Diastasis Recti – what is it, do I have it, and if I do, what do I do about it?
In order to answer these questions, we first have to look a little closer at our anatomy. The “abs” are made up of several layers of muscle and fascia. These include the Transverse Abdominis (TA), which is the deepest layer that acts as a corset to brace and stabilize the spine. The Internal Obliques (IO) and External Obliques (EO) aid in respiration, and work together to create trunk rotation. Finally, the Rectus Abdominis (the 6 pack muscle) sits atop these other muscles, and is responsible for flexing the spine and compressing the abdominal contents. It is connected by a thin sheath of tendinous tissue called the Linea Alba. The Linea Alba’s primary job is to stabilize the rectus muscles and aid in load transfer (distributing weight from one place to another).
Diastasis Recti (DR) is a thinning of the aforementioned linea alba, causing a separation of the rectus muscle bellies. DR is noted in both men and women, and can happen during pregnancy, with excessive weight gain (especially the “beer belly” population), or as a result of poor load transfer with decreased or overactive pelvic floor activation. A telltale sign that you may have diastasis recti is a “coning” or “doming” effect when sitting up from a lying position, bending over, or when lifting under load. Diastasis can get worse with poor core pressure management and/or with the wrong exercises.
The gold standard diagnosis of a diastasis is performed via ultrasound. However, it can be checked and measured for width and depth with your fingers.
- Start by lying on your back with your knees bent and feet flat on the floor.
- Find your belly button and place your fingers just above it.
- Gently lift your head and take note of what you feel.
- Do your fingers sink or do you feel tension underneath your fingers?
- Do you feel your abdominals close in around your fingers?
- Take note of how many fingers (width & depth) before you feel tension.
- You’ll repeat this process 3-4 fingers above your bell button (toward you ribs) and 3-4 fingers below (toward your pubic bone) and record your findings.
- Repeat all the steps above again, this time brace your abs and lift your pelvic floor (as if stopping the flow of urine) prior to lifting your head.
- Record those findings and compare them to previously recorded findings.
*Note: We place more importance on the depth and tension felt, than the width, but all factors are great indicators of where we start and our progress.
It is worth noting that there are different types of diastasis, which is why we test at, above, and below the naval. Also note, these should be checked/tested in different positions. Things might look/feel great while lying on your back, but in a plank or quadruped position, or while the core is loaded (ie. squats, deadlifts, pull ups, etc.), you may find that your diastasis worsens.
Now that we know what diastasis is and how to know if we have it, what do we do? Diastasis Recti typically forms from a poor pressure management system. Our core is unable to efficiently/effectively handle the load we are asking it to. So, to better manage DR, we need to better manage our core pressures and make sure all of our core musculature is showing up equally. We do this by:
- Improving our breathing
- Coordinating our pelvic floor with our breath
- Managing strength and tension through our abdominals
- Making sure other “players” in our kinetic chain are showing up appropriately
If you have questions about diastasis and the management thereof, make sure to reach out to a medical professional for help – it can be fairly simple, or quite complex. When searching for a medical provider to best help with treatment of DR, seeking a therapist that specializes in Pelvic Floor therapy can prove to be especially effective in the reduction of, and any painful symptoms that can arise due to Diastasis Recti.