How to Fix Your Diastasis Recti

with our Pelvic and Orthopedic Physiotherapist, Agnes Budyn

What is Diastasis Recti? 

Diastasis Recti Abdominis (aka diastasis) is a separation of the abdominal muscles called the Rectus abdominis or the “six pack muscles”. Diastasis is very common and a normal occurrence during pregnancy as your belly expands and puts pressure on the abdominal muscles to stretch along the midline and allow space for a growing baby. However, diastasis can also occur in people who are not pregnant, often due to factors like excessive abdominal strain, obesity, improper exercise techniques, or repeated heavy lifting. 

What are common symptoms of diastasis recti? 

Common symptoms of diastasis recti include a visible bulge or “doming” along the midline of the abdomen, especially when engaging the abdominal muscles or sitting up, and can also result in or contribute to lower back pain. 

How do I know if I have diastasis recti? 

Here is a simple self-check at home to get an idea of whether you might have diastasis recti:

1. Find a Comfortable Spot: Lie on your back on a flat surface, such as a yoga mat or a bed. Bend your knees and place your feet flat on the surface. 

2. Locate Your Belly Button: Place your fingers just above your belly button horizontally and feel for any tension 

3. Engage Your Abdominal Muscles: Gently lift your head off the ground, as if you were doing a mini crunch. You don't need to lift very high—just enough to engage your abdominal muscles while holding your fingers in the above position. 

4. Feel for a Gap and for Tension: As you lift your head, pay attention to the area above your belly button where your fingers are placed. Use your fingers to feel for a gap or separation between the muscles. The separation might feel like a soft, squishy area or a gap where your fingers sink in. Pay attention not only to the width of the separation but also how squishy the tissue feels. Do your fingers sink in very deep, or not at all? 

5. Check Different Points: Repeat this process by moving your fingers a few inches above and below your belly button, as well as at your belly button level. This can help you determine the extent of any separation. 

Keep in mind that it's normal for there to be some gap between the abdominal muscles, especially in the immediate postpartum period. Also know that this is only one of many ways to check for separation and does not take into account functional movements or positions. You can see a pelvic physiotherapist for a more in depth assessment of this. 

If you notice a lack of tension (fingers sinking in very deep), a significant gap or if you're experiencing discomfort, it's a good idea to consult a healthcare professional, such as a pelvic floor physical therapist, for a proper evaluation and guidance.

How do I fix my diastasis recti? 

While we tend to be very fixated on how to “close the gap” to fix diastasis recti, the width of your diastasis gap (“ab separation”) is actually not important for daily function. What matters most is how our core is functioning and the core strength we have. When healing diastasis, we want to shift our focus to improving how our core functions and supports us in our daily activities. 

What if I still want to close my gap? 

If trying to close your diastasis gap is important to you, here are a few things to keep in mind:

1. If you’re newly postpartum, time may help to close the width of your gap, and it’s possible that core strengthening may contribute to this as well. 

2. Surgery is an option that some individuals may consider for closing their gap, and you should speak with your primary care provider and/or a pelvic physiotherapist about this if you want to learn more. 

3. Try to remind yourself that the width of your gap is not important for your general health and core function. Instead, try to shift your focus and energy towards improving your core function. 

How do I improve my core function? 

To improve your core function, it is first important to understand the core and how these muscles work. The inner core consists of 4 parts: 

1- the diaphragm (used for breathing) 

2-the pelvic floor 

3-multifidus (small, deep muscle of the low back) 

4- transversus abdominis (deepest layer of abdominal muscle) 

These 4 structures work together to create the integrity of the core system by changing pressures inside your abdomen via the core breath. For example, when you inhale, your belly should rise and expand as the pelvic floor releases. When you exhale, your belly should draw in as the pelvic floor engages. 

When working in a coordinated and efficient way, these structures provide the fundamentals for optimal strength and support of your spine and pelvis. They are the basis for recovering your core strength and function. Once your individual and unique condition is assessed, a progressive overload strength program will be invaluable in gradually restoring strength and function. 

For more information and to book an assessment, contact your pelvic floor physiotherapist. Your core and abdominal separation will be assessed in various positions and you will be given a personalized treatment plan to help rebuild and retrain your core to feel your best!

Agnes Budyn, RPT, Certified Pelvic Floor Physiotherapist