What is diastasis recti? Separation of the abdominal muscles it is especially common in pregnant and postpartum women. You can fix the problem with exercises.
Diastasis recti abdominis, also known as DRA or abdominal separation, is a gap of around 2 to 3 centimeters between your abdominal muscles. There are several variations that can occur, including abs that are open above the belly button, below the belly button, or all the way up the torso.
Diastasis recti is caused by internal abdominal pressure that pushes your abs apart, and it can happen to both men and women of any age. Many babies are born with some degree of separated abs; the muscles usually come together by age three. However, when abdominal separation occurs at a later age due to strain, injury, or pregnancy, it can cause back pain, poor posture, urinary incontinence, and a loose or “pooching” belly.
Diastasis recti often develops during pregnancy and can persist postpartum. A study of abdominal separation due to pregnancy found that it is most often centered right around the belly button.
The majority of pregnant women will develop some degree of DRA during either their second or third trimester. One study found that 100 percent of participants had abdominal separation by 35 weeks of gestation. However, that number had declined to only 39 percent by six months postpartum.
There have been few studies done on risk factors for DRA during pregnancy, so doctors are unsure exactly what causes severe cases of abdominal separation or allows some women to heal quickly while others struggle to regain their core strength. Some researchers have proposed high age, pregnancy with multiples, cesarean section delivery, high pregnancy weight gain, and a lack of postpartum childcare as factors that increase the severity of DRA.
Abdominal separation is often visible as a ridge of loose and protruding tissue running down the center of the belly. However, this is not always a reliable way to know whether you have DRA. A 2008 study noted that you can have abdominal protrusion even without diastasis recti and that not all patients with DRA show abdominal protrusion.
You can self-check for separation by lying flat on the ground and using your fingers to press at, above, and below your belly button to see if there is a gap between your abdominal muscles. However, the best way to know whether you have DRA is to have your doctor check. Medical professionals can check for separation by pressing on your belly, though some may prefer to use an ultrasound to determine the extent of separation and where it has occurred.
In cases of severe DRA, your doctor may recommend abdominoplasty, or abdominal surgery, to help bring your muscles back together. These surgeries have an encouraging success rate; one review of surgical abdominal repair found that diastasis was corrected in all participating patients by six months after surgery.
In patients with more core strength, exercise for diastasis recti may be enough to help your abdominal muscles come back together. Though limited research has been done on the effects of exercise, initial results indicate that it may help reduce or heal DRA. In pregnant women, exercise both during and after pregnancy can help strengthen the abdominal muscles and limit separation.
General exercise can help strengthen your core and improve diastasis, but certain exercises may be more beneficial than others. A study conducted in 1988 found that the most effective exercises for reducing separation between the abdominal muscles were “quadruped exercises,” which are performed when you are on your hands and knees. These include pelvic tilts, also known as cat-cow exercises in yoga, or lifting one extremity while balancing on the other three.
Before beginning any treatment or exercises regimen it is a good idea to talk with your doctor about your overall health and the best way to begin helping your body heal.
April 20, 2017
Janet O’Dell, RN