Most often seen in women during the third trimester of pregnancy and postpartum, diastasis recti, or abdominal muscle separation, is a common condition caused by increased pressure on the abdominal muscles. While most cases can resolve on their own over time, diastasis recti repair may require physical therapy, at-home exercise programs, or surgical intervention in order to restore proper muscle function.
While diastasis recti is not painful or dangerous, leaving it untreated can lead to complications such as umbilical hernia, lower back pain, and urinary incontinence. Let’s take a closer look at this condition and the treatment options that are currently available.
What Is Diastasis Recti?
Diastasis recti is a condition that affects the rectus abdominis muscles, also known as the muscles that make up the well-known six-pack. The rectus abdominis muscles run vertically in your front stomach section and are divided into both a left and right side by a tissue band known as the linea alba.
During pregnancy, as your uterus grows to support your growing baby, it places pressure on the abdominal muscles, stretching them out and causing the linea alba to thin and pull apart. In many cases, this rubber band-like tissue retracts back into place a few weeks after delivery, however, if it does not, it is considered diastasis recti, continuing to cause the belly to stick out and continue making you look pregnant.
Complications from Diastasis Recti
If diastasis recti does not improve on its own and goes untreated, it can lead to complications such as:
- Lower back pain
- Urinary incontinence, especially when you cough or sneeze
- Pelvic pain
- Hip pain
- Painful intercourse
- Umbilical hernia
- Pelvic floor dysfunction
How Do You Know If You Have Diastasis Recti?
Diastasis recti does not cause any pain or discomfort directly, but you may notice pain or discomfort associated with some of the complications it contributes to, such as core weakness or lower back pain. The most common sign you may have this muscle separation is a bulge in your abdominal area that does not go away despite losing your pregnancy weight. You can test at-home for diastasis recti by following these steps:
- Lie on your back with your knees bent and feet flat.
- Lift your shoulders up in a sit-up like position with one hand behind your head for support.
- Take your other hand and place it palm down on your belly, with your fingers pointing towards your toes.
- Feel for a gap between your left and right rectus abdominis muscles and, using fingers, measure the space within the gap. If this measures two or more fingers in width, you have diastasis recti and should talk with your physician.
Treating Diastasis Recti
The first course of treatment for diastasis recti is physical therapy and at-home exercises designed to engage the deep abdominal muscles. These include exercises designed to stabilize your core muscles. However, common abdominal exercises, such as sit-ups or crunches, can actually make it worse. You will need to follow the exercise plans your physical therapist advises.
If physical therapy is unsuccessful, you can opt for surgical repair. A tummy tuck procedure not only allows you to remove excess fat tissue and stretched skin but allows the surgeon to repair these stretched muscles and give you the pre-pregnancy body contours you have worked hard to achieve.
Preventing Diastasis Recti
While there is no way to avoid abdominal muscle separation during pregnancy, there are things that you can do to reduce your risk of diastasis recti both during pregnancy and postpartum.
- Maintain healthy weight gain during pregnancy.
- Avoid core exercises such as sit-ups and crunches after the 12th week of pregnancy and until your abdominal muscles heal during postpartum recovery.
- Maintain proper posture by standing up straight with your shoulders back and breathe deeply in order to expand both your ribs and belly.
- Reduce the amount of lifting you do postpartum, as this can put additional strain on your abdominal muscles. This includes carrying your young children or lifting heavy bags from the store.
If you believe you have diastasis recti, talk with your doctor about your exercise options. If, after giving them a try, you are still living with muscle separation, consider a tummy tuck to not only correct your separated muscles. This might also be the time to consider a mommy makeover where you can address many areas, such as a tummy tuck and a breast augmentation, that will help you achieve your pre-pregnancy shape.
Dr. Kobienia is a board-certified plastic surgeon who has provided the greater Minneapolis, MN, area with plastic and reconstructive surgery for over 20 years. Many have benefited not only from his expertise in plastic surgery, but also the genuine kindness and professionalism in his approach.
