Understanding and Preventing Diastasis Recti (Abdominal Separation)


If you are currently pregnant you may well have been reading up on what you can do to take care of your body and the different types of exercise you should or shouldn’t be doing. You may well have also read about the risks of developing a “mummy tummy” or “separated abs”, otherwise known as a diastasis recti. So what exactly is it? How worried should I be? And what can I do to prevent it?

What is diastasis recti?
Diastasis recti is a condition characterized by the separation of the abdominal muscles, specifically the rectus abdominis (your six-pack muscle). Diastasis recti occurs when the connective tissue (the linea alba) that holds the rectus abdominis muscles together becomes stretched and weakened. This results in a separation of your six pack muscle, typically along the midline of the abdomen. During pregnancy, the growing uterus and hormonal changes contribute to the development of diastasis recti and it is estimated that 100% of women will have a diastasis by their 3rd trimester. Our bodies are designed this way so our abdomen can adjust and adapt to the growing baby.

diastasis recti treatment

It is worth noting that whilst this condition is most commonly pregnancy related, it can also affect men and women outside of pregnancy. Anything that places repetitive, excessive pressure on the linea alba can eventually result in a diastasis – examples include obesity, repetitive heavy lifting, and chronic coughing.

While diastasis recti is not inherently dangerous, it can lead to various complications, such as lower back and/or pelvic pain, pelvic floor dysfunction (i.e. incontinence), postural dysfunction, a weakened core, and cosmetic issues with abdominal muscles that look like they’re bulging or doming. Fortunately there are preventive measures you can take to minimize the risk of developing diastasis recti.

How do I know if I have it?
You can do a little test yourself to check whether you have diastasis recti. Lie on your back with your knees bent and feet flat on the floor. Place your fingers horizontally across your abdomen, just above the belly button. Gently press down and lift your head and shoulders off the ground. If you feel a gap between the muscles or notice a bulge, you may have diastasis recti. Whilst this is a useful self-
test, we recommend you wait until you are at least 8 weeks post-partum before assessing for a diastasis as everyone will have some degree of separation in the immediate aftermath of delivery which can take up to 12 weeks to heal.

There are some predisposing factors, however, that may impact how well or to what extent the separation resolves naturally. These are:

  • Multiparity (having more than one pregnancy)
  • Carrying multiples
  • Your genetics
  • Your age
  • Hormones that cause connective tissue to soften

Despite the above, there are still many things that you can control to help reduce your chances of developing a prolonged post-partum diastasis.

Preventing Diastasis Recti:

  1. Pay attention to your posture. During pregnancy your centre of gravity will shift forwards, creating an excessive arch in your lumbar spine and drawing your pelvis forwards into an anteriorly tilted position. This shift in posture can put more strain on your already stretched abdominal muscles and can contribute towards a diastasis. Practicing better posture during the day will not only help reduce the risk of developing an diastasis but is also essential for overall core strength and stability. Whether you’re pregnant or not, make a conscious effort to sit and stand tall, aligning your spine and engaging your core muscles. This helps distribute the load more evenly across the abdominal area.

    When standing try:
    – Lengthening through the back of your neck, stacking your ears over your shoulders
    – Soften through the rib cage and stack your ribs over your hips
    – Shift your hips back with your weight evenly distributed through the arches and heels of your feet
  2. Exercise during pregnancy is hugely beneficial for many reasons but certain precautions need to be taken to make sure it is safe. Modifying how your strengthen your abdominal and core muscles is necessary in order to reduce amount of strain placed on the linea alba. Planks, sit-ups and crunches are a no-go and can be replaced with modified versions that focus on strengthening the deep core muscles (such as the transverse abdominis and pelvic floor muscles) which can provide additional support to the rectus abdominis muscles. Working alongside a women’s health care practitioner who specialises in pre-natal exercise is highly recommended.
  3. Being mindful of how you move, especially as your delivery date approaches, will help prevent unnecessary strain on the abdominal muscles and the linea alba.

    – When getting out of bed try rolling onto your side and using your arms to help push you upright rather than opting for the more usual “sit-up” movement.

    – When getting up from the sofa you can shuffle your bottom forwards to the edge of the chair, place your feet slightly wider than hip width apart, hinge forwards at the hips bringing your nose over your knees. Then exhale as you push through your legs and rise a standing position.

    – When lifting heavy objects, be sure to engage your core muscles and avoid straining the midline of your abdomen. Instead of bending forwards to lift, squat down and use your leg muscles. Exhaling as you push back up into standing will help minimize stress through the linea alba.
  4. Don’t strain to poop. Constipation can be an issue for some women during pregnancy and repeated straining when on the toilet can increase your intra-abdominal pressure, which will in turn place extra pressure through the linea alba. Try to maintain healthy bowel function by eating a diet rich in fibre, drinking enough water, and maintaining regular exercise. Another simple step is to start using a toilet stool. Propping your feet on a step and bringing your knees higher than your hips will help your natural bowel movements and hopefully means you don’t have to push too hard.
  5. A gradual and graded return to exercise postpartum is always advised. After giving birth it’s important to ease back into exercise to allow your body time to heal and to work on regaining core strength. Often specific exercises are needed to help bring tension and integrity back into the linea alba, together with pelvic floor muscle retraining, before heading straight back to running, weight lifting, and other more intense and high impact exercise. Consulting and working with your women’s health practitioner for specific advice and exercises is highly recommended.

If you want any further information regarding diastasis recti or how you might best go about preventing prolonged issues post-partum, please don’t hesitate to reach out to us at Hong Kong Sports Clinic. Our team of highly dedicated women’s health care professionals are on hand to answer any query you might have.

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