Diastasis Recti: What It Is and How to Treat It Without Surgery

Diastasis Recti is a condition in which your most superficial abdominal muscles (rectus abdominus) separate along the midline of the body. The left and right sides of the abs split apart and the connective tissue along the midline stretches and becomes weaker. It most commonly occurs during pregnancy or during childbirth, but many people, including some men, have a diastasis recti and just don’t know it! It has been said that even the founder of Pilates, Joseph Pilates, had a diastasis!

Other than the abdominal “pooch” appearance that can go along with a diastasis, there can also be functional deficits. These muscles are designed to help support your back and your organs, and if they are no longer in the proper location and holding the proper tension, they fail at these important jobs. Pelvic pain, incontinence, back pain, and poor joint mechanics can all occur when someone has a diastasis. The goal is to draw the muscles back towards the midline, so that they can start doing their job again, and that the connective tissue no longer has to work overtime to provide that support in their absence.

The main cause of a diastasis is continuous stretching or overuse of the rectus abdominus muscles. Pregnancy or carrying a lot of excess weight in the abdomen is the primary cause of stretching of these muscles. Strangely enough, overtraining this set of muscles (overuse) in the quest for better looking abs, can actually cause a diastasis to occur, which allows for an abdominal protrusion, which causes the abs to look more “pooched-out”. So many fitness buffs create that vicious cycle because there is such a strong popular focus on crunches, bicycles, jackknives, and similar exercises that contract the rectus abdominus almost to the exclusion of the transverse abdominus (the deepest, most stabilizing layer of the core). If we can strike a balance between training the front of the abs, as well as the deepest layers of core support (deep low back muscles, transverse abs, diaphragm, and pelvic floor muscles), we can prevent a diastasis from occurring. And once a diastasis occurs, shifting the focus away from traditional abdominal exercises and towards more comprehensive core strengthening, can help decrease the severity of the condition and also increase the stability and function of the core.

Treatment of Diastasis Recti

***Exercises to do:

Transverse ab strengtheners (heel slides, modified dead bugs, core contractions/compressions)

Glut exercises (gluteal bridges, squats, single leg deadlift, squats)

Pelvic floor exercise (kegels with transverse ab contraction)

Diaphragm exercises (deep breathing relax on inhale, pull navel to spine on exhale)

***Exercises to avoid:

Forward flexion (Crunches, bicycles, rollups and rolldowns, jackknives, boat pose)

Forward loaded exercises (front plank, full pushup, bird-dog, burpees)

Extreme extension (ab exercises over exercise ball, full upward facing dog)

Auxiliary Care for Healing Diastasis Recti

It’s important for the pelvis to be well aligned and balance while you work to heal a diastasis. If the pelvic joints are restricted or out of alignment, it will be more difficult to maintain proper core stabilization during challenging exercises and everyday activities. Likewise if the any muscles that attach to the pelvis or core are overly tight, that can cause a pull on the bony structure of the pelvis and skeleton, resulting in pain, tightness, and lack of function. A major culprit that causes a whole cascade of dysfunction is the psoas muscle. Chiropractic adjustments and Active Release Techniques (ART) can help restore proper pelvic alignment and muscle balance.