Even if you haven’t heard of the term “diastasis recti” or “DR”, chances are you have probably heard of the “Mommy Tummy”. Diastasis can be one underlying cause resulting in the appearance of a “Mommy Tummy”. So what exactly is diastasis recti and how can you tell if you have one?
This condition is a midline separation between the left and right halves of one of the abdominal muscle layers called the rectus abdominis. This layer of muscles is what we traditionally refer to as our “6-pack abs” (yes, they’re in there!) and they naturally separate during pregnancy along the connective tissue called the linea alba to accommodate for the baby as she/he grows inside your abdomen. This is completely normal during pregnancy, and in fact, 100% of women will have this type of abdominal separation by the end of their pregnancy and immediately postpartum. For many women, the diastasis will heal slowly postpartum as the two halves of the abdominal wall return closer together. But without specific exercise, 45% of women will still have a midline abdominal separation at 6 months postpartum and one third of women will still have a diastasis at 1 year postpartum! ¹
The separation itself isn’t necessarily cause for concern, but can result in feeling of weakness with activities such as picking up your kids, reaching out to lift something, getting on and off the floor, or sitting up from bed. It can also result in a feeling of abdominal organs wanting to “fall out” when exercising on hands and knees or belly-down positions. You may notice a pronounced “coning” or “doming” shape to your abdomen when sitting up or leaning back. Because the abdominal muscles work together with the pelvic floor, diaphragm (breathing muscle), and deep back muscles as part of our core, a weakness in the abdominals can create more strain on the back or pelvic floor resulting in issues such as chronic low back pain, sciatica, urinary leakage and even painful intercourse.
So what’s a woman to do? Well, the good news is that through specific exercises targeted at the deep abdominal layers and breathing/pelvic floor connection, you can close the gap, create better tension along the linea alba and create better support through the core. A pelvic floor physical therapist can assess the extent of your diastasis and how you are able to transfer load through the core. She can also assess the muscles of the low back and pelvic floor to see how they are working with the abdominals and breathing muscle as part of your core team. A pelvic floor PT can instruct you in specific exercises to help rebalance the core system, relieve pain, and tone through the abdominals. She can instruct you in exercises to avoid as you are healing and provide hands-on treatment to help release any “stuck” areas of tension. Sometimes, therapeutic taping techniques can be used to provide additional support for the short-term as you learn how to turn on the deep abdominal muscles again postpartum.
What about sit-ups, crunches, push-ups and planks? There are a lot of blogs out there with lists of exercises to avoid or never perform again if you have a diastasis. In reality, there are no hard and fast rules that can be applied to everyone with abdominal separation. Even exercises like sit-ups and crunches can potentially be performed with a diastasis if you have learned the specific techniques to manage the pressure going forward into the abdominals. Every exercise needs to be evaluated on an individual basis, and your pelvic floor PT can help you create a list of “safe to perform” vs “avoid for now” and help you modify an exercise to adapt it to your current strength level as you progress.
In summary, no matter how long it’s been since you’ve been pregnant, working with a pelvic floor physical therapist can help you to create positive changes in your body including strengthening, toning, and pain relief! If you would like to get started on healing today, click on the book now button above to request an appointment.
1. Sperstad JB, et al. Br J Sports Med 2016;50:1092–1096. doi:10.1136/bjsports-2016-096065. https://bjsm.bmj.com/content/bjsports/50/17/1092.full.pdf
Dr. Julie Berube is a pelvic floor physical therapist who is on a mission to revolutionize the standard of healthcare for women in Central New York and the Syracuse area.