Mamas, we all have some desire to return to our pre-baby body shape. Sometimes we struggle with reducing the “pooch” in the lower abdomen. I know I did for the first eighteen months after having Baby Elvis. If you have one, it may mean you have diastasis recti, a condition where the two bellies of the six-pack abdominal muscles separate from each other, causing the bulge, or “pooch.”

Since I suffered and healed from this on my own, I put together a simple infographic you can download at the end of this post with details on how to check for this and how to heal from abdominal separation.

Here’s the deal: Diastasis means separation, and recti is the abdominal muscles, or the rectus abdominus. Diastasis recti can cause your stomach to stick out more because your muscles have widened and separated. Even at rest, it may be noticeable. Bottom line: The abdominus muscles separate from the linea alba, which is the connective tissue in your stomach.

With the right help and exerdises, you can make diastasis recti close. Urban Wellness Clinic is here to help. We’ve seen mothers with a diastasis two years after having their baby and we’ve seen mamas do our exercises and close their diastsis 8 weeks after delivery.  We will go into what factors made this difference.

Who Gets Diastasis Recti?

Millions of people deal with diastasis recti each year, many of whom are newly postpartum. In fact, about two-thirds of pregnant women have it. It tends to happen to women who deliver a particularly large baby or a second or third baby.

Even after a mom has lost the baby weight, her stomach may not appear back to pre-baby shape. It’s important to note that studies have shown that 60% of mothers have diastasis recti at six-weeks postpartum and nearly a third have it after a year.

That’s not all: The abdominal separation can happen to anyone, including men. For them, it can come from doing sit-ups or weightlifting with incorrect form.

Whether it’s pregnancy, sudden weight gain, a C-section, abdominal surgery, or weightlifting, or just simply holding more weight around your abdomen, there are several underlying causes which lead to separation.

At Urban Wellness Clinic, we see diastasis recti in people with a weak deep intrinsic core (transverse abdominus, internal abdominal obliques, diaphragm, and pelvic floor muscles) or chest breathers. It can lead to lower back pain and urine leakage and may make it harder to breathe and move properly.

The linea alba, which holds everything in working order among the abdominal muscles, loses its ability to stabilize the abdomen. Other abdominal muscle meet at the linea alba, causing a compromise in several muscles, including your rectus abdominus, your transverse abdominus, and your internal and external oblique muscles.

There are ways to minimize the symptoms of diastasis recti and make it much more manageable and much less noticeable, especially through physical rehabilitaiton and DNS exercises.

Who Diagnoses Diastasis Recti?

If you suspect you may have abdominal separation, visit your rehabilitation specialist at Urban Wellness Clinic. We’ll be able to tell you for sure if you have diastasis recti and provide ways to minimize its effects.

How do you know if you have abdominal separation?

Here’s the deal: Diastasis recti typically presents with several other symptoms besides just the pooch. You may have lower back pain, suffer from constipation, or have pain with sex. In serious cases, a hernia may occur.

During pregnancy, there is a huge amount of pressure put on your abdominal muscles, especially during the third trimester. You may also feel a general lack of core strength, experience incontinence (urine leakage) with bearing down or laughing or notice a dome in your stomach muscles when you lie on your back.

At the Urban Wellness Clinic, we often find that certain conditions make you more likely to develop diastasis recti. This includes having old belly button rings, abdominal scars from a previous surgery, especially from appendectomy and gall bladder removal, a history of poor breathing mechanics and rib flare, or an excessive low back sway, which is called lordosis.

Is it important to have diastasis recti checked?

I can’t emphasize this enough: A lot of cases of diastasis recti go unchecked until the pooch is noticeable. Why does this matter? Diastasis recti can cause pelvic floor dysfunction, back pain, bloating, and hernias, so it’s important to get it managed as quickly as possible.

Diastasis recti becomes a really serious condition when there is a hernia associated with the separation, because the intestines can get caught and strangled in the herniation–a cause for emergency surgery.

If you want to do a self-check before your doctor’s visit, you can lie on the floor like you’re about to do a crunch, lifting your head off the floor. Then, put two fingers horizontally just above your belly button. Lift your head and shoulders and feel the area. If you’re feeling a gap much bigger than the width of one and half of your fingers, you may have an abdominal separation. Your doctor will perform the same evaluation.

But there’s a catch: Checking too frequently can actually damage the tissue and weaken the muscles, worsening the gap. You may want to check at four to six weeks postpartum and then see a chiropractor for a definitive diagnosis.

How can you heal diastasis recti?

The best part? Completely healing diastasis recti is possible with exercises and preventative measures to minimize symptoms and side effects. The bottom line is about focusing on alignment and strengthening the core.

Postpartum functional exercises and techniques are helpful, such as dynamic exercise slings and braces, which provide support while sleeping, making your body more comfortable and helping to train the muscles back into place.

It’s important to get diastasis recti managed as quickly as possible.

However, tools like splints and braces aren’t healing your muscles. Rather, they’re simply taking the load off and helping support the muscles, not necessarily providing long-term results. Also, they don’t allow for a full belly breath and limit good core stability which are both essential for healing abdominal separation.

How we help heal diastasis recti – Urban Wellness Clinic Approach

At the Urban Wellness Clinic, we use Neurokinetic Therapy to determine which muscles are overcompensating for other muscles. This helps us detect the root cause of muscle pain and weakness.

Often, we find overactive tight muscles compensating for other muscles that are used for breathing out or exhaling. This has become especially common today, when we burn the candle at both ends and breathe short and shallow, which exacerbates diastasis recti.

We find that muscles commonly inhibited to be transverse abdominus, internal obliques, and multifidi, which lack the full potential to help protect the rectus position and exacerbate diastasis recti.

Tupler Technique: Is it worth it?

The Tupler technique is a common method for healing diastasis recti. A therapist uses a splint to take the pressure off of your connective tissue, allowing it to heal better.

The goal is to focus on preventing diastasis recti from flaring up by building up strength in the transverse abdominus. This is achieved by drawing the stomach up and in. As the weakened tissue becomes stronger, the muscles come back together.

However, the Tupler technique doesn’t access the deeper core muscles, which means the rectus abdominus muscles will most likely eventually separate again, which we see often with our patients.

Got Diastasis Recti? Don’t do this!

One of the worst things you can do for diastasis recti are exercises like crunches, planks, or forward folds, especially too soon after giving birth. These exercises harm more than help.

Instead, focus on the exercises that don’t really feel like exercise at all, such as deep breathing and moving like a baby. Breathe deep from your diaphragm with 360-degree expansion around your abdomen, waistline, and low back. There will be an eccentric contraction of the transverse abdominis deep down into your lower core and pelvic floor as you simply breathe.

Though it might not seem like the biggest caloric payoff, there’s almost nothing more helpful for people with diastasis recti.

When your diastasis recti is more serious

Surgery for diastasis recti may be an option for more serious cases with three or more fingers width of separation and those with hernias, strangulated intestines, or debilitation.

But there’s a catch: Insurance companies often determine that surgery for diastasis recti, called abdominoplasty, is a cosmetic procedure unless paired with hernia surgery. That’s because it’s essentially a tummy tuck, where the muscles are sewn back together.

If you have an abdominoplasty, beware. At Urban Wellness Clinic, we often times we see neck and back pain down the road with our tummy tuck patients, because they have been tightened down so much.

Generally speaking, the best relief from diastasis recti comes from building up the deep intrinsic abdominal strength again, whether through exercise or breath work.

We can help! Contact us today about diastasis recti. Call us at 212-355-0445 or email us at info@urbanwellnessclinic.com. We’re here for you!

Best in health,

Dr. Emily Kiberd

Get the Diastasis Recti infographic