All about diastatis recti – and what to do about it

By Dr. Ashley Wozniak, PT, DPT

Many pregnant and postpartum women have heard the term “diastatis recti” - but what exactly does that mean? And more importantly, how do you know if you have one or not? Does anything need to be done about it?

During pregnancy, the top layer of the abdominal muscles – the “six pack” – becomes separated down the middle. That separation is a condition called diastasis recti. But don’t be afraid of that word separation: It’s key to understand that diastasis is actually a lengthening of the connective tissue that’s found between the ab muscles.

That connective tissue does need to lengthen and stretch out a bit to accommodate the growing babe. It’s a normal process and will happen to every pregnant woman to some degree.

Check it out

So how can you find out whether you have diastasis recti? During postpartum, a Physical Therapist who specializes in women’s postpartum healing can do a quick, simple assessment to determine whether a diastasis is present, and the level of severity.

The assessment involves doing several forms of a small crunch while lying on your back. Note: This is not typically assessed at a 6-week postpartum appointment with an OB or midwife.

As a Physical Therapist, there are three factors I look at during the test:

1. amount of widening of the connective tissue (how far apart is it)

2. depth and integrity of the connective tissue

3. most importantly, the amount of tension that the woman is able to appropriately create by contracting the transverse abdominus (deep “corset” ab muscle, or TA)

How to heal

How can a diastasis recti be healed? The old-school way of thinking about healing a diastasis is to strengthen the TA– the deepest core muscles. It’s important to first have a trained Physical Therapist assess not only the deep core muscles but also the top layer “six-pack” muscles. Believe it or not, sometimes those can become too tight after they were lengthened out by our postpartum positioning during baby care activities!

It’s important to assess the internal and external obliques, as well as to take a look at the balance between all four of the ab muscle groups (TA, six-pack, internal obliques, external obliques). And it’s key to make sure that the pelvic floor is contracting and relaxing at the right times in coordination with the ab muscles. Remember- our pelvic floor muscles may have tension throughout which would need to be addressed first (learning to relax) before learning to strengthening and coordinate.

Other key muscles crucial in healing diastasis may include- serratus anterior, our pectoralis muscles, psoas, and our back musculature.

Proper intra-abdominal pressure management – the right breathing pattern – is also needed. Without the right breathing, the diastasis won’t be able to heal properly.

Dr. Ashley’s Quick Tips: Five Do’s and Don’ts for Diastasis

• Do have an assessment with a Physical Therapist who specializes in women’s prenatal and postpartum health.

• Do be conscious of body mechanics: how you carry your baby, feed your baby, and your daily movements.

• Don’t bear-down “push” when going to the bathroom.

• Don’t do exercises such as crunches, sit-ups, or front-loading exercises such as planks immediately.

• Don’t extend your lower back (lean back when holding or carrying baby) – as that can keep abdominals lengthened out and increase pressure into the abdominal and pelvic region.

Let’s talk

Do you think you might have diastasis recti? Not sure? Talk about your pregnancy or postpartum goals for healing with our Physical Therapist, Dr. Ashley Wozniak. Learn more about our studio, wellness programs and Physical Therapy offerings at www.inspiredmaternity.com.

Inspired Maternity is a one of a kind Pregnancy and Postnatal Health, Wellness and Fitness Studio located in Peoria, Ill. We offer in-studio prenatal and postpartum fitness programs and Physical Therapy assessments throughout the calendar year, as well as virtual options and telehealth visits.