What Is Diastasis Recti, and Why Does It Happen During Pregnancy?

The separation of abdominal muscles during pregnancy.

Welcoming twin boys, Asher and Aksel, into the world in November 2019, professional volleyball player Morgan Miller, who is married to former Olympic skier Bode Miller, shared a relatively common yet often unspoken consequence of pregnancy and childbirth. On her Instagram page, Miller candidly revealed that she’s experiencing diastasis recti, a condition characterized by the separation of the abdominal muscles. Even 14 months postpartum, she continues to grapple with this issue, displaying a noticeable dent down the center of her stomach, and she’s taken to social media to share her journey of recovery and healing.

Understanding Diastasis Recti

Diastasis recti, a condition of separated abdominal muscles, can be a significant concern for women who have gone through pregnancy and childbirth. During pregnancy, the linea alba, which is the central seam of the abdomen, naturally thins out to accommodate the growing uterus. This stretching of the abdominal muscles is a normal and expected part of pregnancy. In most cases, this stretching resolves on its own postpartum, often as early as 12 weeks after giving birth. However, approximately 30% of women continue to experience diastasis recti after pregnancy.

It’s important to clarify that diastasis recti is not a tearing of the abdominal muscles; rather, it involves the stretching and widening of the linea alba, causing the two sides of the rectus abdominis muscles to move farther apart. The extent of this stretching is not as crucial as its depth and the ability to generate tension. Even with a mild diastasis, individuals can still generate tension to support their core.

Factors Contributing to Diastasis Recti

The likelihood of developing diastasis recti can be influenced by various factors. Genetics play a role, particularly the presence of strong collagen, which is the primary structural component of connective tissue. Strong collagen aids in the thickening of the linea alba after delivery and helps generate the necessary tension to restore the abdominal wall. Unfortunately, collagen production is genetic, and individuals with thin skin or those who tend to bruise or tear easily after minor injuries may produce less collagen. This reduced collagen production increases the chances of not fully restoring pre-pregnancy tension in the linea alba.

Having multiple pregnancies, especially close together, can also increase the risk of diastasis recti. Furthermore, the likelihood of developing this condition is higher for individuals who become pregnant at or after the age of 35, those expecting a heavy baby, or those carrying multiple babies.

Recognizing Diastasis Recti

Identifying diastasis recti involves looking for certain signs and symptoms. The most noticeable sign is a bulge in the middle of the abdomen. Sometimes, this bulge may not be apparent until tension is created, such as during activities like coughing. Individuals can also use their fingers to assess their condition. By feeling the vertical line above or below the navel, they can determine if there is any separation. The ability to fit one or two fingers in between is usually considered normal, while three or more fingers suggest the presence of diastasis. A gap of more than 2 centimeters, slightly over half an inch, is deemed abnormal.

Treating Diastasis Recti

Many individuals turn to exercises as a means to address diastasis recti. The key lies in improving core function and adopting proper diaphragmatic breathing techniques. However, it’s essential to commit to an appropriate exercise program, as results may not be immediately visible.

Consulting a physical therapist with expertise in women’s health is advisable for measuring diastasis and identifying the most effective exercises to generate tension or close the gap. These exercises often focus on coordinating the deep abdominal muscles to bring tissues together, ultimately producing the supportive tension required for healing.

Morgan Miller, for example, began her postpartum journey with a regimen that included physical therapy and basic pilates just two weeks after giving birth. She emphasizes the importance of performing exercises correctly, particularly by engaging the abdominal muscles and the pelvic floor. For instance, during crunches, she ensures that her stomach moves inward, creating the desired dent, rather than outward, which can strain the abdominal area.

Crucially, it’s absolutely essential to exercise caution and avoid engaging in activities that could exert undue pressure on the abdominal area, as these activities have the potential to further stretch the delicate linea alba or impede the reconnection process with the muscles responsible for providing essential support. Such activities explicitly include traditional curl-ups, sit-ups, or any form of abdominal exercises that entail lifting the head off the floor while in a supine position or maintaining the legs parallel to the ground, as these movements may inadvertently exacerbate the condition and hinder the progress of diastasis recti recovery. Instead, it’s advisable to prioritize gentle and diastasis-safe exercises recommended by a healthcare professional to facilitate healing without compromising the abdominal integrity.

Moreover, it’s crucial for individuals to exercise patience and maintain realistic expectations, as the natural healing process can take up to a substantial 18 months for collagen to realign and close the abdominal gap fully. During this time, consistent adherence to recommended exercises and lifestyle modifications is essential. If, even after this extended period, they still find themselves struggling to generate sufficient abdominal tension to adequately support the back and pelvis, surgical intervention may emerge as a viable consideration, especially if the diastasis recti persists, measuring larger than three fingers in width. However, it’s always advisable to consult with a skilled healthcare professional to explore all available options and make an informed decision about the most appropriate course of action for their specific case.

In addition to the exercises recommended by a knowledgeable physical therapist, maintaining proper posture and avoiding heavy lifting, especially when carrying a baby on one hip, are absolutely crucial for diastasis recti recovery. It’s vital to approach the healing process with unwavering diligence and patience, as the path to recovery can differ significantly for each individual. Ultimately, raising awareness, gaining in-depth knowledge, and seeking expert guidance from healthcare professionals play pivotal and indispensable roles in effectively addressing and successfully managing diastasis recti for those who experience it during or after pregnancy. It is essential to prioritize self-care and well-being while navigating this journey, as a holistic approach to healing often yields the best results.