Reviewed By: Pramod Kerkar, MD, FFARCSI

The condition of partial or complete separation of the rectus abdominis also known by the name of six pack muscles which meet at the midline of the stomach, is called diastasis recti. This condition does not have a specific treatment, but can be managed with rehabilitation and prevented with appropriate care. It is important to know the diastasis recti causes, symptoms, management and complications.

What is Diastasis Recti & How Can It Be Managed?

What is Diastasis Recti?

Diastasis recti, commonly occurs during and just after pregnancy, because the uterus stretches the abdominal muscles to accommodate the growing baby. According to a study, it was found that 60% of women experience diastasis recti at the of their pregnancy or during the postpartum period. However, this condition is not only limited to pregnancy, but can affect anyone, including men and new born babies. In certain cases, this condition can occur because of heavy lifting without the correct technique or performing unsafe or excessive abdominal exercises. Let us look at the important diastasis recti causes, symptoms, management and complications.

Causes of Diastasis Recti

One of the main causes of diastasis recti is excessive inner-abdominal pressure. Whena female is pregnant, there is gradual stretching of the muscles of the abdomen and related connective tissues due to the expanding uterus. They are supported by the pregnancy hormones estrogen and relaxin. Pushing during delivery can also result in diastasis recti.

Some abdominal separation can be experienced during and following pregnancy too. Earlier, body mass index (BMI), weight of the baby, weight gain during pregnancy, and maternal age were considered to be the risk factors for diastasis recti. However in a study conducted in 2015, no connection was found between these factors, and pregnant women were more likely to experience the condition. Newborn babies, especially premature infants, are sometimes born with diastasis recti because their abdominal muscles are not well developed and connected. These too are some of the causes of diastasis recti. In such cases, the condition usually gets corrected on its own in time.

Symptoms of Diastasis Recti

One of the most evident symptoms of diastasis recti is a bulge in the stomach which appears especially when the abdominal muscles are contracted or strained. Other symptoms include bloating, constipation, lower back pain, and poor posture. During pregnancy, no noticeable symptoms of diastasis recti appear since the abdominal muscles are separated but as the uterus grows and the female is in the second or the third trimester there is a visible bulge that develops above and below the bellybutton. It becomes most noticeable when the woman tries using her ab muscles to sit up, stand, or lie down. The doctor should be contacted immediately in case the woman experiences back, abdominal or pelvic pain. These could some of the symptoms of diastasis recti. Post-delivery, appearance of a bulge in the belly area is the most prominent symptom of diastasis. It makes the woman look pregnant, even when she is not.

To self-check for diastasis recti after childbirth, women should lie on their back with their legs bent, and feet flat on the floor. They should then raise their shoulders slightly above the floor, while supporting their head with one hand, and then looking down at their belly. They should move their other hand above and below their bellybutton, and all along their midline abdominal muscles, and try to fit their fingers in the gaps between their muscles. If they have a separation or gap of 1 or 2 fingers in length, they are likely to be having mild-to-moderate case of diastasis recti. A few weeks after delivery, this separation becomes smaller and smaller as the muscles regain strength. The doctor or physical therapist can also use a measuring tool called a caliper or an ultrasound to diagnose diastasis recti more accurately.

Management of Diastasis Recti

This condition can be managed well with supports, exercises and rehabilitation. Here are some of the most effective ways of management of diastasis recti.

  • Abdominal binders - Excessive internal pressure in the abdomen is the main cause for diastasis recti. Most women tend to experience a little bit of abdominal separation while pregnant. This leads to weakening of their core and back or pelvic pain. They may need to wear abdominal binders throughout the day for supporting their core muscles. This is one of the best ways to manage diastasis recti.
  • Good posture - Diastasis recti patients should practice good posture, support their lower back when sitting with a pillow or towel placed behind them, and avoid lifting heavy weights or further straining their abdominal muscles until after delivery. While standing up off the floor or getting in or out of bed, the individual should bend their knees, roll, and support them self with their arm.
  • Strengthening exercises - During pregnancy, one can continue strengthening their core, but must follow modified exercises whch are safe to do during pregnancy for diastasis recti. For some females, diastasis recti can correct itself post-delivery as the abdominal muscles regain strength. If symptoms or separation are still experienced 8 weeks postpartum, exercises can prove helpful for them. Postpartum treatment for diastasis recti generally involves deep stomach muscle and pelvic floor exercises. While they help in management of diastasis recti, appropriate care must be taken.

It is necessary to get the approval of their doctor before starting with exercises after delivery. They should follow a specialized workout for diastasis recti. Traditional sit-ups, crunches, and planks should be avoided postpartum, until the abdomen gets healed from diastasis recti, as these exercises can worsen the condition. Any strenuous exercises in which the ab muscles bulge out should also be avoided. One should also keep away from holding the baby on one hip, coughing without supporting the ab muscles, and lifting or carrying heavy loads.

Complications of Diastasis Recti

Complications of diastasis recti include back and pelvic pain, postural damage, compromised trunk stability and mobility, pelvic floor dysfunction, and even hernia, in severe cases. Keep a watch for such warning signs and seek immediate medical help.

Prevention of Diastasis Recti

Prevention of diastasis recti, women should practice strengthening their core, including the pelvic floor and oblique muscles, during pre-pregnancy. Good form should always be maintained when performing abdominal exercises. Weight management and toned muscles with regular exercises too help in prevention of diastasis recti.

Outlook

Proper rehabilitation in diastasis recti helps to prevent complications and helps in recovery. The patient can seek the guidance of a physical therapist who specializes in postpartum recovery for the right exercises to help improve the diastasis recti symptoms. A patient should talk to their doctor about a treatment plan which is most suitable for them. If pain and symptoms of diastasis recti interfere with the patient’s ability to perform day-to-day activities, surgery may be considered by the doctor.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: November 6, 2018

This article does not provide medical advice. See disclaimer

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