Let’s talk Diastasis Recti (DR) in postpartum women!

What is it?
Diastasis Recti (DR) is a thinning or separating of the linea alba, which is the connective tissue/fascia that connects the two sides of the rectus abdominis (6-pack) muscles. The connective tissue is what thins or separates, not the actual muscles. You can have a diastasis in different places such as above the belly button, just above the belly button, below the belly button, or completely open. (See picture below!)

To be considered a diastasis, there needs to be greater than a 2 finger width separation OR softness/squishiness under the diastasis. The softness/squishiness is actually MORE important than the finger width gap because that is a signal to us that the deep inner core system is not working properly! What it should feel like underneath the linea alba/connective tissue is firm like a trampoline!
Is it normal?
During pregnancy, some natural stretching and diastasis formation occur and is completely normal! One study by Mota et al. in 2014 showed that 100% of women had some diastasis formation in their 3rd trimester. However, the wrong exercises or improper form or poor movement patterns can cause a DR to get worse. This is where we want to take caution! The linea alba that connects the two sides of the rectus abdominis helps transfer load through your trunk. So, if the gap is too large or too squishy, it can be an ineffective point for load transfer, which could lead to issues such as pelvic floor dysfunction, low back pain, or SIJ pain.
Women who have not had a baby as well as men can also have a diastasis, thus reinforcing the theory that diastasis correlates with function of the abdominal canister meaning your diaphragm function, core, and pelvic floor function!
How do you check for a diastasis?
It’s as simple as lying on your back with your knees bent and feeling with your fingers at different areas along the linea alba. Then, simply lift your head off the ground and assess again. You are feeling for gap (# of finger widths) and for depth (squishiness/fingers sinking in). Remember, DEPTH is more important than the GAP!! We want it to feel firm like a trampoline, not soft and squishy!
What should I do about it?
A postpartum or pelvic floor physical therapist can help you assess for a diastasis recti & guide you in the proper exercise program for you! Like I said before, it can be a sign that the deep inner core system is not working properly and we need to figure out what’s not working to create balance in the system so you can effectively transfer load through your trunk!
In general, I recommend to anyone with a DR to assess it in any position as you are doing exercise to ensure there is no worsening or bulging in the diastasis. If there is, you likely need to modify the exercise you are doing! ALWAYS check your DR in front loading exercises like planks or roll-ups, indirect front loading exercises such as pull-ups or standing arm work, transitions in yoga, and even things like running and swimming!
Something that may be fine for one person to do may not be the best thing for you! It’s not that you can’t do it, we may just need to modify it for you for a period of time to meet you where you are at and help you safely get that system working properly so that down the road you can do everything and anything you want without having to worry!
Do you think you have a diastasis? Are you having trouble getting your core to fire after having a baby? Do you have difficulty controlling your breath during movements?
Call 614-437-9002 OR Email khartley@grandviewprimarycare.com today!! :)
I would love to help you heal your diastasis and get your entire system working so you can be at your optimal function!!
Kaitlin Hartley, PT, DPT