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Separated Abs (Diastasis Recti)

Ab Separation

Whether your abs feel weak or you see an odd bulge down the midline of your belly, we’ve got you. Separated abs — PTs call it diastasis rectus abdominis (DRA) — is common postpartum and can also be the result of overworking your abs. It’s never too late to repair DRA, but the sooner you do, the better: If left untreated, side effects can include back pain and bladder/bowel leaks.

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What Causes Separated Abs

During pregnancy, connective tissue between the rectus abdominis muscles stretches to fit your baby (picture taffy being gently pulled apart), creating a gap. At the gym, DRA can be the result of overworking upper abdominals while undertraining deeper core muscles.

Work 1:1 With A Physical Therapist

Your PT will work with you to create a therapeutic exercise program that can improve DRA without surgery. Your treatment plan may include:

  • Strategies for avoiding strain on your abs
  • Techniques to re-activate abdominal muscle & tissue
  • Exercises that help reduce ab separation

Closing The Gap

Increasing tension in connective tissue takes time. Most patients notice improvement within 6-8 weeks and see a more significant change in 3+ months. Be patient with your body!

Common & Treatable

At 1 year postpartum, 1 in 3 women have DRA that doesn’t typically resolve on its own. Physical therapy delivers results without the need for surgery.

"I still look 5 months pregnant."
"My abs bulge out after I eat."
"I can’t connect with my ab muscles."

Sources: Mommers EHH, et al. The general surgeon's perspective of rectus diastasis. Surg Endosc. 2017; Sperstad JB, et al. Diastasis recti abdominis during pregnancy and 12 months after childbirth. British Journal of Sports Medicine. 2016.

Separated Abs FAQ

What is diastasis recti?

Diastasis recti is the stretching of the linea alba, the midline connective tissue between the rectus abdominis or “six-pack” muscles. Without adequate tension in the linea alba, your abdominals are not well supported. Long-term effects can include back pain and poor posture, as well as pelvic floor issues, including bladder and bowel leaks.

What does diastasis recti look like?

Diastasis recti isn’t always visible, but many patients with DRA notice a bulge down the midline of their belly, especially when their abdominal muscles are tensed during exercise or when coughing. Other patients report still looking pregnant, months or years after they’ve delivered their baby.

How do I know if I have diastasis recti?

The best way to know if you have DRA is to be evaluated by a physical therapist online or in-person, but you can try checking yourself at home:

  1. Lie on your back with your knees bent and place your feet flat on the floor.
  2. Place your hand above your belly button in the middle of your belly with your fingers pointing toward your legs.
  3. With one hand under your head for support, lift your head an inch or so off the ground and simultaneously apply gentle pressure with your fingers to the midline of your abdominals, both above, over, and below your belly button. Without DRA, your fingers should encounter resistance, like pushing on a fully inflated exercise ball. If your fingers sink into a separation between your abdominals at any point, it’s very likely that you have diastasis recti.
How long does it take for diastasis recti to heal?

Our patients typically see improvement in the first 6-8 weeks and a more noticeable difference in 3+ months. As physical therapists, we want you to be able to safely do all the activities you need and love to do, without having to worry about pain, injury, or other negative side effects of DRA.

Which exercises are safe with diastasis recti?

The safest exercises for you will depend on several factors, including your fitness level and the severity of your DRA. One of the benefits of working with a physical therapist is that they can design an ideal therapeutic exercise program for you.

Two exercises to be careful with: crunches and planks. Crunches can worsen DRA, so you’ll want to avoid them. Your physical therapist will also show you strategies for avoiding crunch-like movements during everyday activities, like getting in and out of bed. Whether or not planks are safe will depend on the extent of your DRA. Your physical therapist can watch you do one and let you know.

I’m pregnant. Is there any way to prevent diastasis recti?

The latest research shows that 100% of women have DRA in the third trimester. This is because some stretching of the tissue between the abdominals is necessary to fit a growing baby. The good news: Your physical therapist can help you proactively treat DRA during pregnancy to reduce its severity — and make it easier to repair — postpartum.

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