Summary List Placement
When your abdominal muscles — also known as rectus abdominis — are under a lot of pressure due to pregnancy or repeated heavy lifting, you may be at risk for a condition known as diastasis rectus abdominis (or diastasis recti).
Diastasis recti is the separation of your abdominal muscles that occurs when its connective tissues are stretched, says Bohdanna Zazulak, DPT, physical therapist and orthopedic certified specialist at the Yale Medicine Department of Orthopaedics & Rehabilitation and Yale New Haven Health. On the body, it appears like a bulge or ridge in the middle of the stomach area.
It is a condition that heals on its own in about six to 12 months in infants and in pregnant women. Core exercises can help stabilize your abs and/or consult a physical therapist to help improve your symptoms. Surgery may be needed if your core isn’t strong enough, it regularly interferes with your daily routines as in the case of pain, or if you’d like to have it fixed for cosmetic reasons.
Here are the symptoms, causes, and treatment of diastasis recti.
How do I know if I have diastasis recti?
There are several symptoms of diastasis recti, which include:
- A bulge in the middle of the abdomen
- Lower back pain that causes difficulty in lifting objects or doing routine daily activities
- Abdominal or pelvic pain
- Incontinence, or the loss of bladder control
Having diastasis recti means that the muscles that meet in the middle of the abdomen become separated. “This causes the belly to protrude, [when laying on your back] with a ridge running down the middle of your abs when you lift your head and shoulders off the ground,” says Zazulak.
People most at risk of diastasis recti include:
- Pregnant or postpartum people, especially those with multiple pregnancies, because the growing uterus stretches the abdominal muscle
- Newborn babies, because their abdominal muscle is not yet fully developed
- Bodybuilders, laborers, and people who do a lot of weight lifting, due to the repeated increase in abdominal pressure
The pressure stretches the abdominal muscles, which makes them weak and unable to generate enough tension. This reduces your core’s ability to control torso movement and maintain the stability of the spine (aka core stability).
Can you fix diastasis recti without surgery?
In some cases, diastasis recti can heal on its own over time and surgery isn’t usually necessary unless its for cosmetic reasons. However, core stability exercises, like deep breathing exercises and pelvic floor contractions, can improve your condition.
If you want to remove the abdominal bulge for cosmetic reasons, you can choose to undergo a procedure called abdominoplasty (aka tummy tuck) to tighten abdominal muscles and remove fat and skin. When your abdominal muscles do not get stronger despite muscle training, and it routinely affects your daily activities, you might need surgery to repair the muscle separation.
According to Zazulak, physical therapy can help improve abdominal strength and core stability. An individualized professional assessment from a physical therapist is necessary to provide effective treatment.
What to avoid when you have diastasis recti
When you have diastasis recti, you should refrain from doing strenuous activities that put pressure on the abdominal muscles, such as:
- Exercises like crunches, sit-ups, and pushups
- Heavy lifting
- Pushing a stroller while leaning forward up a steep hill
- Wearing a front-loading baby carrier
- Sports that require forceful abdominal contraction, like tennis or golf
Having weak abdominal muscles also means modifying simple daily activities like getting out of bed, says Zazulak. Instead of sitting up instantly, you’d need to roll onto your side and use your arms to help yourself up.
Diastasis recti is a condition where the abdominal muscles are separated due to excessive stretching or pressure from pregnancy or repeated heavy lifting. It is usually characterized by a bulge in the middle of the abdomen, but other symptoms include pain in the abdomen, lower back, or pelvic area.
The condition can heal on its own, and surgery isn’t usually necessary unless it limits your functional movement. To avoid developing diastasis recti, you must regularly strengthen your core with abdominal exercises.
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