Diastasis recti: a gut reaction

Diastasis recti abdominis may be the most common postpartum condition you've never heard of. It afflicts the majority of new moms--but too many health care professionals don’t look for it during the six-week postpartum checkup. If you have any of these symptoms, you may have diastasis recti:

An abdominal bulge that doesn’t go away, even if you’ve lost your baby weight
Core weakness (for example, difficulty getting out of bed) that doesn’t improve, even if you do crunches and sit-ups
Abdominal, low back, hip, or pelvic pain
Urinary incontinence (leakage) when you sneeze, cough, or laugh
Frequent urination
Constipation or diarrhea

Bust a gut

What exactly is diastasis recti abdominis? It’s a mouthful of a term describing a large gap down the middle of the rectus abdominis (large abdominal muscle).

During pregnancy, the hormone relaxin helps the uterus stretch to accommodate the growing baby. In some cases, the expanding uterus pushes against the abdominal wall until the left and right sides of the rectus abdominis separate, as if unzipped. When the gap is the width of two or more fingers, diastasis recti is diagnosed. This can happen during pregnancy or postpartum.

The weaker your abdominals and the more children you’ve had, the greater your risk of developing both diastasis recti and an umbilical hernia (bulging belly button). Anything that puts pressure on your abdominals—overexertion, doing the wrong exercises the wrong way, straining during bowel movements, coughing, or sneezing—can, over time, turn risk into reality.

With diastasis recti, there’s less abdominal support to hold your organs in place. Your bladder or uterus can slip down (prolapse). Straining your abdominals increases your odds of prolapse.

Diagnosing diastasis: gut check

Ask your obstetrician to check for diastasis recti at your postpartum checkup. If you’ve already had a checkup and notice any of the symptoms listed above, see your provider again. Or ask Raquel and her staff to evaluate you.

Rectifying recti: closing the gap

The approach to repairing diastasis recti may seem counterintuitive. It's natural to think, "My core is weak, so I’ll strengthen it." But old standbys such as crunches, plank exercises, and sit-ups don't help diastasis recti. As a matter of fact, they can overload your weakened abdominals and cause the problems described above.

To heal diastasis recti, Raquel and her staff teach you exercises that safely engage your abdominal muscles and help close the gap. But we don’t stop there. It’s vital to use your abdominals properly during daily activities, so we show you belly-friendly ways to sit, stand, lie down, and get up. We also show you how to brace your muscles to prevent further injury while coughing and sneezing, during bowel movements, and during exercise and exertion.

In addition, we teach you diaphragmatic breathing exercises to help relax your pelvic floor. We may suggest wearing a brace or binder during activities such as heavy lifting and cleaning.

The key is to isolate and safely strengthen your abdominals—and guide them back into place. This approach restores a healthy belly and helps resolve back pain, hip pain, pelvic pain, and incontinence.

After a few sessions, most patients are on the road to recovery. Their abdominals start healing, and their gap begins narrowing. Then their core strength returns, their symptoms resolve, and they can return to their pre-diastasis exercise routine.

Mind the gap

After physical therapy ends, it’s important to keep moving mindfully. The key to lifelong belly health is twofold:

Keep doing your diastasis recti exercises.
Apply your new “core consciousness” to all your daily activities, workouts, and sports—and, of course, to any future pregnancies and recoveries!