What is Diastasis Recti?
The rectus abdominis muscles of the abdomen, or the “6 pack” muscles, are connected in the midline of the abdomen by a connective tissue called the linea alba. The linea alba can become damaged/stretched leading to a separation between the rectus abdominis which is referred to as a diastasis recti. The muscle action of the rectus abdominis is to flex the trunk such as when sitting up from a lying down position, the rectus abdominis works to provide support for the internal organs. If the linea alba becomes damaged it can lead to core weakness, low back pain, pelvic pain, difficulty with labor, gastro-intestional problems including constipation or gas/bloating, hernia or urinary leakage.
Diastasis recti is most prevalent in pregnant women – and in fact occurs in most women during pregnancy – but to varying degrees. It can be significant and lead to problems while in others no adverse effects are noticed. Why is this so common in pregnancy? Well, during pregnancy the growing uterus stretches the rectus abdominis muscles which lengthens and weakens them, thus stretching them apart as well as lengthwise. This stretching increases the stress on the linea alba and can lead to diastasis recti. As already mentioned, this is normal during pregnancy to some degree but can become problematic if separation becomes moderate to severe.
Although diastasis recti is most prevalent in pregnant women, it can occur in anyone and is also very common in older males. Causes of diastasis recti outside of pregnancy are repetitive heavy lifting with inadequate core strength, weight gain (especially in the abdomen), abdominal surgeries and repetitive exercises that over stress the rectus abdominis and linea alba.
How to know if you have diastasis recti? To test for a diastasis first lie down on your back, then lift your head and shoulders up off of the floor. If you notice a vertical bulge down the midline of your abdomen this indicates a diastasis. You can also perform the finger test to determine the severity of your diastasis. If you have a gap between your rectus abdominus muscles that is greater than approximately 2-3 finger widths (approximately because finger width can vary) or 2.7 cm, this indicates a diastasis. You can also measure depth of the diastasis as another measurement of severity. The deeper your finger goes into the gap towards the knuckle, the more severe the diastasis is. An outie belly button or severe bloat after eating can also indicate diastasis.
Things to avoid if you have a diastasis recti:
- Lifting – depending on severity, even lifting objects that you consider to be light could be causing more damage
- Sitting straight up in bed – rather you should roll to your side and push yourself up with your arms while bracing your abdominal muscles tightly
- Straining while going to the bathroom
- Coughing without providing support to your abdomen
- Strenuous exercises that cause a bulge in your abdomen – including but not limited to crunches, sit ups, leg raises/lowers, front planks, exercises on your hands and knees
What can you do to treat a diastasis recti? It is recommended that you seek treatment from a physical therapist to learn proper exercises to promote healing of your diastasis and prevent further damage. In addition, there are splints that you can wear and kinesiotape techniques that work to hold the rectus abdominis muscles together when active. If these options are not available to you, you can substitute these with a sheet or towel. To do so you would wrap the sheet or towel around you from back to front, crossing the ends over in midline and pull tight. This technique can be used when performing gentle core exercises that promote healing as well as when performing bed mobility tasks or using the restroom.
As always, our knowledgeable team of Physical Therapists, Physical Therapy Assistants and Athletic Trainers at Active Physical Therapy are here to help you heal and get back to your normal activities without limitation. Please do not hesitate to seek our help if you have been diagnosed with a diastasis recti or think you may have one.
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