Diastasis recti is a condition where the abdominal muscles separate. This is commonly associated with pregnancy (and multiple pregnancies) as the abdominal muscles stretch to allow the baby to grow. There is a natural separation line between the two rectus abdominis muscles called the linea alba. The separation occurs at that midline. A 2-3 cm separation occurs naturally with pregnancy and usually will resolve in the post-partum period. However, larger or lasting separations can cause your abdominals to function improperly. If they do not function properly, the abdominal muscles do not support your core, back and abdomen like they should. This can lead to back pain, pelvic pain or pelvic floor problems such as urinary incontinence or pelvic organ prolapse. Although it is important to address the separation, the primary goal of rehabilitating a diastasis should not be to close the gap but to learn proper recruitment of those msucles for daily activities. Some gaps close while others may persist. This varies from person to person.
You can assess for a diastasis at home. Start by lying on your back with your knees bent up. Place your finger tips horizontally at your belly button. Lift your head, as if doing a crunch exercise, enough to feel your abdominals engage. Move your fingers back and forth in between the two abdominal muscles to see if there is a gap. Take note how many fingers you can fit in that gap. Now, move upwards towards your breastbone along that midline to see how far upwards the gap may go. Repeat this below your belly button going towards the pubic bone to see how low the gap may extend. Again, assess for the length and width of the gap.
You can also see how your abdominal muscles are functioning by trying a cough. Place your hands over the abdominal muscles. Try a cough. Do your abdominals come out towards your hands and create a dome or do they pull in away from your hands. They should pull inwards. No doming should occur.
What can I do if I think I have a diastasis?
Transverse abdominis exercises have been shown, in more recent data, to have the best benefit in helping your abdominals function. The transverse abdominis, another abdominal muscle, wraps horizontally around the abdomen and will allow you to create movement towards the center of the abdomen. This supports the diastasis. You can find this muscle by pulling your belly button in towards your spine and trying to flatten your lower belly (from pubic bone to belly button). Sit ups and crunches should be avoided as exercises as they do not provide horizontal support to either side of the diastasis.
If you need help assessing your diastasis or with finding transverse abdominis exercises to help support your diastasis, contact our office today for an individualized assessment with our physical therapist! Our specially trained physical therapist will be able to evaluate your exact condition and provide a specific program for you.