Having a baby is exciting and rewarding, but pregnancy and childbirth also bring changes to your body.
After delivery, some new moms may experience diastasis recti — a separation of the rectus abdominis muscles. Specialized physical therapy can help you reduce this unwelcome change and regain strength in these muscles.
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What Is Diastasis Recti?
The rectus abdominis, or “six-pack muscles,” are a pair of long, flat muscles that run vertically down each side of the abdomen. These muscles help stabilize your trunk and hold in your internal organs.
Diastasis recti occurs when these muscles separate during pregnancy or after you give birth, leaving a gap, a belly pouch, or a sense of abdominal weakness.
The linea alba is the connective tissue that joins the two sides of the rectus abdominis muscle. As the belly expands during pregnancy, this connective tissue stretches and causes the muscle to separate from the linea alba. Pregnancy hormones help this connective tissue to relax as the baby grows and during labor and delivery.
As postpartum hormones return to pre-pregnancy levels, the linea alba heals and the muscles come back together. If this doesn’t happen in three to six months, there may be a gap that won’t close without treatment. Approximately 40 percent of women still have some degree of diastasis six months after giving birth.
A diastasis recti can look like the top of a loaf of bread or a ridge protruding from your midline. This ridge becomes more prominent when you strain and hold your breath while sitting up, lifting, or even coughing and sneezing. The ridge may go away or cave in when you lie down or relax your abdominal muscles.
How is it Treated?
It can be difficult to rebuild core strength and bring these muscles back together once the connective tissues get stretched out, but it’s not impossible. Traditional crunches can make the condition worse because they stretch the connective tissue even more.
A physical therapist can guide you in doing specific exercises to correct the diastasis. Physical therapy also can help women having a hard time strengthening their core, even if they don’t have a diastasis recti.
If the diastasis is severe and you don’t plan to get pregnant again, surgery may be an option. This involves stitching the abdominal wall muscles back together along the midline. For women who do plan to have more children, it’s better to participate in physical therapy to strengthen the core before the next pregnancy. A diastasis may recur, but it’s likely to be less severe.
Other health issues that may arise due to a diastasis include chronic low back pain, pelvic or hip pain, constipation, urinary incontinence, and pain during sex.
How Can I Prevent Diastasis Recti?
Before becoming pregnant, take preventive measures and do exercises to strengthen your core muscles. You can continue some of these exercises through the first trimester but consult your doctor. Staying active helps, as well. Women who exercise regularly during pregnancy are less likely to develop diastasis recti.
To learn more about physical therapy and women’s rehab, visit UPMC Rehabilitation Institute.
Editor's Note: This article was originally published on , and was last reviewed on .
The UPMC Rehabilitation Institute offers inpatient, outpatient, and transitional rehabilitation, as well as outpatient physician services so that care is available to meet the needs of our patients at each phase of the recovery process. Renowned physiatrists from the University of Pittsburgh Department of Physical Medicine and Rehabilitation, as well as highly trained physical, occupational, and speech therapists, provide individualized care in 12 inpatient units within acute care hospitals and over 80 outpatient locations close to home and work.