How to tell if you have diastasis recti while pregnant

Are you pregnant and hoping to maintain your core strength throughout your pregnancy?

Have you heard that diastasis recti can be common during pregnancy and are worried about possibly developing a diastasis?

If so, then this blog is for you!

In this post, I’ll go over all the basics about diastasis recti, diastasis while pregnant, how to check yourself for a diastasis, and quick tips to help if you think you may have one.

What is diastasis recti?

First let’s talk about what a diastasis recti actually is. If you look up the definition, it will tell you that a diastasis recti is “a separation of the abdominal muscles”, but it can sometimes be hard to understand what that means so let me show you a picture. 

Diastasis recti image used with permission via Pelvic Global

The image here shows a healthy abdomen in the top left picture and variations of diastasis recti in the other illustrations. As you can see, diastasis recti occurs when the two halves of the six-pack muscle separate (the muscle is named the rectus abdominis 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 time period (hello, pregnancy!) which puts strain on the tissues in the abdomen.

Though common in pregnancy, it is not exclusive to pregnancy and can develop in men or children as well (though in children, it’s usually due to growing pains rather than weight gain but that’s a topic for another day). 

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.

Many patients with a DR worry about aesthetics as having a diastasis can cause the stomach to look a bit distorted, which can be understandably bothersome. Especially during pregnancy and postpartum when struggles with body image are already common. 

But from my perspective as a Pelvic Health Physical Therapist, having a 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.

You see the core is made up not just of the ab muscles (which get all the glory!), but the back muscles, the diaphragm muscle (which sits under the rib cage), and my personal favorite, the pelvic floor muscles.

If the abdominals 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.

Core musculature image used with permission via Pelvic Global

So when new mamas have a diastasis recti and low back pain or urinary leakage, there’s very likely a connection!

But the good news is that:

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!

And 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).

So with that being said, let’s first review how to check yourself for a diastasis, then I’ll go over some quick things to start working on if you do indeed have one.

How to check if you have a diastasis recti:

(Note that we check this the same way in pregnant and non-pregnant people so this applies to everyone!)

1. Sit or lay down comfortably.

2. Place the pads of your fingers just below your sternum and lightly press your fingers into the skin.

3. While holding pressure down, feel from side to side. 

4. If you have a diastasis, you will feel a gap in the center and the ridges of the recti abdominis muscles on the sides.

5. You can repeat down the entire center line of your abdomen, from your sternum to your pubic bone.

6. You can also repeat while holding a curl up (while lying on your back, with knees bent and feet flat, lift your head up off the floor), as sometimes people will not have a diastasis at rest but will have one when working the core (or vice versa!).

7. If you do not feel a gap anywhere then you’re good!

8. If you do feel a gap, the wider and deeper it is, the more significant the diastasis. We typically measure this in finger widths. But don’t worry too much because we’ll go over two things that you can do immediately to begin healing. 

My first tip for DR patients is to breathe! More specifically, breathe whenever you’re moving, which includes exercising of course, but also during your day. Make a conscious effort to breathe when you’re getting out of bed, when you’re standing up from a chair, when you’re picking up groceries or your kiddo. Basically any time that you’re moving your body, I want you to breathe. Which sounds obvious, but if you start paying attention, you might be surprised how often you subconsciously hold your breath!

If we’re subconsciously holding our breath during physical efforts, then this can put more strain on a diastasis! When you recall that a diastasis develops to begin with from too much strain on the abdomen, the last thing we want to do while attempting to heal a DR is to put more (unnecessary) strain on our muscles.

Now, that doesn’t mean that you shouldn’t exercise because there’s a difference between undue strain and the stress from exercise which brings me to my next point…

How to engage your core to help decrease risk of diastasis and treat diastasis

If you have a diastasis recti, you need to learn how to properly engage your core.

Let’s go over how to do that.

1. First, lay on your back and rest your hands on the sides of your ribcage (likely easiest with feet flat on the floor and knees bent).

2. Take a few deep breaths and feel your belly and your ribs expand as you inhale.

3. Then audibly exhale through pursed lips and feel your core muscles tightening under your hands.  

4. On your next exhale, you can contract your deep core muscles even more by focusing on drawing your ribs together & hips closer to each other. Imagine your core muscles as a corset tightening around your torso. 

5. You can also think of lifting your pelvic floor up at the same time.

6. If you do this correctly, you should feel the gap of your diastasis close when you engage your core. That’s the whole goal!

This can take a few tries to get right, especially if you aren’t used to using your deeper core, but just keep trying until it begins to feel a bit more natural. And if you’re really struggling to make the mind-muscle connection, seeing a Pelvic Floor Physical Therapist (like me!) can be so helpful as we can give you hands-on cues & corrections to help you learn the technique. 

I start almost all of my diastasis recti patients with the above two tips (one more time, they are: to be conscious of your breath, and to learn how to engage your deep core) as they really lay the foundation for healing. Then once you master the basics, that’s where the fun begins as you progress back into higher-level exercises like pilates, weight lifting, or running. 

I want everyone with a diastasis to know that you can recover! And if you do need help, I’d love to be your guide.  If you are local to Durham, NC, feel free to schedule a free discovery call with me if you’d like to talk about your specific situation and how to recover your core. You can also learn more about pregnancy and postpartum physical therapy here.

Next on your reading list:

1. Can you do pelvic floor therapy while pregnant?

2. Is pelvic floor therapy covered by insurance?

3. What to look for in a Pelvic Health Physical Therapist