Can you heal diastasis recti while pregnant?

Mar 5

While decreasing and improving diastasis recti while pregnant is possible, healing diastasis recti completely while you're pregnant shouldn't be the ultimate goal, as diastasis is a an entirely normal part of pregnancy to make room for your growing baby. Instead of trying to heal the diastasis entirely during pregnancy, make it a goal to optimize your abdominal muscle control and core muscles during pregnancy so you can avoid secondary effects of diastasis like low back pain, leaking, and pelvic pain as well as have the best chance for complete healing of your abdominal muscle separation when you reach the postpartum period.

While diastatis can feel and look pretty alarming while you are pregnancy, please know that healing it during this time isn't the goal.

This blog post will go over what exactly diastasis is and what realistic goals for the presence and mitigation of diastasis while pregnant as well as recovery and healing of the abdominal wall after baby.

What is diastasis recti?

First, let’s talk about what a diastasis recti is. In short, it is “a separation of the abdominal muscles.” Typically, you will see or feel a line of separation in your abdominal muscles that runs top to bottom, from your sternum to your pelvic bone.

Diastasis recti occurs when the two halves of the six-pack muscle separate (the rectus abdominis muscles so diastasis recti quite literally means separation of the six-pack muscle) along what we call the linea alba, a piece of connective tissue that runs down the center of the abdomen.

This most often occurs with a large amount of weight gain in a short period (hello, pregnancy!) which strains the tissues in the abdomen.

Diastasis recti during pregnancy (which is also sometimes referred to as diastasis recti abdominis and can be abbreviated as either DR or DRA) can be problematic for a few reasons, even though some diastasis is completely necessary during pregnancy.

Many patients with a diastasis recti (DR) worry about how it looks. A diastasis can make the stomach appear distorted, which can be bothersome. This is especially true during pregnancy and postpartum when struggles with body image are already common.

But from my perspective as a Pelvic Health Physical Therapist, having an excessive diastasis recti is a cause for concern because it can often go along with having a weaker "deep core", which can in turn be linked to a host of other issues such as lower back or pelvic pain, urinary incontinence, or pelvic organ prolapse.

The core is made up not just of the ab muscles, but also the back muscles, the diaphragm muscle (which sits under the rib cage), and my personal favorite, the pelvic floor muscles.

If the deep core abdominals (especially the transverse abdominis) are weak, then the core won’t be able to work as efficiently as a whole, and there will be more strain on other parts of the core, such as the back or the pelvic floor, leading to the aforementioned issues.

So when pregnant women have a diastasis recti and low back pain or urinary leakage, there’s very likely a connection.

But, also know that the goal is not to get rid of your diastasis, but rather optimize your deep core mechanics, which can contribute to less of a diastasis overall and an easier postpartum recovery.

Do you have diastasis? Check out my blog post to learn how to tell if you have diastasis from the comfort of your own home.

Some other thoughts:

1. You can have a diastasis recti and not have any issues at all. → Even if you have a separation, you may not experience any issues if you can still properly engage your core during movements!

2. Even if you are having problems due to your diastasis, there’s plenty to work on that can help it improve (and yes, it's more than just abdominal exercises and kegels).

Why is a diastasis common during pregnancy?

Diastasis is very common during pregnancy because there is a large amount of weight gain in a short time period, which puts strain on the tissues in the abdomen.

If the tissues are extra stressed due to the increased weight and you are not putting a conscious effort into learning how to contract the core muscles and manage pressure effectively, the diastasis that you are seeing and feeling will likely get worse, which can lead to the symptoms I mentioned above.

Some abdominal separation is also typical because room needs to be made for the growing baby. If the structure was rigid, the body wouldn't be able to accommodate the baby.

What to do about diastasis while pregnant

If you are expecting, I would highly recommend pregnancy pelvic floor physical therapy as well as postpartum physical therapy after your baby is born.

Inside pelvic PT sessions, we are able to determine exactly where your strengths and weaknesses are.

This means that we can:

Mitigate excessive diastasis
Gain core control and coordination to help with decreasing likelihood for a large diastasis as well as improved breathing and bracing mechanics
Avoid symptoms that come about secondary to diastasis like leaking, back pain, pelvic pain, and more
Determine what exercises are safe and effective outside of PT (ie: CrossFit, pilates, etc.) as well as give you strategies so that you can do whatever type of exercise that you prefer to utilize to stay active during pregnancy
Optimize core muscles prior to birth so that postpartum recovery is more smooth

This is more than just "brace your core!" and "do a Kegel!" (or 5 million Kegels).

In summary, I can understand that seeing and feeling a diastasis can feel alarming and scary. I highly recommend finding a pelvic health physical therapist local to you so you can start to build your pregnancy and postpartum team with a goal of mitigating pregnancy-related symptoms that are secondary to diastasis and pregnancy as a whole as well as return to life postpartum and maximize your recovery and birth experience.