It’s common knowledge that it takes about as long to regain your pre-pregnancy body as it did to gain weight during pregnancy – around nine months. However, if you notice a persistent belly bulge that doesn’t disappear months after giving birth, it could be a sign of diastasis recti, a condition characterized by the separation of your abdominal muscles.
Normally, the gap between your abdominal muscles is quite small, approximately 0.5 to 1 centimeter, or about the width of one finger. Diastasis recti occurs when this gap widens to two or more finger widths, causing your belly to protrude. This bulge can sometimes feel firm or “hard” to the touch, which may be concerning for new mothers.
What are the Causes of Diastasis Recti?
Your abdominal muscles, specifically the rectus abdominis, typically meet in the midline of your abdomen. During pregnancy, hormonal changes cause the connective tissue (linea alba) that holds these muscles together to thin and stretch. This natural process allows your belly to expand to accommodate your growing baby. As your uterus expands, it pushes the abdominal muscles apart. In diastasis recti, these muscles become so stretched that they don’t fully return to their original position after childbirth.
While diastasis recti is prevalent after pregnancy, affecting approximately two-thirds of pregnant women, it’s not exclusive to new mothers. Newborn babies and even men can also develop this condition. In men, diastasis recti can result from excessive strain during exercises like sit-ups or heavy weightlifting, or any activities that put significant pressure on the abdominal area.
Who is More Likely to Develop Diastasis Recti?
Certain factors can increase your risk of developing diastasis recti:
- Multiple Pregnancies: Having more than one child increases the likelihood.
- Closely Spaced Pregnancies: Pregnancies that occur close together don’t give abdominal muscles much time to recover.
- Advanced Maternal Age: Being older than 35 when pregnant can increase risk.
- Carrying Multiples: Pregnancies with twins or triplets put extra strain on the abdominal wall.
- Large Baby: Carrying a heavy baby can contribute to muscle separation.
- Small Body Frame: Women with smaller frames may be more susceptible.
- Previous Diastasis Recti: If you experienced diastasis recti in a prior pregnancy, you’re more likely to have it again.
Recognizing the Symptoms of Diastasis Recti
The most prominent symptom of diastasis recti is a persistent belly bulge that remains eight weeks or more after delivery. You might observe a noticeable bulge pushing outward or a sunken area along the center of your abdomen, particularly when you engage your abdominal muscles, even slightly. This bulge might feel firm, contributing to the sensation of a “hard belly.”
Diastasis recti can weaken your core and lead to pelvic organ prolapse, where pelvic organs descend from their normal position, because the separated abdominal muscles are unable to adequately support your spine, bowels, bladder, and other internal organs. Furthermore, diastasis recti can contribute to other health issues, including:
- Constipation
- Lower back pain
- Urinary incontinence
- Abdominal discomfort or soreness
In severe cases, diastasis recti can lead to a hernia. This occurs when internal organs or tissues protrude through a weakened area in the abdominal wall and may require surgical intervention.
Can Diastasis Recti Be Prevented?
While some risk factors for diastasis recti are beyond your control, you can take steps to minimize strain on your abdominal muscles during pregnancy, potentially reducing your risk.
- Avoid Intense Abdominal Exercises: Refrain from crunches and other strenuous abdominal exercises after your first trimester.
- Practice Proper Body Mechanics: Use correct techniques when lifting older children, getting out of bed, and exercising to minimize abdominal strain.
- Maintain Abdominal Strength Gently: Engage in gentle core-strengthening exercises like pelvic tilts and Kegel exercises throughout your pregnancy.
After delivery, allow your body sufficient time to heal. Avoid any abdominal exercises, especially crunches, until you have received clearance from your healthcare provider. Discuss safe exercises with your OB/GYN during your postpartum check-ups.
How is Diastasis Recti Addressed?
The initial step in managing diastasis recti is to determine the extent of the muscle separation. Your healthcare provider can assess this by checking how many fingers fit into the gap between your abdominal muscles. Treatment often involves physical therapy, focusing on specific exercises, core stabilization, and proper bracing techniques. In more severe cases, surgery may be considered.
A physical therapy plan for diastasis recti might include:
- Gentle Abdominal Exercises: Targeted exercises to gradually strengthen and bring the abdominal muscles back together.
- Abdominal Binder: Wearing a support belt or abdominal binder around your belly can provide support and aid muscle recovery.
- Manual Therapy: Hands-on techniques to release tension in tight abdominal muscles.
- Abdominal Taping: Supportive taping to assist muscle engagement and core strengthening.
- Body Mechanics Education: Learning to engage core muscles correctly during exercise and daily activities to prevent widening the muscle gap.
The duration of physical therapy varies depending on individual progress and the severity of diastasis recti. Physical therapy can be particularly effective for women with less severe separations and for those who want to address diastasis recti before future pregnancies.
For significant diastasis recti that doesn’t improve with physical therapy, surgical options may be considered. Discuss your treatment options with your OB/GYN to determine the most appropriate course of action for your situation.
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For a consultation with Virtua Physical Therapy & Rehabilitation, please call 855-847-8821.
