Diastasis Recti--Don't fear the "Split"

Diastasis Recti has become a huge buzz word in pregnancy and postpartum circles.   If you look at social media, there are a lot of blogs and websites; most with fear inducing information like “exercises NEVER  to do in pregnancy” or “How to Prevent Diastasis Recti.”

Here’s the thing--awareness is good, but sometimes the message gets cloudy.  Diastasis recti or DR isn’t something that all pregnant women should fear; It is a NORMAL part of pregnancy that can be managed.

You can’t prevent Diastasis recti in pregnancy; just like we can’t prevent ACL tears from happening on a field. But in both cases, we can educate and try to train our bodies to adapt to different stresses like breath holding and pushing too hard.   

“Coning” or “doming” looks like a bump in the middle of your stomach when you do things that put too much pressure through the stomach on activities like holding your breath, laughing, or coughing. It has become something women have been told to avoid at all costs---But this is where the fear has taken over.   How can you not sneeze or cough? To limit ourselves in everyday life is absurd and not the message I want to send. As PT’s, we have learned that managing this pressure through some strategies can help you continue your workout--even if you cone or dome out a bit.

Unfortunately there is a lot of bad messaging out there from influencers who may not be either up to date on actual research or have the knowledge they should to help women achieve their best self. There is no quick fix after having a baby.  There isn’t one exercise that will heal your DR, and there certainly aren’t any guarantees when it comes to the human body.

But in the aspect of positivity, here are some facts that you CAN count on from a professional and expert :

  • Diastasis recti is a stretching or thinning of the linea alba which is the fascial connection between the abdominal muscles.  It’s an objective finding that I use as a guideline to the next steps in your program. It does not define your pregnancy, your postpartum state, or your recovery and  fitness level.

  • Diastasis recti is NORMAL and is a finding in 100% of pregnant women

  • 2 cm/ finger widths or comparable measure is considered normal after pregnancy--our hopes are that we will  start getting away from this measure soon-- as research emerges, we know that it’s more about tension vs. distance. In fact, some of the distance may increase if your tension is actually better.

  • We measure how your DR functions, not how far apart you are to determine our programs. The tension you are able to produce is a good measure of how we progress

  • Coning or doming is when the abdominal pressure is pushing through the linea alba. We can learn to control this pressure with different strategies to keep you working out safely.

  • Some diastasis improve after birth, some don’t. Some require extensive rehab, and some may have surgery as an option. None of this is an indication of your pre or postpartum fitness level or your “success” during pregnancy and birth

  • Surgery for DR is called an abdominoplasty. It is discussed in some cases and is a personal decision with many factors that go into this.

Some of those “get your body back” websites or “heal your DR!” messaging can be inaccurate and lead to further injury down the road. Research continues to advance in this area every day. 20 years ago I used to have women (and men) use a sheet and pull together both sides of your stomach to make the linea alba come together!!!!    Seems silly, but that’s what we had for education. I obviously don’t do that now, but it shows, just like in orthopedics, that when studies come out, I adapt my treatment and your program. Can you say the same for the part time blogger who is showing you their six pack abs?

Another misconception is that if you discover you have DR 1.2 or even 10 years after birth, that there is nothing you can do about it---wrong. Again, we want to look at how you function, how your body is responding to pressure and abdominal challenges ,like lifting, to see how we can help.

Diastasis Recti isn’t something to be feared. You have enough to worry about taking care of your baby, juggling your schedule, and most importantly, healing. What IS important is that you address these findings from a professional who is trained in how to assess and correctly treat diastasis recti.  

You never question giving your kids the best care--don’t you deserve the same?