How to Measure Diastasis Recti Function

How to Measure Function

How do you know if you have a functional or a dysfunctional diastasis recti?

Let me answer that.

Just kidding. I’m a blogger and personal trainer who has never seen you in person. Go to a doctor or physical therapist.

In the meantime, think about the way you move and feel. Do you have pain in your hips or pelvic girdle? Do you have trouble standing on one leg? Can you do a Kegel? Is your abdomen achy by the end of the day? Are you limited in your movements?

I don’t have a list of questions that can answer if your diastasis recti is dysfunctional. Perhaps your weak abdomen is the result of a gap between your rectus abdominis, or perhaps your muscles themselves are simply weak. The answers aren’t clear.

However, below are self-tests that can highlight red flags to discuss with your medical professional[1].

Don’t freak out if you can’t do some of these. It doesn’t mean you are permanently broken. It doesn’t mean you need surgery.

It does mean you need to pay attention to your core.

Therefore, think of the following as little flags to plant in your mind, not as diagnosis.

(Sidenote: Maybe you don’t have any clear functional problems, but you still want to narrow your diastasis. Narrowing the gap may flatten your belly, but it may not. And, a flat belly and a diastasis can coexist for many women. Therefore, fixating on the size of the gap can be counter-productive, for both function and vanity).

How to Measure Function:[2]

1. Linea Alba Tension:

Most physical therapists test your ability to generate tension in the connective tissue surrounding your abdominals (a.k.a. your linea alba). Tension is necessary for stability. See if you can feel this on yourself.

Lie on your back with knees bent and perform a headlift, as if you are “testing” for the presence of a diastasis. See how many fingers you can insert, but more importantly, how deep your fingers sink into your abdomen.

Lower your head. Then, try it again, BUT first pre-contract your pelvic floor and your transverse abdominis by performing a Kegel that you pretend to pull into your lower abdomen. Is the connective tissue shallower, meaning your fingers don’t sink as far down as they did before? The gap may even feel larger, but I wouldn’t freak out about that. Feeling that tension is a good thing. It means your muscles are able to pull on your connective tissue.

diastasis recti test

2. One Arm Push-up Exercise:

This is actually hard. Better to have your butt stick up a little than your belly sag. But the ideal is neutral.
This is actually hard. Better to have your butt stick up a little than your belly sag. But the ideal is neutral.

Get into a knee push up position. Transfer your weight to one arm without letting your hips tilt or drop. You’ll notice in the picture, this still isn’t easy for me. Can you do this exercise without doming your belly outward? If not, that’s a sign of weak abdominals that may or may not be related to a diastasis recti.

3. Back Bridge Test:

onelegbridgefunction

Perform a back bridge, then lift one leg level with the other knee. Can you keep your hips fairly level?

4. Supine Pooch Test:

Perform this sequence of supine leg exercises. Keep your belly from pooching by lifting the pelvic floor and gently bracing your abdominals. I like to picture an X on my abdomen with the center at my belly button. Then, I imagine ever so slightly pulling the 4 ends of the X into my belly button.

Exhale as you contract.

If you can’t maintain this pelvic lift and gentle brace, the exercise is too hard.

If exercise A is too hard, you have very limited stability. In physical therapy, I started at A and worked my way up to E. I still can’t do F. Most people probably shouldn’t do F at all, which is why I don’t show a picture. If you incorporate E or F into your fitness routine before you are ready, you’ll likely hurt yourself. I’m looking at you Pilates and yoga fans.

A. Knee Out: Lie on your back and bend your knees. Slowly lower one knee to the side. Return. And then lower the other. Can you maintain stability in your hips and abdomen?

It's best to have two crazy kids running around as you do this.
It’s best to have two crazy kids running around as you do this.

B. Heel Slide: Lie on your back with your knees bent. Wear socks on your feet. Slowly slide one leg out. Return. And then slide the other. Again, can you maintain stability?

Wearing socks makes this a little easier.
Wearing socks makes this a little easier.

C. Bent Leg Lower: Lie on your back with your knees in a table top position. Lower one leg at a time with your knees bent.

Bent Leg Lower

D. Straight Leg Lower: Lie on your back with your knees in a table top position. Lower one leg at a time, straightening the knee as your lower.

Straight Leg Lower

E. Double Bent Leg Lower: Lie on your back with your knees in a table top position. Lower both legs, with knees bent, at the same time. Do not arch your back or pooch your belly!

Double Bent Leg Lower

F. Double Straight Leg Lower: Lie on your back with your knees in a table top position. Lower both legs, with knees straightened, at the same time.

5. How often do you pee yourself?

Okay, so technically this question probably has nothing to do with your diastasis recti. We don’t actually have good evidence  that DR causes pelvic floor disorder and indeed have evidence that it does not. However, even if a DR doesn’t cause pelvic floor problems, some women co-present with an ab gap and urinary incontinence (not all, but some). This is probably because being pregnant causes the DR and pushing out a baby causes the incontinence. In other words, carrying a baby in your belly and expelling a baby from your vagina are connected (shocking, right). Ergo, symptoms overlap even if your actual DR didn’t cause the incontinence (I know many personal trainers insist a DR will cause incontinence, but that is NOT supported by the evidence).

Therefore, I ask “how often do you pee yourself” as a way to make sure women do not overlook their pelvic floors. Often moms will obsess about their bulging bellies but will overlook any pelvic floor symptoms. Don’t do that.

Do you leak urine when you cough, laugh, sneeze, jump, or chase after your kid? Although this type of incontinence is incredibly common after having a baby, especially after vaginal births, it can be helped.

If you can’t generate midline tension, keep your hips level, stop your belly from pooching, or keep urine from leaking, your abdominal canister and pelvic floor are compromised. Do not fear, proper muscle activation, breathing patterns, and appropriate exercise can help many women.

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

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Footnotes:

[1] I don’t disclaim because I’m sheepish or unsure, but rather because intellectual integrity demands we recognize our advice giving limits. Sometimes web sources are too quick to call themselves experts on your specific situation without having ever seen you. I once had an “online expert” insist I could close my diastasis by stopping rib thrusting, as if that was the structural cause of all my problems. It’s not that easy.
[2] These tests are gleaned from many sources, but mostly and separately from the physical therapists Diane Lee and Stuart McGill.

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