Do you have diastasis recti but aren’t sure how to tell?
And have you ever wondered…
Does diastasis recti ever heal?
How do you improve diastasis recti symptoms?
While healing diastasis recti after pregnancy is a full body effort, there are exercises to help. This is encouraging news! Read on for what it is, how to tell if you have it, and what exercises you can try to fix diastasis recti!
What is diastasis recti?
Diastasis recti is, in short, the thinning of the linea alba (the tissue that connects your rectus abdominis along the middle and your ribs and pelvis vertically) due to pressure outward that enables the sides of the rectus to separate more than normal. For clarity, the rectus is always separated in the middle; it’s how it is designed. When you have diastasis though, that thinning of the linea alba allows the separation to become wider. This can happen in men as well as women, but for the sake of this post, I’ll focus on women who have been pregnant.
When you are pregnant and your baby grows, the belly expands and this can cause the abs to separate along the midline (more than they normally are), leaving the fascia (connective tissue) to support. It isn’t usually painful (as it is not a tear in the muscle, just a larger separation than normally exists), but it can cause some problems depending on how you use your abs (or rather, if you don’t) to carry weight in everyday activities or exercise.
Problems caused by diastasis recti
When you have diastasis, it can cause the abdominal pressure system to be unbalanced. What we want to happen when we breathe is for all muscles surrounding your chest/back/abs from your diaphragm to pelvic floor to expand and contract evenly. That doesn’t usually happen when you have diastasis because pressure follows the path of least resistance.
What I mean is, when you breathe with diastasis, you are more likely to have your belly expand than your back. Over time, this can cause back muscles to tighten, and the more they tighten, the more the pressure of the breath will push outward on your linea alba. Diastasis doesn’t usually cause back problems, but they can co-exist, likely indicating an issue with overall pressure management and muscular imbalance. Our bodies are wonderful at learning, so we just have to teach them a different way so we don’t create a circular problem 🙂
Diastasis can also contribute to poor posture and thus poor breathing (which can impact stress and sleep). It can also add to pelvic floor issues (and actually, we see the reverse, where pelvic floor tightness can worsen diastasis). And it may open you up to risk of hernias (with the most vulnerable spot being around the belly button).
When diastasis isn’t a problem
You might find that you have diastasis but aren’t experiencing symptoms. This might be because when you load (i.e., lift something heavy or exert effort that could cause the pressure in your abdominal canister to change), you may be bracing appropriately. Just because there is a gap doesn’t mean you are necessarily injuring yourself with every move. But, we do have to be mindful about how to move, breathe, and lift properly.
How to tell if you have diastasis recti
While a physician can diagnose through the use of an ultrasound (the most accurate way to tell if you have diastasis recti), you can check this at home too (although it’s always recommended to have a physician advising you on medical and health issues). First, lie on the ground. Gently lift your head, just until you feel your abs start to engage. Using two fingers, gently touch your midline a few inches above, at, and below the belly button. You’re measuring width and depth (in terms of fingers and knuckles). So, for example, you might be two fingers wide and 1 knuckle deep. Also take note of whether the area feels firm or squishy. Be gentle with yourself as you measure, and do not force anything. You’ll likely notice that the gap is larger at your belly button (where pressure once pressed outward the most). Of course, if there is no gap, you don’t have a diastasis :) And generally, less than two fingers width is not considered a diastasis. But if there is a larger gap, in any of these places, write down your measurements, and re-check over time to watch for improvement.
What’s also important is to check all three of these places in different positions. You can do this on hands and knees, in a plank, and in a side plank (as soon as you build strength to try these safely). Why? Because sometimes, you might have a diastasis but when you engage your muscles, they come together appropriately and support your body. If this is happening, you’re not as likely to have other problems commonly associated with diastasis (like those mentioned earlier in this post).
Diastasis exercises to start healing
Before you start exercising, you need to be sure that 1) you are aware of your posture, aligning it appropriately in various positions, and 2) you are breathing properly. Proper posture means hips over the middle of your feet when standing, ribcage over pelvis when sitting or standing, and head aligned back with shoulder (not pressed forward). There are more nuances to proper postures, but these will give a good start. It can be difficult to maintain if you don’t have core strength to keep ribs from lifting in the front (or if you have back tightness that pulls it up), so that’s why a full body solution is required to begin healing.
That said, I want you to have some exercises to start with. These are some that can be advanced as you gain strength, and they are ones that I give almost all of my clients.
5 exercises to heal diastasis recti
Before trying deadbugs, you’ll want to be able to engage your transverse abdominals, and I have a video for you on that. Check out that video and then try deadbugs, as described below. For deadbugs, you'll start lying on your back, bend knees and plant your feet on the floor. Slightly tuck your pelvis under (this will minimize the space between low back and the ground). Exhale, then contract the pelvic floor (this is a kegel) and begin to engage your transverse abdominals. You need to continue to breathe through this. The TAs should not pooch. They will move as you breathe but you need to continue to hold tension while breathing. Then, lift one leg a little bit off the floor, and lower. Continue breathing, and try the other leg. Repeat for a few reps, and relax. Do not do this when you reach a point where you can’t maintain form. Ways to advance as you gain strength? Lift legs higher, or both at the same time. Be careful that your back (or other muscle group) doesn’t take over for your abs.
Lie on the ground with feet on the wall, knees bent at a 90 degree angle and positioned directly above your hips. Slightly tuck pelvis under (minimizing the space between your low bak and the floor), and breathe up/down/all the way around (360 breathing). Ribs should stay down (they’ll move a little with breathing, but be conscious not to lift the front more than the sides or back). Exhale ALL the way out. Most of us don’t do that regularly (or all the way IN, for that matter). So, try again, exhaling ALL THE WAY OUT. When you get to the end of your exhale you’ll start to feel your transverse abdominals start to engage. This is what we want! Don’t let the lower belly pooch (that means you aren’t engaging your TAs and you’re letting other abs take over). Once you’ve mastered this breathing practice, you can advance it by breathing into a straw, then a balloon when the straw is mastered.
You can try this lying down or sitting against a wall. Either way, you’ll move your arms, with palms facing up/out, to make angel wings. Only move them as high (towards your head, either along the floor or wall behind you) as you can without lifting the front of your ribcage. Breathe slowly when you get to the highest point. Try one arm at a time and then both.
Try this yoga pose a little differently than usual, and bring your knees together. So, knees and feet together, reach forward with your arms, resting your belly and chest on your thighs. If this is tight on your hips or shoulders, you can put a blanket in between hamstrings and calves, or a pillow under your shoulders. From this position, take 360 breaths, and allow the breath to release some tightness in your paraspinals (back muscles on either side of your spine).
I love this option as a “use what you have” exercise. Grab the side of a door frame with one hand (facing perpendicularly to the door, i.e., as if you were walking sideways through the doorway). Lean away from it, so that feet are on the ground and touching the base of the door frame. Engage your side abs and arms to pull yourself upright again. If you use only your arms, you’ll miss out on the ab workout, so I recommend trying to engage abs first, then use your arms to get you the rest of the way.
What exercises not to do for diastasis
When you do exercises with proper form, in which you can breathe while bracing or holding tension in your muscles, you’ll be able to handle the pressure without worsening your diastasis. So the answer is – any exercise that makes you unable to manage pressure, either because you don't have enough strength yet or because you’ve done enough reps that you are starting to fall out of form, is an exercise that you should not be doing. This could be any exercise for any part of the body, especially given the linea alba’s connection between ribs and pelvis. All movements matter in healing.
Does diastasis recti ever heal?
It depends. Yes, it can. It doesn't always. And what does healing mean? Remember that your rectus is supposed to have two sides, so there will always be a gap. What we are looking for is a firmness in that gap vs. a squishiness, and less than 2 fingers’ width and 1 knuckle deep, generally speaking. Fascia takes time to heal, possibly 6 months or more, but it can heal. So for a while, you may need to remember that you are building strength, releasing tension, and supporting your body’s ability to heal. We might not be able to heal the fascia directly, but we can work to minimize the pressure put on it, so it can work to heal on its own. Meanwhile, you are supporting your body’s strength so you lower the risk of problems associated with diastasis. I like to encourage clients to measure their progress over time because it won’t happen overnight, but you will begin to see progress. And it may be that somewhere along the progress journey, you find the healing that you need, even if the gap doesn’t reach what it was before.
Additional resources to help with diastasis recti
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I like Katy Bowman and Sarah Duvall for all of the videos they share. In particular, Katy Bowman has a book called Diastasis Recti that goes into more detail than I have in this post, and it includes a bunch of small and large movements you can try to help. Sarah Duvall, among many resources, has an article on diastasis that includes her 4-part Diastasis Recti Video Series.