Ultimate Guide to Diastasis Recti: What it is, What Causes it, How to Check for it, and How to Heal it

I discovered I had diastasis recti with our second baby girl. As soon as I discovered it, I went to work trying to repair it. In this post I’m going to explain what diastasis recti is, what causes it, how to check for it, how to heal it, and even what you can do to help prevent it.

how to heal diastasis recti

Below are the four main sections of this Diastasis Recti Guide. You can use them as the table of contents to take you to the specific information you’re searching for.

Under “How to Prevent Diastasis Recti” you will also find how you can check to see if you have abdominal separation.

 
 

I have to admit that I’ve allowed life to get in the way of my DR exercises the past several months. I’ve made some great progress, but I have a little ways to go before it’s gone completely.

Do you have diastasis recti? Or maybe you know someone who has been affected by it? As common as diastasis recti is, it’s more than likely you or someone you know has been impacted by it. But over the next weeks I am going to explain what exactly diastasis recti is, what causes it, how to prevent it, and how to heal it.

What is Diastasis Recti?

Diastasis Recti diagram courtesy of  Baby Center .

Diastasis Recti diagram courtesy of Baby Center.

The term “diastasis recti” is made of two Greek words: “diastasis” meaning separation and “recti” referring to the rectus abdominis muscle. Diastasis recti is a condition in which the right and left halves of the Rectus Abdominis muscle spread apart at the body’s mid line fascia, the linea alba. Pregnancy hormones combined with the uterus’ pressure against the abdominal wall cause a widening and thinning of the mid line tissue that softens the connective tissue. It can occur anytime in the last half of pregnancy but is most commonly seen after pregnancy when the abdominal wall is lax and the thinner mid line tissue no longer provides adequate support for the torso and internal organs. A space of more than 2 to 2.5 finger-widths, or 2 centimeters, is considered problematic, but can be repaired with the correct exercise program.

It is a fairly common condition and happens among 2 out of 3 women during pregnancy and postpartum. Having more than one child makes the condition more likely, especially if the children are close in age. It’s more common among women who are over 35 and pregnant, or those having a heavy baby, twins, triplets, or more. But women aren’t the only ones to experience Diastasis Recti. Newborn babies have been known to have Diastasis Recti as well, but usually goes away on its own. Men can also experience Diastasis recti from yo-yo dieting, poor sit-ups technique, or improper weightlifting.

The condition can cause lower back pain, constipation, and urine leaking. It can even make it harder to breathe and to move normally. In very rare, extreme cases, the tissue may tear, and organs may come through the opening resulting in a hernia.

But the good news is that it can be healed and I am going to help you!

What Causes Diastasis Recti?

Diastasis recti occurs when the uterus begins pushing against the abdominal wall. The pressure of the uterus along with the pregnancy hormones cause the midline tissue to widen and become thinner resulting in softened connective tissue. Diastasis recti is most common after pregnancy when the woman’s abdominal wall is soft. As a result the midline tissue no longer provides sufficient support to the woman’s internal organs.

Diastasis recti can be caused from several different issues including having more than one child, especially when the children are close in age. Women over the age of 35 also are more likely to experience Diastasis recti. Heavier babies or multiple babies born in the same pregnancy can also be a cause.

But did you know women aren’t alone in this experience? Newborns can also experience diastasis recti, but it will typically goes away on its own. And men have also been found to have diastasis recti. For men, it can be caused from yo-yo dieting, poor sit-up form, or other improper exercise techniques.

How to Prevent Diastasis Recti

How common is distasis recti? And can you prevent it? These are both common questions when talking about DR.

I have good news and I have not-so-good news. Let’s get the not-so-good news out of the way: diastasis recti is more common than you might think. According to WebMD, about two-thirds of pregnant women will experience it.

Now for the GOOD NEWS! Diastasis recti can be prevented!

[SIDE NOTE: Stay tuned – I’ll explain how to heal diastasis recti.]

Some women’s mid lines will close to less than 2 finger-widths after birth without doing anything. But this isn’t the case for many. For most women with diastasis recti, the tissue separation remains too wide and can end up causing problems. So let’s discuss what we can do to prevent this from ever being an issue.

Protecting your midline should be a top priority during pregnancy. Lynn of Intuitive Hands Physical Therapy in Colorado says women should be protecting their belly by contracting the belly button back toward the spine with everything they do during pregnancy. As with most prevention, diastasis recti can be avoided by following a few simple guidelines.

Protect your abdomen during coughing episodes

It may sound extreme, but even coughing can be a cause of diastasis recti. Should you catch a cold during your pregnancy, or experience a coughing episode, be sure to brace your abdomen with your hands during these episodes. Brace your abdomen by placing one hand in front of your abs and one on your back and holding securely.

Utilize the log roll method when getting out of bed (or couch)

Ben Butts, P.T., director of rehabilitation services and Performance Therapy at Providence Saint John’s Health Center in Santa Monica, California strongly recommends protecting your vulnerable abdomen from separation by using the log roll maneuver to help when getting out of bed, up off the couch, or off the floor (any time you are laying in a supine position). This is often a method healthcare providers recommend patients utilize in the hospital. Parents Magazine explains the log roll method as, “rolling onto one side with your torso and head aligned, then using your arms to help push yourself up to a sitting position.”

Use caution when lying down

When laying down, begin by sitting on the edge of the bed. Then pull your belly button back to your spine and lay down on your side pulling your legs up onto the bed. Following this step, place your head on the pillow while you are on your side. As you roll to your back make sure your stomach is once again contracted.

Maintain this method of lying down even after your baby is born.

Avoid certain yoga poses and abdominal exercises

There are many movements to avoid during pregnancy. Yoga poses that stretch your abs such as the cow pose, up-dog, backbends, and belly breathing exercises should all be avoided. Additionally, any pilates exercises that utilize a head float position, upper body flexion, or double leg extension should also be avoided. As a general rule, any yoga or pilates abdominal movement that stretches your abdomen should be avoided during your pregnancy.

Avoid any abdominal exercises that causes your abdomen to bulge during execution. Exercises such as crunches, sit ups, oblique curls, bicycles, and roll ups/roll downs should all be avoided. According to Intuitive Hands Physical Therapy, “Doing a crunch shortens the recti muscles and actually makes any separation worse.  When the muscles shorten they bulge out in the middle. Crunches also increases pressure in the pelvic bowl area. This can weaken the pelvic floor muscles and contribute to pelvic organ prolapse.”

Motherhood has enough difficulties. In the next section I’ll explain how you can check to see if you have diastasis recti and the exercises you can do to heal it.

how to check for diastasis recti

How to Check for Diastasis Recti

After reading all about diastasis recti, I’m sure you’re left with one question: “How do I know if I have diastasis recti?” Thankfully you can conduct an easy assessment on yourself to know if you have it and how severe it might be.

Diastasis recti self-assessment

1. Lie on your back with your knees bent, and the soles of your feet flat on the floor.

2. Place your palms on your belly with your fingers on your belly button.

3. Slightly lift your head and neck just off the floor while you press down with your fingers. If you feel a gap down the middle of your abdomen, that is the diastasis.

4. Do the same test right above your belly button and just below the belly button (the separation can vary in width in either location).

When conducting this simple test make sure that you’re using proper form. Simply lifting your head off the floor won’t accurately indicate whether you have diastasis recti or not. Your ribcage must move closer to your pelvis in order to contract your abdominals. Remember that everyone’s midline is lax following childbirth. You may even feel a “hole” while doing this exercise - don’t panic. With time, your midline tissue will become tighter and this hole will begin to disappear (or become more shallow).

If, while performing this exercise, you see a round, hard, bulge protruding from your belly button area, or along your mid line, inform your OBGYN. If not healed, diastasis recti can lead to lower back pain, constipation, and urine leaking. It can also make vaginal delivery more difficult for future pregnancies.

How to Heal Diastasis Recti

And now for your second burning question: “How do I heal diastasis recti?"

As stated in the previous post, "Diastasis recti: how many women get it? And how do you prevent it?” avoid any exercises, movements, or activities that place stress on your abdominal midline. Any movements that stretch or overly expand the abdomen should be avoided.

Unfortunately, there’s a wide range of advice available online that can make it very difficult to decipher what is best. You may have come across advice that has lead to unnecessary alarm or even worse, cause further separation if followed. In general, your midline should be treated delicately following childbirth. As with any new exercise or therapy program, you should consult your physician and/or physical therapist before you begin. Thankfully, there are many beneficial exercises that will heal your diastasis recti.

The following are a collection of safe and highly effective exercises that will help dissipate your abdominal separation and strengthen your midline following pregnancy.

I’ve found the following five exercises to be the most effective in healing my diastasis recti. Once you have accomplished the first four weeks, maintain the repetition schedule of Week 4 in order to heal your midsection.

Exercises to heal diastasis recti

Week 1:

Exercise 1

Single leg lifts

Repetition: 3 rounds of 5 per side

Exercise 2

Single leg tucks

Repetition: 3 rounds of 5 per side

Exercise 3

Cat-cow

Repetition: 3 rounds of 5

Exercise 4

Table-top

Repetition: 3 rounds of 5

Exercise 5

Single leg lifts

Repetition: 3 rounds of 5

Week 2:

Exercise 1

Single leg lifts

Repetition: 3 rounds of 10 per side

Exercise 2

Single leg tucks

Repetition: 3 rounds of 10 per side

Exercise 3

Cat-cow

Repetition: 3 rounds of 10

Exercise 4

Table-top

Repetition: 3 rounds of 10

Exercise 5

Single leg lifts

Repetition: 3 rounds of 10

Week 3:

Exercise 1

Single leg lifts

Repetition: 3 rounds of 15 per side

Exercise 2

Single leg tucks

Repetition: 3 rounds of 15 per side

Exercise 3

Cat-cow

Repetition: 3 rounds of 15

Exercise 4

Table-top

Repetition: 3 rounds of 15

Exercise 5

Single leg lifts

Repetition: 3 rounds of 15

Week 4:

Exercise 1

Single leg lifts

Repetition: 3 rounds of 20 per side

Exercise 2

Single leg tucks

Repetition: 3 rounds of 20 per side

Exercise 3

Cat-cow

Repetition: 3 rounds of 20

Exercise 4

Table-top

Repetition: 3 rounds of 20

Exercise 5

Single leg lifts

Repetition: 3 rounds of 20

Let me ask you:

What exercises have you used to heal your diastasis recti?


About the author:

Kara Swanson is a certified nutritionist and founder of Life Well Lived. She is married to her best friend and the proud mother of three. Her passion is to make nutrition simple+easy+delicious!