A diastasis recti is a separation of the abdominal wall muscles (the rectus abdominis). Most of us know the famous 6-pack muscles by looking at fitness models or bodybuilders as they are the most superficial layer of muscle and easily spottable when body fat is low and muscle tone is high. With a diastasis recti, these muscles separate in the center of the abs, causing a gap between the left and right sides of the muscle. The left and right sides of the muscle attach into a connective tissue that runs from your ribs to your pubic bone and that tissue, the linea alba - stretches and thins and as a result - the 6-pack splits - left from right.

In both men and women, this gap can be created in the midline of your belly anywhere from the pubic bone to the base of your ribcage. One obvious way to feel for the gap is during a crunch or sit-up, where one would normally feel tension and closure at the center of the abs, there is a space and a gap and your fingers can sink into your belly easily...

What Causes Diastasis Recti:

Diastasis recti is a partial or complete separation of the rectus abdominis muscles due to weakened midline tissues, the linea alba. This separation can take place between the infra/cost/al and the pubis regions.

The most common causes of Diastasis recti include:

• Multiple pregnancies
• Rapid weight loss or gain
• Improper engagement of abdominal muscles (i.e. weightlifting)
• Underlying abdominal disease, illness: (i.e. cancer, cirrhosis)
• Obesity

Additional Causes of Diastasis Recti:

Many people wrongly believe that a diastasis recti only occurs postpartum. That is just not the case. Many athletes, body builders, and even those with a sedentary lifestyle can develop a diastasis recti.

Although many symptoms are the same in men and women with a diastasis, how they appear can be somewhat different.

Most commonly, a diastasis recti develops during pregnancy. However, men and children can also develop diastasis recti if there are underlying core issues such as:

• Weakened Core Muscles
• Core Injury
• Unusual Abdominal Pressure

Diastasis recti occurs due to an unnatural amount of pressure within the abdominal wall and core muscles. This can occur due to injury, improper breathing patterns, core tension, imbalance of pressure within the abdomen, and even through over toned muscles (oblique dominance).

Who Develops It Most Often?

The risk of developing a diastasis recti varies with each individual. However, I have noticed some similarities with how it can develop:

• Multiple pregnancies
• Rapid weight loss or gain
• Weightlifting
• Certain core exercises that induce a lot of core pressure
• Underlying Abdominal Illnesses (i.e. stomach cancer, or cirrhosis)
• Obesity

Determining what factors in your daily life could be weakening your core and correcting them is the primary concern when dealing with DR. Although there are some risk factors that can lead to a diastasis recti developing, oftentimes it's uncertain.

How to Prevent it

Numerous techniques for preventing diastasis recti include postural awareness, corrective workouts, and an effective prehab strategy while pregnant. Yet, most of these are very important to remember despite your gender, or whether you’re expectant or otherwise.

• Understand a good/ healthy and balanced/ useful core method
• Employ appropriate breathing patterns
• Free your abs of excess tension
• Avoid exercises which increase focalized stress in the abdomen
• Exercise great posture

Although diastasis recti is not entirely avoidable, the listing helps paint a clear picture on how to protect your core while still staying active. The key is to be mindful of your body’s function and how to increase your functionality and build strength without causing harm to your body. It is possible to be active and functional without injury. 

How to Test

If you think you have a diastasis recti, you can perform a self-test at home or have a physical therapist assess you. A self-assessment can be performed as follows:

1. Lie on your back in a comfortable position. Bend your knees and place your feet flat on the floor.
2. Place one hand on the midline of your core with your fingers pointing straight down on your abs.
3. If you need support for your head, place your other hand under your head and neck for support. Slowly lift your head and add minimal pressure to your fingers placed on your core. With no diastasis recti, there is the feeling of a toned wall as you lift your head up. If you feel a gap, or your fingers sink into your core, you likely have diastasis recti. In very obvious cases, you can feel the sides of your core muscles in between that gap on the left and right sides.
4. Repeat the process for the areas just above your belly button and below your belly button to determine whether or not the diastasis recti is isolated or in your core as a whole.

As mentioned before, a gap that is only one or two finger widths wide might not be a big concern, unless it is deep - but caution is recommended. However, if you discover that you have a gap ranging from 2.7 cms or larger (2.5 fingers or larger) you should consult a PT or OT.

Treatment Options

Healing looks different for each person and the time it takes to heal depends on the severity of the injury to the linea alba and connective tissues.

Knowing it takes a long time should give you hope! For some people it can take years to properly heal and to restore full function. Getting back to doing all the things you love can happen. Healing just takes time.

I have found that what best helps most of my clients with diastasis recti are:

• A program, like my Restore Your Core program, which aids in learning proper core loading strategies and encourages a holistic approach to healing and getting stronger.
• Diet modification. I am not a dietician and don’t make recommendations, but digestion can be affected by diastasis recti. Many clients have found that intermittent fasting, no sugar, and no gluten has helped them. Consult your dietician if bloating and constipation are an issue for you.
• Add more load. Heavier weights and harder moves to strengthen your core further.
• Myofascial release with an expert can resolve unhealthy patterns like oblique dominance or releasing scar tissue that is inhibiting function.
• Add cardio once your core system is more optimized.
• Changing your mindset about outcomes and expectations without fearing movement.