Postpartum Problem: Diastasis Recti

If you’ve given birth, there’s a high likelihood that you’re living with some degree of diastasis recti, a separation of your abdominal muscles that meet in the center line of your stomach. It’s estimated that roughly 60 percent of women have the condition six weeks after birth and 30 percent who still are living with it one year later. The condition can cause substantial back pain, poor posture, and urinary or bowel issues. And the matter is often complicated because many women believe what they are seeing or feeling is a hernia, which happens when the internal organs protrude through the lining of the abdominal wall causing an uncomfortable bulge.

Diastasis recti is more common in women who are petite, shorter in stature, have larger babies or have had multiple pregnancies. Giving birth later in life, a swayed posture and poor muscle tone can also contribute to the condition. Although it’s most commonly seen in women, men can also be affected, particularly those who have abdominal obesity.  

Recommended treatment

The first way to address diastasis recti is through abdominal exercises, but not just any kind of ab exercises will do. In fact, typical crunches are not recommended for people with this condition because it can make symptoms worse. It’s important to rebuild strength in the pelvic floor, diaphragm and the transverse abdominus muscle that’s deep within your core. A few options include pelvic tilts on your hands and knees, elevated bent knee marches and elevated leg extensions. Exercises with demonstrations are readily available when you Google ‘diastasis recti exercises.’

Physical therapy is also an effective option to minimize the appearance of the diastasis, although it’s important to give your body some time to heal immediately after giving birth – think six to eight weeks – before incorporating any core exercises into your routine. While abdominal exercises and/or physical therapy do provide improvement and relief for many women, severe cases of a diastasis can be corrected through surgery.

In some cases, a belly button or umbilical hernia and diastasis recti may exist at the same time – although they are unrelated conditions. In these situations, when the hernia is surgically repaired, the separated diastasis can also be brought back together by a general surgeon.

What you need to know

If you think you have a hernia, diastasis recti or are not sure of your condition, it’s important to talk to your physician or schedule an appointment for a surgical evaluation. In many cases, the problem can be diagnosed with a physical exam or a CT to evaluate the abdominal wall. If the problem is a hernia, it will continue to worsen over time. While surgery isn’t always necessary right away, it’s important to have a surgeon explain your options and be aware of your condition. If it’s diastasis recti, we can also determine if surgery is appropriate or if a referral to physical therapy is the best treatment option.

CHI Memorial Surgical Associates provides a hernia repair and other general surgery.