Diastasis Recti

Diastasis recti is a widening of the linea alba, the connective tissue that runs down the midline of your abdomen, separating the rectus abdominis muscles. The linea alba is formed from the tendons of the obliques and transversus abdominis, and contributes to trunk stability.

Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com

A widening of the linea alba of less than 2 cm is considered “normal”. Diastasis recti is often associated with the perinatal period, but it can occur during any time and in any gender. Nearly all pregnant persons by week 35 gestation will have a diastasis recti; it is a natural adaptation to make room for the growing baby.

Risk Factors:

• Abdominal obesity
• History of heavy lifting or abdominal flexion training
• Chronic straining or coughing
• Genetic factors that will contribute to connective tissue laxity
• Number of pregnancies
• Increasing age

Intra-abdominal pressure management strategies are key for managing diastasis recti and tension through the linea alba. During pregnancy and in the early postpartum period, be aware of what is called abdominal doming or coning:

• Occurs commonly with certain abdominal exercises, overhead movements, spinal flexion (crunches/sit-ups), or increased lean back on a row machine.
• Pay special attention when getting in or out of bed, lifting baby and car seat, or pushing a stroller.

Doming or coning is a sign that your intra-abdominal pressure generated is greater than what your tissues can handle. If there is increased pressure through the linea alba repeatedly, there is an increased risk of weakening that tissue.

Permission to use copyright image from Pelvic Guru, LLC pelvicguru.com

What to Do About Diastasis

• Modify exercise and movements during pregnancy that are more likely to stress the linea alba. There is no standard "safe" and "not safe" exercise list. What may be okay for one person is not recommended for someone else, so working with a pelvic health professional can really help you feel confident in what you're doing!
• Learn how to connect to your abdomen and pelvic floor postpartum, and gradually progress in strengthening your muscles.
• Manage constipation so you aren't straining on the toilet.
• Learn how to manage intra-abdominal pressure with daily movements and exercise. This includes how to breathe with movements, how to appropriately use your muscles with exercise, and learning which position optimized core mechanics.