Diastasis Recti: An Unknown But Common Condition

Published on: December 10, 2021

39% of all women have diastasis recti six months after giving birth. What is it, and how do you know if you have it? Ingrid explains.

By Ingrid Hanifen

What is diastasis recti? Simply put, it’s the thinning of the connective tissue that joins the abdominal muscles in the middle, or a separation of the abdominal muscles. When I was pregnant with my first son, no one told me that my abdominal muscles would pull apart over the course of nine months to accommodate my growing bump. Logically, it makes sense. Where is the baby supposed to go? Your abdominals must stretch to make room for the baby. I didn’t know that abdominal separation had a term: diastasis recti. I had never heard of the condition in all my years of working as a personal trainer and as a nurse. While having a diastasis is normal after giving birth, the separation does not always close on its own, and in fact, some women may make the separation worse by doing the wrong exercises or movement patterns. 

Your abdominals are made up of 4 muscles.

• Rectus abdominis, or the ‘six pack’ runs from your xiphoid and rib cage to your pubic bone, and these are the muscles that separate during pregnancy. 
• External obliques are the outer layer of your abs that run diagonally downward. 
• Internal obliques are located just underneath the external obliques and run diagonally up your sides.
• Transversus abdominis, or ‘corset’ muscles; the deepest inner core muscles that wrap around your waist to support your spine and help to support your inner organs. The transverse abdominals are the main stability muscles for the abdominals and spine. 

At their due date, 100% of women had a diastasis (Mota et al., 2015), at six weeks postpartum 60% (Sperstad Et Al., 2016) had a diastasis, and at six months postpartum, 39% of all women had a diastasis. Most women are unaware that they have diastasis recti, and most doctors do not check for it at the standard six-week checkup. So, how do you know if you have it? The gold standard for checking is with an ultrasound, but here is a simple self-test that you can do. 

Check width and depth: above, at, and below the belly button.

1. Lie on your back with your knees bent and your feet flat on the floor. Your feet should be about a foot away from your bottom.
2. Lift your head about one inch off the floor, while keeping your shoulders on the ground.
3. Use your fingers to see how wide your gap is. Your palm should be facing
   you while measuring. Make sure to check all three areas listed above.
4. Technically, anything over 2.5 finger widths is considered a diastasis.
5. Now, measure the depth. How deep do your fingers go into the gap? 

While the width of the separation is important, the depth that your fingers sink in is also important, perhaps even more so. How many knuckles deep do your fingers go? The tissue should feel like a trampoline on firm connective tissue. They should not sink in. If you are doing the test and you notice that your separation is wide and your knuckles sink deep into your abdominal separation, then it’s time to seek help. Through correct exercises and knowledge, it is possible to close the gap and strengthen the connective tissue and deep inner core. Physical therapists, especially pelvic floor physical therapists, can help. 

Additionally, personal trainers that are postpartum certified can also help to correct the separation. Healing a diastasis is not a one-size-fits-all solution. Each woman is different, therefore, each approach to healing should be unique to that individual. 

Are all exercises safe to do after giving birth? If your doctor says it’s okay to exercise and you have tested yourself and you have diastasis recti or your separation is deep, there are some exercises that will make the problem worse. Standard crunches, sit-ups, planks, or twisting ab movements can make the separation wider. These types of exercises are not a no-no forever, but it is important to address the core pressure system first, and then slowly progress each exercise from there. While most separations will heal naturally on their own, many women will have to purposely retrain their deep inner core and pelvic floor muscles so that they are able to narrow the gap and firm up the connective tissue between the abdominals. 

Photos from Canva.

References 

Mota, P., Pascoal, A.G., Carita, A.I., & Bo, K. (2015). Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Manual Therapy, 20(1), 200-205, https://doi.org/10.1016/j.math.2014.09.002

Sperstad, J.B., Tennfjord, M.K., Hilde, G., Ellstrom-Engh, M., & Bo, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: Prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine, 50(17), 1092-1096. https://doi.org/10.1136/bjsports-2016-096065

About the Author

Ingrid Hanifen BSN, RN, CPT has a background in nursing and exercise science. She is a Gentle Sleep expert and personal trainer with a specialization in pregnancy and postpartum exercise. She currently lives in Bangkok with her husband and two boys. Please get in touch at Ingrid@BestRestFamilies.com for more information.

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