Diastasis Recti, what is it?

A diastasis recti is a stretching of the linea alba, the connective tissue between your rectus abdominus (6-pack) muscles. It is normal to have a 2 cm width between these muscles, and most people will have an elongation greater than this during pregnancy. Diastasis recti can also be found in the general population (those who have never been pregnant) as a normal variation of human anatomy. The bottom line is: this is normal. 

Social Media is misleading!

This is a normal physiologic change during pregnancy and can last after pregnancy too. It becomes problematic if your core muscles cannot generate adequate tension in this region (due to weakness or lack of coordination). This tension is needed to counter the intra-abdominal pressure generated from coughing, laughing, sneezing, breathing. It is also needed to created the trunk stiffness needed for efficient and comfortable movement activities (lifting, running, sports).

What can physical therapy do?

Your therapist will teach you to manage your abdominal pressure with breathing strategies, and specific exercises to improve the coordination and strength of your core, as well as exercises to improve postural awareness and control, as this plays a significant role in the intra-abdominal pressures we create.

What external support do you recommend?

In almost all cases, an abdominal brace can be worn for the first few months after pregnancy, even when sleeping to help fascia heal.  This is not necessary for all. For best results, deep core retraining is recommended.

How is this different from a hernia?

A hernia is a separation of the linea alba. This can become problematic if your internal organs get stuck within that separation. If you are not having pain with a hernia, it is likely a sign that conservative care can address these concerns.  If there is pain on your evaluation, surgery may be warranted. If you are a surgical candidate, when you elect to have surgery will depend on lactation strategies and any plans you have for future pregnancies. Your therapist will ensure you get to an orthopedist that specializes in hernia repair.

So what if it persists during exercise?

If you have been cleared to return to exercise post pregnancy, your therapist will observe your performance with the movements involved in your preferred form of exercise.  If your form is appropriate, you will be cleared to return to these activities even if you have a separation. If you maintain appropriate form and pressure management during, it is unlikely you will worsen your diastasis. If there are points of the performance that you are not hitting, your therapist will work on improving your movement pattern to ensure safety.  

It is an old "school of thought" to discourage strength training and exercise. We want our new moms and parents to feel strong and empowered, not to place arbitrary rules on them!