Any woman who has experienced childbirth knows the tolls that pregnancy can take on your body. While the end result is a bundle of joy, the nine-month journey leading up to it can affect your physical and mental well-being. Perhaps nowhere is this more evident than your rapidly expanding belly. As the baby grows and the stomach expands, some women's abdominal muscles physically separate (called diastasis recti), leading to issues both during their pregnancy and after it.
While many cases will self-correct in the months after you give birth, core stabilization exercises can help improve the symptoms caused by separated abdominal muscles.
What’s Diastasis Recti?
The main abdominal muscle in the front part of our stomach is called the rectus abdominis. This muscle (commonly referred to as the six-pack) is separated into a left and a right portion by a layer of thick cartilage called the linea alba. In diastasis recti, the increasing size of a woman's uterus and stomach cause a portion of the linea alba to stretch and the two sections of the rectus abdominis muscle to separate from each other.
Who’s at Risk?
Diastasis recti is most common in females during pregnancy. In fact, a 2015 study in Manual Therapy stated that all pregnant women experience some degree of abdominal separation by about 35 weeks of gestation. Pregnant women are not the only people who are affected, however. This issue can also occur in either gender as a result of being obese or after surgeries to the stomach or abdomen.
Several other risk factors may increase the likelihood of developing separated abs. Women carrying a baby at an advanced age, women who are pregnant with multiple babies at once (called multiparity) or women with a history of multiple pregnancies are at a greater risk of diastasis recti. In addition, consistently having to lift heavier items (like other children) more than 20 times per week during your pregnancy can also place a great amount of strain on the rectus abdominis, possibly leading to separation.
What Are the Symptoms?
Diastasis recti can cause a variety of symptoms. Most commonly, the separation of your abdominal muscles causes a noticeable bulge in the middle of your abdomen. This bulge is typically not changed by diet or exercise. Discomfort or pain in your lower back may also occur.
In addition, the condition may impact the abdominal control of your pelvis and can lead to urinary or fecal incontinence. In some more extreme cases, it can even lead to pelvic prolapse, in which your pelvic organs (the rectum, bladder or uterus) begin to protrude out of your vagina.
Read more: Diastasis Recti Complications
Try These Diastasis Exercises
After childbirth, most women's diastasis recti resolves on its own. This is not always the case, however. A 2017 study in Surgical Endoscopy estimated that 33 percent of moms continue to experience abdominal separation symptoms even 12 months after giving birth.
In the instance of persistent symptoms, performing specific core-strengthening exercises may be beneficial. Initiating a core stabilization program can help decrease the degree of abdominal separation, lower your pain levels and improve your overall quality of life in the months after you give birth.
Try adding diastasis exercises to your daily routine. Three sets of 10 repetitions of each technique can be performed daily.
Add in Pelvic Tilts
HOW TO DO IT: Lie on your back with your knees bent and your feet on the floor. Then, contract your ab muscles as you flatten out your lower back. Your pelvis should rock backward toward the floor as you do this. Maintain this position for 5 to 10 seconds before you return to the initial position.
Do Some Planks
HOW TO DO IT: Get onto your stomach with your elbows on the ground under your shoulders and your knees held straight. Next, prop up onto your forearms and toes while keeping your stomach muscles clenched. Without allowing your lower back to arch, hold this pose for 10 seconds before lowering to the ground again.
A 2016 study in the Journal of Sports and Orthopedic Physical Therapy found that performing curl-ups can decrease the gap between the two portions of the rectus abdominis muscle in people with diastasis recti.
HOW TO DO IT: Lie on your back with your knees bent and your arms crossed over your chest. Slowly lift your head and upper back in the air like you're doing a crunch until the bottom of your shoulder blades are no longer touching the ground. Hold your body here for 3 seconds before slowly lowering yourself down again.
Remember Your Kegels
HOW TO DO IT: Lie on your back in a quiet space. Contract your deep pelvic muscles as though you're trying to stop urinating midstream or trying to stop yourself from passing gas. Make sure you continue breathing while doing this and hold the squeeze for 5 to 10 seconds before relaxing. Once you get the hang of it, you can also try doing Kegels while standing or walking.
Read more: Abdominal Belt After Pregnancy
Do I Need Surgery?
Should your abdominal separation fail to improve on its own or with strengthening exercises, you may need to consider a surgical correction. While there are several different types of operations, the primary goal is to repair or close the gap in the linea alba to improve the stomach's stability.
A 2016 study in Surgery found that the surgical correction of abdominal separations that were 3 centimeters or larger successfully prevented recurrence, decreased disability and lowered pain. It also improved the overall strength of the abdominal wall.
If your symptoms fail to improve, or if you experience worsening pain, incontinence or pelvic muscle prolapse, be sure to speak to your doctor who will discuss which treatment options are right for you so you can start feeling like yourself again.
- Seminars in Plastic Surgery: Management Strategies for Diastasis Recti
- American Physical Therapy Association: Physical Therapist's Guide to Diastasis Rectus Abdominis
- British Journal of Sports Medicine: Diastasis Recti Abdominis During Pregnancy and 12 Months After Childbirth: Prevalence, Risk Factors, and Report of Lumbopelvic Pain
- Physical Therapy: Relationship Between Interrectus Distance and Symptom Severity in Women With Diastasis Recti Abdominis in the Early Postpartum Period
- Harvard Health Publishing: What to Do About Pelvic Organ Prolapse?
- Surgical Endoscopy: The General Surgeon’s Perspective of Rectus Diastasis
- Journal of Musculoskeletal and Neuronal Interactions: Efficacy of Deep Core Stability Exercise Program in Postpartum Women With Diastasis Recti Abdominis
- Journal of Exercise Rehabilitation: Effects of Three Spinal Stabilization Techniques on Activation and Thickness of Abdominal Muscle
- Sports Health: A Multidisciplinary Approach: Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball
- Journal of Orthopaedic and Sports Physical Therapy: Behavior of the Linea Alba During a Curl-Up Task in Diastasis Rectus Abdominis
- Mayo Clinic: Kegel Exercises: A How-to Guide for Women
- Surgery: Operative Correction of Abdominal Rectus Diastasis (ARD) Reduces Pain and Improves Abdominal Wall Muscle Strength
- Manual Therapy: Prevalence and Risk Factors of Diastasis Recti Abdominis From Late Pregnancy to 6 Months Postpartum, and Relationship With Lumbo-Pelvic Pain