During and after pregnancy, many women experience physical changes in their bodies. One common issue that arises is diastasis recti, often referred to as the “mommy pooch.” This condition occurs when the abdominal muscles separate due to the expanding uterus during pregnancy. In this guide, we’ll cover what diastasis recti actually is, how to check for it at home, which exercises help (and which make it worse), and how physical therapy can close the gap for good.
Understanding Diastasis Recti
Diastasis recti is a condition that affects the connective tissue between the rectus abdominis muscles, commonly known as the “six-pack” muscles. Normally, these muscles are held together by a strong band of connective tissue called the linea alba. However, during pregnancy, hormonal changes and the growing baby can cause the linea alba to stretch and weaken, resulting in a separation of the abdominal muscles.
How Common Is Diastasis Recti?
Diastasis recti is far more common than most new moms realize. It develops naturally in the majority of women by the third trimester simply because of how much the abdomen has to stretch to accommodate a growing baby. For many, the gap narrows on its own in the weeks after delivery, but for a large share of postpartum women, some separation is still present six months later. That’s why it’s worth checking for and addressing early, rather than assuming it will resolve by itself.
How to Check for Diastasis Recti at Home
The Two-Finger Test
You can get a general sense of whether you have diastasis recti with a simple self-check:
- Lie on your back with your knees bent and feet flat on the floor.
- Lift your head and shoulders slightly off the ground, as if starting a sit-up, keeping one hand behind your head for support.
- Place the fingertips of your other hand just above your belly button, palm facing down.
- Feel for a gap between the left and right sides of your abdominal muscles, and note how many finger-widths fit inside it. Repeat at and below the belly button.
A gap of two finger-widths or more is generally considered diastasis recti. This test is a helpful starting point, but a physical therapist can give you an accurate measurement and a treatment plan tailored to your specific separation.
Causes and Risk Factors
While pregnancy is the primary cause of diastasis recti, there are other factors that can contribute to its development. These include:
- Multiple pregnancies: Women who have had multiple pregnancies are at a higher risk due to the repeated stretching of the abdominal muscles.
- Pregnancies spaced less than 12 months apart: The abdominal wall has less time to recover between pregnancies.
- Age: As women age, their skin and muscles lose elasticity, making them more susceptible to diastasis recti.
- Carrying multiples or a larger baby: More stretch on the abdomen increases the likelihood of separation.
- Improper exercise: Performing exercises incorrectly or engaging in activities that strain the abdominal muscles can worsen or even cause diastasis recti.
Symptoms and Diagnosis
The most noticeable symptom of diastasis recti is the visible bulge or “pooch” in the midsection, especially when the affected person is engaged in activities like sit-ups or planks. Other common symptoms include lower back pain, poor posture, and difficulty engaging the core muscles. While a physical examination by a healthcare professional is usually sufficient to diagnose diastasis recti, additional tests such as ultrasound may be used to confirm the extent of the separation.
Exercises to Avoid If You Have Diastasis Recti
Certain movements put outward pressure on the abdominal wall and can widen the gap instead of closing it. If you suspect you have diastasis recti, it’s best to avoid:
- Crunches, sit-ups, or any exercise that lifts your head and shoulders off the ground
- Planks and push-ups, unless modified by a physical therapist
- Yoga poses that bulge the belly forward, such as downward dog or boat pose
- Double leg lifts and similar Pilates moves
- Heavy lifting or any activity that causes your stomach to dome or cone outward
If you notice doming or coning in your abdomen during any activity, that’s a sign to stop and modify the movement.
Addressing Diastasis Recti
Fortunately, there are several non-invasive methods to address diastasis recti and promote the healing of the abdominal muscles:
- Physical therapy: A physical therapist specializing in postpartum care can guide women through exercises that help strengthen the core muscles and close the gap between the abdominal muscles.
- Core exercises: Specific exercises that focus on the deep core muscles, such as pelvic tilts and transverse abdominal contractions, can be beneficial in restoring the integrity of the abdominal muscles.
- Posture correction: Maintaining proper posture throughout the day can reduce strain on the weakened abdominal muscles. Using supportive devices like abdominal binders or specialized belts can also provide additional support.
- Lifestyle changes: Incorporating a balanced diet and regular exercise into your routine can help manage weight and strengthen the overall body, including the abdominal muscles.
- Surgical intervention: In severe cases where non-invasive methods fail to produce desired results, surgical options such as abdominoplasty (tummy tuck) may be considered. However, it is important to consult with a qualified healthcare professional to determine if surgery is necessary.
Safe Core Exercises That Help
Instead of traditional ab exercises, a physical therapist will typically start you on movements that engage the deep core without straining the midline, such as diaphragmatic breathing, pelvic tilts, transverse abdominis activation, bird dogs, dead bugs, and glute bridges. The right starting point and progression depend on the severity of your separation, which is why an individualized evaluation matters more than following a generic workout.
Preventing Diastasis Recti
While it may not always be possible to prevent diastasis recti, there are steps that can be taken to minimize the risk and promote faster recovery:
- Practice safe exercises during pregnancy: Engage in pregnancy-safe exercises that focus on strengthening the core without putting excessive strain on the abdominal muscles.
- Avoid heavy lifting: Refrain from lifting heavy objects during and after pregnancy, as it can strain the abdominal muscles and worsen the condition.
- Support the abdomen during daily activities: When performing activities that require significant abdominal effort, such as lifting a toddler or carrying groceries, consider using your arms and legs more and engaging the core muscles less.
Why See a Pelvic Floor Physical Therapist in Houston
Diastasis recti doesn’t heal correctly on its own for everyone, and generic ab workouts can sometimes make it worse. At Revolve Physical Therapy, our pelvic floor specialists assess the size and location of your separation and build a progressive plan around it, rather than a one-size-fits-all routine. We see patients at our River Oaks, Memorial, Sugar Land, and East Downtown (EaDo) locations throughout the Houston area, with direct access so you can start care without waiting on a referral.
Conclusion
Diastasis recti is a common condition experienced by many women during and after pregnancy. While it may cause concern and affect self-confidence, there are effective ways to address and manage it. By incorporating proper exercises, maintaining good posture, and seeking professional guidance, women can regain strength in their abdominal muscles and improve their overall well-being. Remember, patience and consistency are key in the journey towards healing and reclaiming a strong core.
Frequently Asked Questions
Many women notice their core feeling stronger within the first couple of weeks of starting the right exercises, since they’re learning to engage the deep core more efficiently. Measurable changes in muscle strength and gap size typically take longer, often around two months of consistent work, and healing time depends on how severe the separation is.
Most cases improve with physical therapy and don’t require surgery. Surgical repair is generally reserved for severe separations that don’t respond to a sustained course of conservative treatment, and most surgeons want to see at least several months to a year of physical therapy first.
Yes. It’s never too late to work on diastasis recti, even if it’s been years since you gave birth. With the right exercise progression, many women see real improvement regardless of how long they’ve had the separation.
It can. The abdominal muscles work together with the low back and pelvic floor, so when they’re separated and weakened, that support system is compromised, which is why diastasis recti is often linked to low back pain, pelvic pain, and urinary incontinence.
Yes, though it’s far less common. It usually develops from repeated heavy straining, such as improper heavy lifting or chronic constipation, rather than pregnancy.