Diastasis Recti: What It Is and How to Overcome It

Diastasis recti is a condition where the belly sticks out due to a widening of the space between your left and right belly muscles. It’s sometimes referred to as a “pooch.”

So what exactly is diastasis recti and how can you treat it? Here’s a look.

Basic facts

Diastasis recti is very common among pregnant women, affecting about two-thirds of all women who become pregnant. It can also be found in newborn babies, though it should go away on its own in these cases. Men can get it as well, possibly from yo-yo dieting, doing sit-ups or weight lifting incorrectly, or from other causes.

Pregnancy puts enough pressure on the belly that causes the inability of muscles in the front of the stomach to keep their shape. “Diastasis” refers to separation, and “recti” refers to ab muscles (short for rectus abdominis). In these cases, the uterus, bowels and other organs only have a thin connective tissue band to hold them all together. Without proper muscle support, a vaginal delivery can become difficult.

Risk Factors and Side Effects

Risk factors for diastasis recti include:

Pregnancy
Being a newborn baby
Having more than one child, especially if they’re close together in age
Having a heavier baby, twins, triplets or more
Yo-yo dieting (in men)
Doing sit-ups or weight lifting improperly (in men)

Diastasis recti can lead to side effects like lower back pain, constipation and urine leaking. It can also cause difficulty with both breathing and movement. In some rare cases, tissue may tear and form a hernia, where organs poke out of the opening.

Dos and Don’ts

There are a couple areas to be careful of in relation to diastasis recti. Two “do” areas:

Do be careful with exercise: Certain fitness moves like sit-ups, crunches, push ups, press-ups and front planks can exacerbate abdominal separation, as can swimming, certain yoga poses and any activities on the hands and knees.
Do heal the belly: Physical therapists don’t have a single standard guideline for bringing muscles back into line. Certain exercises involving a belly splint may help (called the Tupler technique), and Pilates or other exercise can help strengthen muscles after connective tissue has healed. If you’re working with a trainer, make sure they are aware of diastasis recti. If possible, begin core strengthening before you become pregnant. Ask your doctor about proper exercises during or after pregnancy.

In addition, a big “don’t” surrounding diastasis recti is straining. Things like constipation, heavy lifting, standing and sitting all can count as straining, as can pushing during birth. All these actions can put undue strain on belly muscles.

Treatment and Prevention

During treatment for diastasis recti, a doctor can measure how far apart belly muscles are using finger widths, measuring instruments or an ultrasound test. Treatment methods include:

• Gentle movements: Many women can learn gentle movements to use while the abs are supported. Ask your doctor about these—they may refer you to a physical therapist.
Tummy tuck: An operation called abdominoplasty (or a “tummy tuck”) might be used, where a surgeon folds and sews back together the weak central ridge.
• Laparoscopy: Surgery done with only small cuts instead of a large one.

Protecting the abdomen can go a long way toward helping muscles refrain from separating. Pregnant women should always use the “log roll” maneuver when getting into or out of bed, or up from the couch or floor—that means rolling onto one side with the head and torso aligned, then pushing with the arms. There are also simple ab workouts that can help. Ask your doctor about these.

If you’re dealing with diastasis recti, your doctor will offer a treatment plan for you.

I practice the full range of family medicine including obstetrics, pediatrics, adolescent medicine and adult medicine. I also practice some orthopedics, remove lumps and bumps, and perform colposcopy, cryotherapy and vasectomies. Due to the volume of deliveries we do, my practice has evolved to be more centered on women and children’s medicine, but I enjoy all aspects of family medicine.