what it isn’t). This blog post aims to demystify diastasis recti, explain how to assess it, and offer guidance on effective management strategies.
What is Diastasis Recti?
Diastasis recti is the natural stretching and thinning between the two rectus abdominis muscles that occurs during pregnancy to accommodate the growing baby. This is due to the softening of the linea alba, the connective tissue that runs along the midline of the abdominal muscles. Hormonal changes and increased laxity contribute to this softening, allowing more space between the rectus muscles. Importantly, diastasis recti is not preventable and occurs as a normal adaptation to pregnancy.
How to Check for Diastasis Recti
You can perform a self-check at home to measure the width and depth of the gap between your rectus muscles. This serves as a baseline to track improvement over time.
Steps to Perform a Self-Check:
Lie on your back with your knees bent and feet flat on the floor.
Lift your head and shoulders slightly off the ground.
Using your fingers, palpate above your belly button, feeling for the two rectus muscles on each side and the gap between them.
Measure the width of the gap by placing your fingers horizontally between the muscles.
Assess the depth of the gap by gently pressing down and seeing how far your fingers can sink.
Assess the tension within this space? Does the tissue have any stiffness to it or is it really compliant?
Repeat this assessment at and below the belly button.
What to Do If You Have Diastasis Recti
Understanding the Condition
Nearly 100% of pregnant individuals will experience diastasis recti to some extent, whether they notice it or not. You may observe a coning or doming along the midline of your abdomen during certain activities that increase intra-abdominal pressure, such as:
Sitting up out of bed
Lifting heavy objects
Performing abdominal exercises that load the anterior abdominal wall
If you notice coning or doming, try engaging your deep core muscles for additional support and exhaling during exertion. If you still struggle with controlling the doming, consider modifying the movement to reduce pressure on the abdominal wall. A pelvic floor physical therapist can help you learn these strategies effectively.
Why Do Some Cases Resolve While Others Persist?
It is still unclear why some cases of diastasis recti heal naturally postpartum while others require intervention. This remains an area lacking extensive research. Several factors may influence recovery, including:
Collagen structure and tissue elasticity
Number of pregnancies and carrying multiples
Size of the baby and rate of abdominal expansion
How to Strengthen the Abdominal Muscles Postpartum
What we do know is that these tissues respond well to strength training. The focus should be on improving tension and strength across all the abdominal muscles, including:
Transverse abdominis
Internal and external obliques
Rectus abdominis
Rather than solely aiming to “close the gap,” the primary goal in physical therapy is to build tension in the abdominal muscles, making daily movements and loaded exercise more manageable over time.
Key Takeaways
Diastasis recti is a natural and necessary adaptation during pregnancy, not something to fear.
Performing a self-assessment can help track progress, but professional guidance may be beneficial.
Engaging the deep core, modifying movements, and core strength training are effective ways to manage symptoms.
The focus should not be on eliminating the gap entirely, but rather on restoring strength and function in the abdominal muscles.
In summary, diastasis recti is a manageable condition that should not prevent you from returning to the exercises and activities you enjoy. Awareness is important, but it’s equally crucial to avoid fear-based movement restrictions. If you need guidance, working with a pelvic floor physical therapist can help you regain confidence in your movement and strength.
