Updated: Mar 28
Abdominal separation (Diastasis Recti) is the most VISIBLE of the common pregnancy and postpartum core conditions. As such, it often gets the most attention. Here's a quick primer on what is, why it's a problem, what you can do about it and when you should ask for help.
So, what is it?
First and foremost, it is your body’s way of stretching to make space for baby. The line of connective tissue that runs down the midline of your abs stretches and thins, which gives the appearance that the 6-pack muscles are moving away from one another. Diastasis can take a variety of shapes, as illustrated in the image below. It’s very common, very normal and happens to nearly every pregnant person.
Curious to know the status of your midline? Click here for a quick and dirty guide to self-assessing yourself. If you have any concerns, connect with a pelvic health physical therapist (see below).
Why is Diastasis Recti a problem?
If you have a wider diastasis that does not generate tension, your core might not feel very strong. If your core isn’t able to generate tension it won’t be able to do a good job creating the central stability you need to complete everyday tasks or exercise (making all those things much more difficult). If this is the case, you will use other parts of your body to compensate and this might lead to secondary aches and pains elsewhere in your body.
What can you do (besides booking that PT appointment)?
The first place to start is by bringing awareness to your body alignment, learning to breathe in a coordinated fashion and by coordinating your breathing to movement. For example, you can use your breath by exhaling through pursed lips during the hardest parts of your exercises or daily activities (think, lifting groceries or carseat). Pay attention to your abdominal muscles and watch out for any activities that cause a bulging, doming or coning of your abdominal midline. Bulging, doming or coning indicates that you could use some help managing your intra-abdominal pressure during that activity.
Doming is a manifestation of less-than-optimal management of intra-abdominal pressure (pressure generated in your abdomen) during exertion. By itself, it is not dangerous; it is an indication that you can improve your pressure management strategies. Here are two photos of different presentations of doming in pregnant bellies.
To learn more about breathing strategies that can help manage symptoms like doming, coning or bulging, read this post on Breathing Strategies in Pregnancy and Postpartum.
When is it time to ask for help?
Well, most of the time, the abdominal separation resolves by 6-8 weeks postpartum. When considering whether or not the diastasis has “healed” or not, we look at whether or not a person can generate tension through the tissue. The ability to generate tension is much more important than the absolute size of the gap. And the gap will not return to zero, friends. It probably didn’t start at zero either (did you check before pregnancy??). At 8 weeks if you still have a gap significantly greater than 2 finger widths apart or one that is very squishy, make an appointment with a pelvic floor PT. You might also look for a postnatal fitness specialist to work with in the mean time. There’s a lot we can do to help optimize your breathing, alignment and movement strategies to promote healing.
For more information on rehabbing a diastasis recti or co-managing a diastasis and prolapse, check out the following links:
This is a fantastic FREE resource that covers a ton of ground. Check this out to learn more about breathing, alignment and exercise considerations if you are trying to heal a diastasis. If you are an athlete or fitness buff, I highly highly recommend this.
2. Social media (Instagram)
In addition to Brianna Battles (@briannabattles and @pregnant.postpartum.athlete, author of the abovementioned ebook), check out @munirahudanipt for super up-to-date and cutting edge education and exercise considerations.
3. What if you are co-managing a diastasis and something else, like a prolapse? I’m linking to two great posts by POP UP (@popuplift) and Dr. Munira Hudani (@munirahudanipt) that discuss the relationships between these conditions and considerations for co-managing them.
@popuplift: DRA & POP
@munirahudanipt: Diastasis Recti Abdominus vs. Pelvic Organ Prolapse
Bonus points: If you'd really like to nerd out with me, you can join me in reading Diastasis Recti by Katy Bowman. I can't officially recommend it yet, since I've just started it. But if you have read it, or would like to read it, let me know and maybe we can talk about it when I'm (we're) done!
If you’re looking for information you aren’t finding here, please send me a message. I can probably help you find what you need!