Diastasis Recti

What Is It?

It is the separating of the abdomen right along the center (the linea alba). The gap can occur anywhere along the linea alba from the end of your sternum to your pubic bone.  The abdominal muscle that gets affected is the rectus abdominis (RA) or the six-pack muscle. This condition most often occurs in pregnancy, but can occur in anyone. Almost all infants are born with a diastasis recti (DR)and repair it on their own as they learn how to regulate their intra abdominal pressure through learning how to move. 

Those who are familiar with DR often think that the only thing they should be worrying about is their transverse abdominis muscles. However, they should understand that there are more areas affected with this condition. Other muscles heavily involved in DR are external abdominal oblique (EAO) and internal abdominal oblique (IAO).   These two muscles and TVA wrap almost all the way around your torso unlike RA.  The abdominal muscles actually heavily affect how we support our low back.  If we have DR, there’s a good chance that we will experience issues with our low back.

An aesthetic symptom of DR is a pooch or bulge in your stomach, especially when you strain or contract your abdominal muscles. Other symptoms include lower back pain, poor posture, bowel control issues, incontinence, leakage, pelvic floor dysfunction, hernias, prolapse, painful sex, core instability (leading to neck pain, shoulder pain, hip pain and so much more).

If you notice that you have these issues and have coning, doming, or separation, you SHOULD get assessed.  You can improve on this a few months post partum, but also decades past baby having years.  It is NOT too late. 

How Do You Get Back To Your Activities After Having This Condition?

I work with a lot of yogis and when they want to get back into their normal routine despite having this condition, I ask them to stay away from certain activities. Such activities include crunching. Doing navasana and even going from up dog to down dog are also advised to be avoided. You want to think of engaging your IAO, EAO, and TVA instead of RA.  

If these are not avoided, it could make DR become worse. You have to make sure that you have already rehabilitated yourself before jumping right back into your former routine.

How Do You Rehabilitate Diastasis Recti?

Rehabilitating your abdominal muscles does not necessarily mean you need to close that gap entirely. It is more based on learning how to properly regulate your intra abdominal pressure. Think about exerting yourself by trying to lift something heavy. The pressure in your abdomen builds and it needs to go somewhere.  With DR the pressure goes to the weakest spot, your midline abdomen.  Working on better rib mobility and better lateral breathing allows you to have the pressure disperse more evenly and take pressure off your DR. 

I start everyone with DR off with learning how to breathe properly again.   I teach people how to breathe 360 degrees around the rib cage.  I don’t want people to breathe with short and shallow stressed breaths or deep belly breaths that push your belly out to the front and stress where the DR is.  I teach patients to breathe laterally and posteriorly into her rib cage.  

I have used a yoga strap in classes to cue 360 degree breath before.  I have students put it around their rib cages and feel whether or not it is tightening all the way around to determine if they are filling evenly. This will help you know where you might be restricted in rib cage mobility.

Pregnant and postpartum moms are not the only ones to get DR.  Men can as well and people that have never had children.  I had a small DR after over working my core for years in college.  I was able to repair and maintain good pressure after that and after two babies.  Another thing to keep in mind is that it is common for babies to be born with DR.  They are able to rehabilitate themselves through learning how to breathe properly and learning all the different movements to take them from lying on their back, rolling over, tummy time, crawling, baby squats, standing, to walking! These developmental milestones require more and more out of their intra abdominal pressure and the slowly learn to integrate it properly.  This is a similar approach to how we work with patients in the office.  It draws a lot from the concepts of Dynamic Neuromuscular Stabilization (a rehab technique based out of Prague).  You can still rehab a DR decades after having it.    

You can discover you have DR by going to a provider and getting assessed by them or you can lie on your back and locate your linea alba. The width and the depth are measured as well as the strength of the linea alba. The texture will also say a lot about you having DR.  If there is doming or coning when you do a crunch, it is also a sign of having DR.

It’s not about closing the gap but managing pressure better and working with how the linea alba holds up the pressure pressing against it. This will help you with your functional benefits.  It is still best to get a consultation from an expert if you believe that you have DR.

If you have any questions, you can drop it in the comment section or you send me a message through Facebook or Instagram. I’d be happy to do another podcast about your questions. Also, if you want me to talk about something specific, let me know!

You can also check my TikTok account as I use the platform to educate viewers about movement, chiropractic education, yoga, pregnancy, and more! 

Thank you for listening and see you next week!