Written By: Dr. Shraddha Wagh PT, DPT, PCES
Are my abs split in two or torn due to my diastasis from pregnancy? — NO!
Diastasis recti (DRA) can occur due to increased stretching in the outermost layer of abdominal muscles. It is commonly seen during pregnancy and postpartum but can also occur in males and females with excessive or rapid weight gain in the abdomen.
The rectus abdominus (RA), also known as the six-pack muscle, is one of the superficial core muscles. The RA’s main job is forward flexion, such as performing a crunch or a sit-up. Both sides of the rectus abdominus muscle are connected by a line of connective tissue known as the linea alba. When the skin and muscles of the abdomen stretch rapidly (common during pregnancy), the linea alba gets pushed outward and stretches. It does NOT separate or split apart!
What does DRA look like and how can I test myself for it at home?
DRA can look different in each person! Some common presentations are:
- A bulge or pooch in, at, above, or below the belly button
- Deep valley that you can sink your fingers into in the middle of your belly
- Distension or protrusion of the belly with movement such as lifting the head, legs, or rolling
To test for DRA at home:
- Lay down on your back with your knees bent.
- Apply pressure with 2-3 fingers in the center of your stomach and gently lift your head up as if you were performing a crunch. Repeat this above and below the belly button.
- If you feel a gap of over > 2 finger widths (~ 2 cm), you may have a diastasis. In addition to feeling how wide the space is, you also want to apply gentle pressure with your finger to assess the depth and if you can feel the pressure of the core muscles against your fingers.
Is there anything I can do to prevent DRA before or during my pregnancy?
There are many factors that can contribute to the development of diastasis such as: age, size, skin tensile strength, size of baby, type of delivery, and history of previous pregnancies. While there is no one set thing that can fully prevent DRA, there are a lot of things you can work on with a pelvic floor PT to reduce the risk of developing it. Pelvic PT’s can work with patients before, during, and after pregnancies to prevent or reduce the development of DRA through soft tissue and fascial mobilizations, breathing exercises, mobility exercises, and progressive core strengthening.
I have a diastasis recti! What should I do to fix it?
For DRA to heal, it is important to practice deep core activation and manage the pressure within your abdomen with all daily activities including bending, lifting, and squatting. Take time to focus on building a mind body connection with your core and abdominal muscles and engage them with movements like exercising or picking up a small child.
The transverse abdominus (TA) is the deepest core muscle that primarily serves as a stabilizer muscle. The TA helps to manage pressure in the abdomen and can help with the depth of a diastasis recti.
To turn on the TA muscle:
- Start on your back with your knees bent (note: the TA can be activated in any position, but this is usually the easiest position to start)
- Practice performing deep inhales through the nose and exhales through the mouth. As you breathe out, gently pull your stomach up and in as if you were trying to flatten it against your back, or as if you wanted to zip up your belly from the bottom to the top. Imagine pulling your abdomen in to fit into a tight pair of pants!
- When done correctly, you should notice flattening and hollowing of the stomach. This activation can and should be performed with all movements to avoid any extra abdominal pressure or stretching of diastasis.
Try this corrective exercise if you have a DRA!
- Lay on your back with your knees bent. Place a bed sheet or towel under your back and crisscross it around your abdomen.
- As you exhale and engage your deep core (TA) muscles, use the ends of the sheet to approximate your diastasis and pull it towards midline to “close” the gap. Using the sheet for closure not only teaches your brain and body the proper position for the skin and muscles, but it also allows you to control the pressure in your abdomen before performing a movement.
- Lift your head as if performing a crunch while activating your TA. When done correctly, the belly should remain flat with no gapping or doming. Alternatively, you can perform less of a head lift (i.e. think 50% head lift) if you do notice doming or bulging at the belly.
- Practice 2-3 sets x10 reps daily
If you test yourself for diastasis at home, it is always important to follow up with a trusted provider to confirm the diagnosis and provide education on how to treat it. Contrary to popular belief, crunches and sit-ups DO NOT heal diastasis & can sometimes actually make it worse! There are several progressive strengthening and mobility exercises that can be used to treat DRA – consult your local pelvic floor PT for an individualized program.
Rebuild Your Core with Expert Pelvic Floor Support
If you suspect diastasis recti or want to prevent it during or after pregnancy, the pelvic health team at JAG PT is here to help. Our therapists provide personalized care plans focused on deep core activation, safe movement, and long-term recovery. Book your evaluation today and take the first step toward a stronger, more supported you.
Sources:
Chiarello, C. M., Falzone, L. A., McCaslin, K. E., Patel, M. N., & Ulery, K. R. (2005). The effects of an exercise program on diastasis recti abdominis in pregnant women. The Journal of Women's & Pelvic Health Physical Therapy, 29(1), 11-16.
Gluppe, S., Engh, M. E., & Bø, K. (2021). What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review with meta-analysis. Brazilian journal of physical therapy, 25(6), 664-675.
Michalska, A., Rokita, W., Wolder, D., Pogorzelska, J., & Kaczmarczyk, K. (2018). Diastasis recti abdominis—a review of treatment methods. Ginekologia polska, 89(2), 97-101.
Nahabedian, M. Y. (2018, August). Management strategies for diastasis recti. In Seminars in Plastic Surgery (Vol. 32, No. 03, pp. 147-154). Thieme Medical Publishers.
