Overcoming Fears and Building Confidence with Diastasis Recti

Diastasis Recti has always been a hot topic in the pregnancy and postpartum space, and some (okay, maybe a lot) of it comes with baggage of fearmongering. Being aware of what diastasis recti is and having information about its relation to function and exercises is a good thing - but sometimes the messaging can get sketchy. In this blog, I will provide you with some information regarding Diastasis Recti and paint a clearer picture of what it means to return to your activities when you have diastasis.

Diastasis Recti is characterized by the separation of your abdominal muscles, specifically your rectus abdominis muscles, which run vertically down the front of your abdomen. They are held together by a band of connective tissue called the linea alba. It can impact women, men, as well as children. However, it is most common in pregnancy, as the abdomen stretches to accommodate the growing baby. Diastasis is not something you should fear, as it is extremely common and normal (as I mentioned in another post, I will never say absolute, but almost 100% common). Not everyone will maintain diastasis recti postpartum, and most will heal on their own without intervention.

The postpartum period is extremely vulnerable, and instilling fear in all women to avoid specific movements and exercises is not something to add to their plate, especially as they try to navigate this new role of motherhood. Every postpartum journey is different, as well as every abdomen, so diastasis should be treated accordingly - with an individualized plan tailored to how much pressure/load that person can handle during exercises/daily activities.

Fear #1: Width of Diastasis Recti

Finger width is most commonly used, and a 2 cm finger width or comparable measurement is considered "normal" after pregnancy. However, we know the vast differences in health professionals' hands/fingers raise concerns about the reliability of this measurement. The most accurate way to measure inter-rectus distance is linear ultrasound imaging. Should we move away from the distance and place more emphasis on how your abdominals and diastasis function with tasks? The fear and psychological distress that come with the "number width" in itself can put a real roadblock on someone's progress, as opposed to empowering them to move, load, and strengthen their abdominal wall.

Fear #2: Coning

Coning is when intra-abdominal pressure is pushing into the point of least resistance - the linea alba. When coning is observed, there is no evidence that you are causing or worsening diastasis. You can learn to control the pressure with different movement strategies to limit purposeful, repetitive coning. So what are some different strategies you could try to see if it decreases the coning with exercise or movement? Changing up breathing strategy, engaging more of your deep muscles (transverse abdominals) to assist with support for pressure management, and modifying the movement by decreasing the demand, such as making the movement smaller, bending knees during abdominal movements, or doing single-leg abdominal movements.

Fear #3: Abdominal Crunches

The messaging around engaging your rectus abdominals during any crunching movement when you have diastasis recti can come across as a bit fearful. We should not be informed to fear any specific type of movement because there will come a time throughout your daily life when you will use those muscles. And guess what? There is nothing wrong with engaging your rectus; it is actually a good thing! Rehabilitation of the whole abdominal wall is important for optimal functioning. Throughout pregnancy, your rectus lengthen and widen to make way for your belly. After you give birth, they remain lengthened, and in this state, they cannot generate tension - so they are weaker, and movement and mind-body connection can be difficult. In order to build them back up, we need to use them. When you do an abdominal crunch or sit-up, the rectus move together, drawing the rib cage and the pelvis closer together. Your rectus abdominals need to be loaded and challenged to build strength from all the months where they took a little vacation as you were growing a human.

In conclusion, Diastasis Recti is not something to be feared. Reaching out to a professional who is trained in treatment strategies specific to up-to-date research on core rehabilitation with diastasis is highly encouraged. Ultimately, what is important is that your treatment is aligned with your specific goals and to return to what is important to you.

You are not broken - you are strong, and you are capable of amazing things.