100% of pregnant people who reach their third trimester will have a diastasis recti. So … should that word really be that scary? In the past few years, it seems to be more of a fear-mongering term circulating around social media. However, by learning more about it, you may find that it does not have to be so anxiety provoking.
What is a Disastasis?
Diastasis Recti refers to the widening and thinning of the Linea Alba, a band of connective tissues that separate the rectus abdominis (aka your 8-pack muscles). It is normal for this to occur during pregnancy, as the abdominal cavity needs to stretch to make room for a growing fetus. The distance between the two sides of the abs is called the inter-recti distance and can be measured via finger widths, while the gold standard of measurement is via ultrasound.
When Should You Be Concerned?
Although diastasis is normal in all pregnancies, coning is not. Although common, coning is a sign that abdominal pressure is not being managed effectively, which results in some of the abdominal contents being pushed out towards the linea alba or into the diastasis recti. This could result in hernias, pelvic floor dysfunction, back pain, etc. Therefore, as pregnancy progresses, it is important to make the appropriate modifications in exercise and activity to protect the abdominal region. Many of these exercises involve recruiting the transverse abdominis muscle, a deeper abdominal muscle that acts as a brace to prevent coning.
Likewise, this linea alba needs to be protected during the postpartum period as it takes time to heal. Studies have shown that at six weeks postpartum, abdominal fascia only regains 51-59% of tensile strength, and 60% of women have a diastasis. Additionally, At 6-7 months, abdominal fascia only regains 73-93% of tensile strength, and 32% of women had a diastasis. Depending on genetics, some people may never get the diastasis to fully approximate. However, as long as pressure is being managed effectively and the deeper abs are being recruited, then this is not a concern functionally. If the look of the diastasis at rest bothers you, you may opt for surgery for aesthetic purposes.
How Can I Safely Resolve the Diastasis?
Physical therapy can be a huge asset for pregnant and postpartum individuals—specifically, a physical therapist specializing in the pelvic floor and working with this population. At your evaluation, the physical therapist may look at your breathing pattern, test muscle strength and flexibility, and palpate for any tension in the muscles. A pelvic floor muscle examination may also be a good indicator of how well everything is functioning and whether it is coordinating to manage abdominal pressure. From the exam, the physical therapist may suggest different functional modifications, work on appropriate abdominal recruitment, or give a graded exercise program for you to return to your desired physical activity.
Do not hesitate to include a physical therapist as part of your birth team. A doctor of physical therapy specializes in the musculoskeletal system and can make a big difference in your birth experience and the speed of your recovery.
Other fun facts about diastasis recti:
– Your newborn baby has it too! It takes your child 2-3 years to approximate this connective tissue. Think about it you are not alone in the postpartum recovery process. Your baby is also learning neuromuscular awareness and how to gain control of these muscles.
– This is also common in many “beer bellies” or those with distended abdomens. Therefore, people of other gender identifications can have diastasis recti, even though they have never been pregnant before.
Written by: Alyssa Woo, PT, DPT, PCES
Pregnancy and Postpartum Certified Exercise Specialist