What moms should know about Diastasis Recti

Jill Heath, PT, DPT

July is Diastasis Recti Awareness month, and there is certainly more awareness needed on this issue!  The information available can be confusing, conflicting, and lacking research-based evidence.  Here are the main things I want all moms to know about diastasis rectus abdominus (DRA).

DRA refers to the separation of the rectus abdominus, or the “six-pack” portion of the abs.  During pregnancy, the connective tissue between the muscle groups (called the linea alba)  expands to allow for the growing baby.  After pregnancy, the amount of separation that remains varies widely among women.

• Separation is normal.  Even before pregnancy, there was a space between the muscles.  The expansion during pregnancy is normal - it has to stretch to allow for the baby.  When you hear someone refer to “healing” DRA it just doesn’t make sense.  Nothing is torn.  When we think that something is broken, it makes us fearful of moving, and our bodies are designed to move.  Simply changing our words can get our mindset on a path of recovery rather than protection.
• The amount of separation depends on a lot of things and is not an indication that you did something wrong.  I hear from lots of moms that they “made it worse” or “did the wrong exercises” during pregnancy.  I frankly think there is enough to feel concerned about as a new mom without adding this to the list!  Certainly there are ways to move that put less pressure on the abdomen, but there are a lot of other factors.  It depends quite a bit on your genetics - how stretchy is your connective tissue (ie ligaments, muscles, skin).  If you are a really flexible person, you might have more separation. 
• Instead of avoiding the wrong movements or exercises, we need to focus on how our body can control movement.  So many women hear that they can never do planks or crunches again.  That’s just not true.  Instead I watch how the moms are doing these exercises.  If there is a bulge at the separation during the movement (referred to as coning or doming), that means the exercise is too much, and we need to teach how to manage the pressures better with the movement.  (See ___ blog post for more details on pressure).  I teach moms to exhale before the movement, which blows off pressure and kicks in our deep core stabilizers, which is step one in progressing back to whatever fitness they want to do.  As a physical therapist, my patient’s goals are my goals!

• So if you are uncertain about your abs after pregnancy, find a physical therapist or postpartum specialist who can help you determine the right program for YOU.