Diastasis Recti is a common condition in postpartum women – here’s what you need to know about what it looks like and how to tackle it.
One thing I loved doing during pregnancy was checking how big my baby was getting. The fruit comparisons were fun – “your baby is as big as a grapefruit”!
Of course, by the end of it, I was super exhausted and wanted my watermelon-sized baby out! While the big baby belly is gone then, postpartum Moms are still left with a little bump that settles down with time.
However, in some cases, the bump doesn’t go away, and one possible reason for it is diastasis rectus abdominis, where the rectus abdominis muscles which get separated during pregnancy fail to get back to their original position.
If you suspect this may have happened to you, let’s find out by learning more about the condition.
What is Diastasis Recti Abdominis?
Diastasis Recti Abdominis, also called DRAM or diastasis recti, is diastasis of rectus abdominis muscles. These are long muscles that run vertically down the belly, from the chest to the pelvis. They lie in front of the stomach and just below the skin, and are what are commonly referred to as ‘six-pack abs’.
The muscles are divided into left and right sides, separated by connective tissue called the linea alba. When you get pregnant, all the muscles and tissues in the abdomen stretch and expand to accommodate the growing baby, including the rectus abdominis and linea alba.
After childbirth, the muscles and tissues begin their healing process. They’re quite elastic in nature and get back to their original positions soon enough. However, sometimes the tissues are stretched so much that they lose their elasticity and don’t come back together. This condition is known as diastasis recti.
Diastasis recti may occur in the third trimester, although it is visible only postpartum. It is estimated that about 60% of all pregnant women get diastasis recti, with more than half of all cases getting resolved within six months. There are a few reasons that make some women more prone to getting diastasis recti than others.
Causes for Diastasis Recti
Multiple pregnancies close to each other
Multiple babies in a single pregnancy, like twins or triplets
Delivering big babies
Vaginal delivery
Being short in height and/or overweight
Being over 35 years old
Symptoms of Diastasis Recti
While diastasis recti may start in the third trimester, the symptoms are only visible after childbirth. The most common symptom is the belly sticking out – giving the appearance of being pregnant several months after giving birth. Here are more symptoms in detail:
A belly pooch that begins around the area of the belly button
Persistence of the tummy bulge despite losing weight
Extra softness around the belly button, like jelly
Doming of abdominal muscles on contraction
Difficulty or weakness when doing everyday tasks like lifting objects
Pain in the lower back, hip or pelvis
Poor or weak posture
Stress incontinence; leaking of urine when sneezing, coughing or laughing
Bloating and constipation
Painful intercourse
Sometimes these symptoms may be confusing – do you really have diastasis recti? You can find out either by doing a home test or visiting the doctor.
Diagnosis of Diastasis Recti
An easy way to check for diastasis recti is a self-examination at home. Here’s how to go about it:
Lie on your back with your knees bent and feet flat on the floor
Anchor your lower back and lift your shoulders and upper back slightly, as if crunching your abs
In this position, push down into the center of your stomach with two fingers – just above the belly button, at the belly button and just below it – you may notice a gap between the muscles
See how many fingers fit between your left and right ab muscles – if you feel like there’s more than a two-finger width of space between your abdominal muscles, you may have diastasis recti
You can confirm the diagnosis by visiting your doctor, who will use their fingers as well as a tool called caliper to measure the gap between your abdominal muscles.
The caliper gives an accurate measurement of the gap, and doctors also check for how strong the surrounding muscles are. In some cases, they may prescribe an ultrasound, which will give a more comprehensive picture. Based on their findings, you will be prescribed certain exercises to fix your diastasis recti.
Exercises to fix Diastasis Recti
Whether you’ve self-diagnosed or got your diagnosis from the doctor, always consult a professional before starting exercises for diastasis recti. You need to ensure that the workouts you do are going to help you and not worsen your condition.
The best exercises for diastasis recti engage the deep abdominal muscles, particularly the TVA, or the transverse abdominis. Along with the abs, you also need to strengthen your diaphragm and pelvic floor. This is why exercises for diastasis recti are unlike regular workouts – they are slow and controlled, focusing on breathing and engagement.
1. Diaphragmatic breathing
Lie down or sit in a comfortable position with your back straight
Place one hand on your belly and the other on your chest
Inhale deeply through the nose, sending the air into your belly – your stomach should rise
Exhale through the mouth with a ‘shh’ sound, emptying your belly of air and tightening your abs as you do so
2. Abdominal bracing
Lie down on your back and try to anchor your lower back to the floor – bend your knees if needed
Inhale and as you exhale, draw your belly button in towards your spine – feel your abs brace and tighten
Hold for 5-10 seconds and release
Repeat 5-10 times
3. Pelvic tilts
Lie down on your back with your knees bent and feet flat on the floor
Push your lower back into the floor, flattening it against the floor and tilting your pelvis backward
Hold for 5 seconds and release
Repeat 5-10 times
4. Umbrella Breathing with Kegel
Sit on a yoga ball or a chair so that your thighs are parallel to the floor and your feet are flat on the floor
Inhale deeply, imagining your ribcage to be an umbrella opening
As you exhale, empty your belly, engaging your abdominal muscles and lifting up your pelvic floor as if you are trying to stop the flow of urine – that counts as a kegel
5. Pelvic tilts on all fours
Get down in a tabletop position, with your hands and the tops of your feet on the floor
Keep wrists under the shoulders and knees under the hips; head and back should be neutral
Inhale deeply into the sides of your torso
Exhale as you curl your spine down and lift your chest
Inhale and return to neutral
6. Kneeling leg and arm extension
Get down in a tabletop position, with your hands and the tops of your feet on the floor
Keep wrists under the shoulders and knees under the hips; head and back should be neutral
Exhale and engage your core by drawing your navel up toward your spine
As you inhale, stretch out your right arm in front and your left leg behind
Exhale and return to neutral. Repeat on the opposite side
7. Side plank
Lie down on your right side and prop up your upper body by supporting yourself on your right forearm
The right elbow should be directly under the right shoulder and left leg stacked on top of the right one
There should be a straight line from your heels to the crown of your head
Hold the pose for 15 seconds while breathing normally and release. Repeat on the other side
8. Heel taps with weights
Lie down on your back with your knees bent and feet flat on the floor
Hold light weights or water bottles in your hands
Lift your feet so that your knees are directly over the hips and calves are parallel to the floor
Start with your arms bent at the elbow and palms facing each other
Inhale into your ribcage and as you exhale, extend the right leg so the right heel touches the floor
At the same time, lift your weights straight up. Make sure your core is engaged throughout
Inhale as you bring your arms and the right leg back to the starting position
Repeat with the left leg
9. Leg lifts
Lie down on your back with your knees bent and feet flat on the floor
Inhale deeply, filling your belly with air
As you exhale and empty your belly, engage your core and lift the right foot, straightening the knee and extending the leg as much as you can
Inhale and lower the leg to the starting position. Repeat on the other side
10. Glute bridge
Lie down on your back with your knees bent and feet flat on the floor
Press your heels firmly into the floor and keep your shoulders down
Tuck your chin into your chest and use your grounded heels to help lift your pelvis off the floor
Squeeze your glutes for a few seconds and lower your hips slowly to the floor
Make sure you avoid these exercises when healing your diastasis recti:
Sit-ups and crunches
Oblique curls and reverse curls
Traditional planks
Backbends or spinal extensions
Yoga poses like boat pose or downward dog
Pilates moves like scissor legs or double leg lifts
High-intensity exercises like HIIT, Tabata or burpees
Exercises with heavy weights
Any exercise that causes the belly to bulge outward
Remember to always start slow and light and then increase the difficulty or weights as you get stronger. Once you are healed, you can try more intensive yoga or pilates to strengthen your ab muscles further.
Other tips to heal Diastasis Recti
As you go about your day, practice diaphragmatic breathing and abdominal bracing to strengthen the abs
Don’t lift anything heavier than your baby
When holding your baby, avoid putting all the weight on one hip
When getting out of bed, bend your knees, roll to your side and bring yourself up using your arm for support
Practice good posture while sitting or standing – a back brace or abdominal brace can help
Place a soft pillow under or behind your lower back for support
Support or engage your ab muscles when coughing or sneezing
Please remember that belly bands don’t really help with diastasis recti. You need to really target the inner muscles to strengthen and heal them, which can only be done with exercise. The best thing, of course, is to take steps to prevent it in the first place!
Prevention of Diastasis Recti
Maintain a healthy weight throughout pregnancy by focusing on healthy foods and avoiding high-calorie junk
Always practice proper posture when sitting, standing or lying down
Start practicing deep breathing exercises as early as you can
Avoid putting pressure on your ab muscles after the first trimester
Don’t lift very heavy weights, and always bend your knees and use your legs to do any lifting
Always get out of bed by rolling onto one side instead of crunching up
Treatment of Diastasis Recti
The majority of diastasis recti cases can be fixed through regular exercises and good posture. It is recommended not to ignore your diastasis recti because if left untreated, it can lead to complications like:
Severe pain in the back and pelvis
Compromised core strength and stability
Poor posture and functional mobility
Pelvic floor dysfunction
Uncomfortable or painful sex
Umbilical hernia
If your diastasis recti is too severe or isn’t healing with exercise, you may require surgery, although this is quite rare. Surgery is usually done for a hernia or as part of a tummy tuck. Even if you’ve recovered from diastasis recti once, you can get it again the next time you get pregnant. However, by following our tips early on, you can prevent it from occurring at all!
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