What is Diastasis Recti and How Can You Prevent It?

By Kris Minear, L/PTA, E-RYT200

Diastasis Recti (pronounced dai·uh·STAY·suhs · rek·TAI) is the medical term for the separation of the connective tissue (called the linea alba) of the rectus abdominis muscles, the most superficial muscles that people generally associate with the “six-pack.” While the six-pack gets all the glory, your core is composed of many more muscles that support your trunk, such as the deep transverse abdominal muscles, spinal muscles, psoas, glutes, and pelvic floor muscles.

Diastasis Recti occurs when there is repetitive pressure placed on the abdominal wall, causing the linea alba to separate, exposing the abdominal contents underneath. Risk factors for developing Diastasis Recti include pregnancy and childbirth, vaginal delivery and pushing, weakcore and pelvic floor muscles, poor posture, and poor training form - especially during heavy-lifting activities.

When there is excessive intra-abdominal pressure, like, for example, when there is a growing fetus and uterus pressing against the abdominal wall, the fascial lining connecting the rectus abdominis becomes weak, overstretched or completely separated. While this may sound scary, there are ways to help prevent Diastasis Recti during pregnancy!

Awareness is key: understanding how to activate your deep core muscles is the first step to preventing Diastasis Recti. To engage your deep transverse abdominal muscles, try lying on your back in a hooklying position with your knees bent, feet flat, and head and shoulders relaxed. You should be able to straighten your arms and tickle the back of your ankles. If you can’t, slide your heels closer to your glutes.

Place your hands on your belly. Take a big breath in through your nose and feel your belly rise up towards the ceiling. When you exhale, hug your belly muscles to your spine and feel your core tighten. It can help to visualize bracing your core as if someone were about to drop a bowling ball on your belly. (Slightly aggressive, I know...) See if you can continue to breathe while keeping your core locked in. (Fun fact: yogis call this abdominal core lock the “Uddiyana Bandha.”)

If you’re further along in your pregnancy and laying on your back doesn’t feel comfortable, then you can also activate your core by sitting in a chair with your hands flat on a table (or a theraballif you have one nearby!) Take a breath in through your nose, and on the exhale press both your

palms into the table or theraball as you brace your belly muscles up and in. Notice if you can feel that strong core-bracing sensation of hugging or squeezing in of your abdominals (which will bring your lowest front ribs slightly closer to your pubic bone) versus a “sucking in” action.

Now that you’ve identified your deep core muscles, try a few standing air squats while maintaining your active core lock and keeping your breath moving! (Warning: it’s a bit like trying to pat your head and rub your belly simultaneously the first few times you try to incorporate breath, core activation, and movement, so be kind to yourself!) Breathe in as you bend both knees and squat low, and exhale when you return to standing. Placing your hands on a chair or table while performing squats can be helpful for stability, especially if you’ve been experiencing ligament laxity during your pregnancy (ICYDK: Ligament laxity is the term for when the ligaments in your body become looser and more flexible during pregnancy due to hormonal shifts to prepare the body for birth!) If it feels safe, you can try squatting with your hands on yourbelly as a reminder to keep your core hugging in towards your body as you squat and breathe.

Using your breath to engage your core is a helpful trick, and will also come in handy as you startto move through your day with more core awareness and engagement. Try exhaling and engaging your core as you move from a seated to a standing position, when you're lifting a heavy object from the floor, and when you transition from laying on your side in bed to pushing up to a seated position. Using an exhale breath while consciously engaging your abdominals as you move throughout your day is one great way to prevent putting excessive pressure on your abdominal wall, especially when your abs are already being pushed forward due to a growing baby!

Learn how to transition safely from supine to sitting in the video below:

Just like how doing a sit up in bed can put excessive pressure on your abdominals when pregnant, performing sit-ups, supine bicycle twists, or crunches during pregnancy can also lead to Diastasis Recti. However, there are safe ways to work your core without crunches!

Activating your core without any movement is called an isometric contraction. Isometrically contracting your core muscles without flexing or extending your spine - like holding a bear crawl position or forearm side-plank, is a great way to keep your core strong without risking excessive abdominal wall pressure. 

To perform a bear crawl position, start on your hands and knees in a quadruped position. Engage your abdominals by hugging your lower belly up and in, and away from the floor. (It may be helpful to visualize pulling your belly button up towards your spine and slightly tucking your tail-bone.) Float your knees up off the floor an inch or two and hold for 3-4 breaths. Try this one in front of a mirror to make sure your spine is straight and your shoulders are aligned over your wrists. 

Want more isometric core tips? Check out more of our favorite pregnancy-safe core alternatives here: 

https://www.fixxedstudios.com/blog/four-pregnancy-safe-exercises-you-can-do-at-home

While working your core safely during pregnancy can help you feel strong and stable, it’s not a definitive fail-safe for preventing Diastasis Recti. Genetics, hormones, birth, and habitual body mechanics can all contribute to developing Diastasis Recti, despite our best efforts to prevent it. However, there are safe ways to rehab abdominal wall separation! Schedule a free 20 minute Pelvic Floor Physical Therapy consultation with us if you notice a bulging between your abdominal wall when performing a sit-up, or if a doctor has diagnosed you with Diastasis Recti. For more info, check out our Pelvic Floor Physical Therapy Program here: 

https://www.fixxedstudios.com/pelvic-floor-pt

Fixxed is a first of its kind recovery studio offering bodywork techniques to help you move and feel your best. We offer quick and effective hands-on services in a one on one setting performed by a licensed physical therapist or athletic trainer. Click HERE to book a free consultation with FIXXED!