Most people don’t hear about diastasis recti until they’re pregnant — and even then, maybe not. (After all, there are a lot of other things to think about.) A common condition where the connective tissue between the abdominal muscles stretches and separates, diastasis recti is often overlooked or dismissed, even though it happens to approximately 60 percent of pregnant women. But it can affect all genders, too, and is sometimes caused by exercise or other vigorous activities. (One woman I know got it from lifting kettlebells too aggressively during quarantine.) The good news is that if you have it, you can treat it.
“Technically, the cause of diastasis recti is excessive intra-abdominal pressure,” says Leah Keller, a personal trainer and founder of pre- and postnatal fitness system Every Mother. “During pregnancy, it’s the growing baby that’s causing this pressure, and generally speaking, it will emerge towards the end of the second trimester and get more pronounced as you enter the third trimester.”
Post-partum, diastasis recti shows up as a slight laxity or “pooch” around the belly button, and it isn’t painful or medically serious in and of itself. For that reason, it’s often thought of as a purely aesthetic problem, and people aren’t informed about whether they actually have it or how to fix it.
Still, it’s not harmless. “Left untreated, diastasis recti can cause a number of functional problems,” cautions Keller. “If the abdomen has become overstretched, then all the other surrounding muscles and areas have to work harder to compensate. Back pain is very common, as well as an overactive pelvic floor and very tight hips and glutes. Those things can make sex painful, and it can even contribute toward urinary stress incontinence.” No thanks.
In men or non-postpartum people, diastasis recti may not be visible in the same way, especially if you’re super-fit — but it still happens. “If you look at a male fitness model or a bodybuilder, sometimes they have a sort of diamond shape between their abs,” says Keller. This is also diastasis recti, but the gym-rat version. “Because their body fat percentage is really low, you don’t discern it in the way, but if they increased their body fat, it would show up as the same sort of pooch we sometimes see postpartum.”
Regardless of how someone might end up with diastasis recti, the prognosis is the same. “The muscles will not necessarily just knit themselves back together,” said Keller. Instead, the most reliable way to fix it is by doing certain types of exercises (you can see some of her recommendations here), similar to physical therapy, which will help repair the connective tissue. These exercises target the transverse abdominis (TVA) muscle, which is the deepest layer of abdominal muscle and supports the upper layers of muscle that have been stretched, thus helping your body’s natural healing process knit the connective tissue back together.
According to Keller, by sticking with the recommended exercises and avoiding anything that might worsen the damage (like lifting very heavy things), you can repair most diastasis recti in as little as 12 weeks. But if you do nothing, she says it’s unlikely that the connective tissue will repair itself completely on its own.
As for compression garments like “waist trainers” or corsets that are often suggested to new mothers? There are specific, individual circumstances where your doctor might recommend them, but generally, they do more harm than good. “If you put on a really tight compression garment around your belly after giving birth, it can push your organs and your pelvic floor further downward, and make everything worse down there,” says Keller.
If you’re not sure if you have diastasis recti, it’s actually pretty easy to check — just lie on your back with your knees bent, gently press down with your fingers above your belly button, and then lift your head slightly off the ground, keeping your shoulder down. If you can feel a gap wider than an inch, you may have diastasis recti.
But don’t freak out. “The best thing people can do to protect themselves is to be in tune with their body, so that when they’re exercising and something doesn’t feel right, they can try to figure out a way to do that movement differently,” Keller. “It’s very, very treatable.”