The term diastasis recti doesn’t always surface in conversations about pregnancy and postpartum life. Yet nearly 60% of women develop the condition during one of these phases.
Diastasis recti is characterized by an abdominal bulge between the right and left stomach muscles and a resulting protruding belly. It occurs when the rectus abdominis, or six-pack muscles, separate as a result of pressure on the connective tissues.
Risk factors for postpartum diastasis recti include if:
There are also controllable risk factors, including poor breath control and postural misalignment.
Postpartum diastasis recti may naturally resolve itself within eight weeks, typically in mild cases with less severe abdominal separation. However, 40% of those with the condition still have a separation at six months postpartum.
As is often the case with postpartum complications, birthing people with long-lasting diastasis recti have to search a little too hard for the information they need to heal.
To help you better understand this common and treatable condition, we’ve answered some frequently asked questions about diastasis recti.
Diastasis recti is caused by increasing pressure on your abdomen from your expanding uterus and growing baby.
Your rectus abdominis muscles run from your sternum to the pubic bone. The two sides are separated by a thin band of connective tissue at the midline called the linea alba.
Throughout pregnancy, the weight of your growing baby pushes down on your pelvic floor and outward against the abdomen. This stretches the linea alba, leading to increased separation between the left and right rectus abdominal muscles.
Pregnancy hormones can also contribute to the stretching of the linea alba.
The linea alba also attaches to the pubic symphysis — a joint located between the left and right pubic bones near the midline. Its expansion during pregnancy can also impact pelvic floor function.
In a woman’s first pregnancy, the separation of the rectus abdominis typically develops during the third trimester. This is because your quickly growing baby puts increasing amounts of pressure on the muscles. During subsequent pregnancies, abdominal separation can develop earlier, sometimes occurring before pregnancy.
For those who do not develop diastasis recti, the linea alba naturally retracts due to its elasticity after delivery. But if the linea alba loses elasticity from the stretching of the connective tissue during pregnancy, the gap will not close on its own. This can result in the abdominal separation of diastasis recti.
Both vaginal and c section delivery affect the abdominal muscles and can cause postpartum diastasis recti. Some research has found that the condition is more common in women who have given birth by c section.
The nature of c section delivery and recovery can weaken the core, resulting in diastasis recti. Discomfort around the incision site and the process of healing from the c section can also impact core function.
If you have diastasis recti after a c section, it’s especially important to work with an experienced physical therapist. These individuals can make sure you’re practicing safe, appropriate exercises that foster your healing and build strength.
Ruth Health’s c section recovery sessions provide emotional and physical support after a c section. This includes breathwork and meditation, gentle movement, and stabilizing physical therapy. You can start as early as 24 hours postpartum.
The condition can be treated with gentle diastasis recti pelvic floor exercises that control breathing and abdominal pressure. Surgery is not necessary in the majority of diastasis recti cases but may be recommended if you have a hernia.
A physical therapist or other professional experienced in the treatment of diastasis recti can make individualized recommendations. In addition, they can help you build up to more challenging movements, if and when appropriate.
As you heal from diastasis recti, there are some activities and exercises to avoid, including crunches and heavy lifting. Use breath control and full-body movements rather than your core when getting out of bed or standing up after sitting.
Wearing a gentle belly wrap early in postpartum will not heal diastasis recti. However, it can promote good posture and support your lower back, which may aid in the recovery process.
Healing diastasis recti looks different for each individual. It can take several weeks or months. The specific timeline depends on both the size of the abdominal separation and the consistency of your physical therapy.
Some diastasis recti pelvic floor exercises are more effective than others at correcting the condition. This is why it’s important to work with an experienced physical therapist and follow their recommendations.
Case in point — oblique exercises were once seen as a standard first step in diastasis recti treatment. Yet there’s growing research that overtraining these stomach muscles during pregnancy and postpartum can worsen the diastasis and tax the psoas.
Instead, tap into the power of simple, supportive movements and try to reconnect to your core through breathwork and paying more attention to your intra-abdominal pressure. This will provide a solid foundation for your physical therapy and help to ensure that exercises engage the right muscles.
Be sure to avoid any movement that pushes the belly out. Here are potential supine exercises — meaning exercises performed while lying on your back — to add to your workout:
Some amount of abdominal separation is to be expected during pregnancy. You can lower your risk of developing more severe postpartum diastasis recti by doing the following.
Starting a pregnancy exercise class can help you stay active and healthy. In addition, working with a physical therapist can help you avoid exercises that put too much pressure on your core muscles.
We’ll help you heal your diastasis recti
No two post-pregnancy bodies are built the same. At Ruth Health, we take an individualized approach to pelvic floor training and c section recovery.
Our 30-minute virtual sessions blend physical therapy with fitness to deliver what your body needs as you heal your diastasis recti.
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