This is a question we are frequently asked by clients who are currently pregnant or have just given birth. Abdominal separation, more commonly referred to as diastasis recti, is relatively common after pregnancy and unfortunately causes much angst amongst women who think they can’t wear certain clothing thereafter or feel their body may never return to a pre-pregnancy normal.
Rest assured, we can help.
What Causes Diastasis Recti?
Diastasis recti occurs when the linea alba (the connective tissue that naturally separates your abdominal muscles) gives way under stress/strain.
This connective tissue is naturally very lax for most adult women and stretches during pregnancy to accommodate the growing uterus by as much as an inch on either side. Experts estimate that around 70% of pregnant women develop what is called diastasis recti (DR), a separation between both halves (left and right) of the Rectus Abdominis (RA).
When you are pregnant and have a baby growing in there, your abdominal muscles bear about 50% more weight than before pregnancy ever started.
Not all Degrees of Diastasis Recti Requires Surgery
The condition of diastasis recti is often measured in degrees of how large the split in the membrane joining the abdominal muscles is. These measurements can be made by a patient using their fingers. Not all degrees of Diastasis recti require surgical intervention.
- Mild Dissection — Postpartum women who have a separation between their RAs of less than 2 finger-breadths. This is the most common finding and can typically improve with effective core stabilization.
- Moderate Dissection — Moderate DR would be present if the linea alba is 2 to 4 finger breadths apart and can sometimes get worse if left untreated, but with effective core stabilization, the body can heal and close these gaps.
- Thick Dissection — Moderate to Thick DR: Where there are 4-5 finger breadths between the RAs. This is a more problematic finding that needs to be assessed and treated earlier on in order for the body to have the opportunity to heal itself.
The tissue between the “6-pack” abdominal muscles is actually a thin layer of fascia called the linea alba. This white fibrous band, which runs from one side of the abdomen to the other side, can split and separate when there is too much pressure placed on it. Diastasis recti is a separation of the linea alba where the abdominal muscles separate from each other.
The Solution: Diastasis Recti Surgery
If a patient has diastasis recti that isn’t self-resolving, surgery is required. Diastasis recti surgery is designed to reduce the size of the gap through which abdominal contents can protrude. It focuses on closing or tightening the muscles in the abdominal area.
In some cases, temporary support such as an abdominal binder may be used to help pull the muscles back together. In other cases, the surgery may involve using tissue such as connective or muscle fascia to cover and support the abdominal wall. Diastasis recti also may be repairable without a full abdominoplasty.
How can you tell if you have diastasis recti?
Can you see a bulge or separation between the right and left sides of your abdominal muscles when you look at yourself in the mirror?
If so, then you probably have diastasis recti. However, this is not always easy to detect without assistance from an experienced physical therapist or another professional with appropriate qualifications.
Under the right conditions, some people with diastasis recti can easily see it (for example, when they are wearing clothing that emphasizes the separation). In contrast, others may not see much of a bulge at all. So don’t be surprised if you have diastasis recti and can’t spot it as easily, as the gap can be as small as a ½ inch or as large as several inches.
For more information on this condition and how to treat it, don’t hesitate to get in touch with our office by phone or through our online contact form.
