What is Diastasis Recti?

What is Diastasis Recti?

The dreaded diastasis recti, a term tossed around the internet as many new mothers glance downwards and ask the Google gods, WTF happened to my belly?

I was one of those new moms. Discovering my gulf wasn’t difficult. It was a vortex sucking my wrinkly skin into its midst. Why could I stuff my fist into my abdomen? Just lucky I guess.

Let’s demystify the gap.

Diastasis recti is a separation of the rectus abdominis, which is also known as your six pack (or four pack or two pack). The aponeurosis insertions of the other abdominal muscles — the external obliques, internal obliques, and transverse abdominis —surround the rectus abdominis and merge to form the linea alba, a connective collagen sheath. You can feel the linea alba with your fingers, especially if you have a large gap.

Since the rectus abdominis is a paired muscle that runs vertically in two parts, a small gap between the two sides is normal. However, as the pregnant belly expands (or beer belly in men), the gap between the rectus grows. Actually, any outward force can widen the gap, which is why strenuous abdominal exercises can worsen or even create a diastasis recti.

For most women, the rectus abdominis reconfigures to its natural position in the months after giving birth, with perhaps a little extra slack here and there that should be improved with corrective exercises. For me, and other similarly blessed women, the space doesn’t narrow to a pre-pregnancy size, and we are left with a permanently stretched out linea alba.

As a result, the abdominal organs push against the linea alba, creating the swollen belly look. This “mummy tummy” is why most women google “diastasis recti.”

Having a baby is hard. Looking like you will always be pregnant is just cruel.

Fortunately, for many women, exercise and knowing what not to do can help. But be wary of advertised cures. Anecdote abounds. Evidence does not.*

How to Check for a Diastasis Recti:

Lie on your back with knees bent. Make sure the lower back is not pressed into the ground, but not lifted too far up either. You should be able to fit a hand between the floor and your lower back. If your rib cage points upward, the arch is too large. If this is the case, place your hands on the bottom of your rib cage and push it down without flattening the back completely.

Place your fingers together and perpendicular to your belly button.

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Ignore my weird wrist action. But you should be able to slide a hand underneath the lower back.

Lift your head slightly until you can feel the two sides of your rectus abdominis. Stop as soon as you feel this.

Do all four fingers slide neatly between the two sides? This is a 4 finger-width gap. Do only 3 or 2 or 1 or less than 1 finger fit? However many you can fit is the size of the gap. Do you need more fingers to fill the gap? Add in the fingers from your other hand.

Try this again a couple inches below your breastbone and a couple inches above your pubic bone.

If you’ve already googled around, you’ve seen some variation of these instructions. For the most part, measuring this way is fine because you can tell if you have a large gap or not. If you can fit 2 or fewer fingers, your gap isn’t large. If you can fit 3, 4, 5, 6, 7, or more, you are likely experiencing some symptoms with your gap. Some people insist on measuring the gap with a ruler, but, outside a doctor’s office, this is overkill.

Knowing the exact millimeter size of the gap won’t change anything.

Keep in mind, this is NOT an exact science.

Change the tilt of your pelvis, either pushing it into the ground or increasing the arch. Remeasure. Your size probably changes. Lift your head a little more. The “size” also changes.

The solution is not more precise measuring. It is less number obsession.

Some women are tormented by the finger-width measurement (I was guilty of that).

Has it changed now? How about now? And now? What about now?

Taking an initial measurement is good as a baseline. For example, if you discover the gap keeps on getting bigger, you will want to examine a possible cause, perhaps too much of a certain kind of movement. But don’t count on this number to tell you anything other than how many fingers you can fit. Don’t measure all the time. It won’t tell you about your health. It won’t tell you about your function. There isn’t a magic number that means you can resume all exercise. Only function can tell you that.

If function is more important than a finger-width measurement, you are probably wondering how you measure function. At least finger-widths are concrete. Function is an annoyingly nebulous term. I have a few suggestions in an upcoming post to help make it more concrete. (Read next: You Don’t Need to Close a Diastasis Recti)

Want to know more about diastasis recti? Then check out the 60+ Page Essay “Why Diastasis Recti Experts Disagree.” 

Footnote

*Wikipedia has an okay description of “diastasis recti,” but whoever wrote and edited the “treatment exercises” portion was basing this on flimsy evidence. The entry references two studies, neither of which looks very good. I’ve read the 2005 study in detail, and color me unimpressed. The 1988 study is behind a paywall and although I regularly shell out money for studies, I couldn’t bring myself to do it for this one. Plus, it is from 1988, reflecting the dearth of actual evidence about diastasis recti! I keep a look out for new high quality studies, but they just aren’t there yet.

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