Beyond “losing the baby weight” — diastasis recti

I had my second child nine months ago, and I’m one of those annoying people that loses lots of weight while breastfeeding, so I’ve been back in my normal clothes for a few months now, lower than my pre-pregnancy weight, etc. But as the weight came off everywhere else, I couldn’t help but notice that my belly just didn’t seem to be shrinking like the rest of my body. I tried to be patient with my body for several months, but something just seemed off.

To start with, I’ve always been shaped like a pear, not an apple, so being thicker around the middle just didn’t seem like my normal body composition. And it wasn’t just a flabby gut, it was like my stomach muscles were sticking out way further than they should be. I have to admit, there was a wee bit of vanity going on, too. Basically, I felt like I was in the awkward stage of pregnancy where your normal clothes don’t fit but maternity clothes are like a tent.

I started researching online and discovered that ab separation, or diastasis recti, is fairly common after pregnancy. A lot of people hear me talk about this and assume it’s a horizontal separation from my abs being cut during my c-section. (They don’t actually cut your abs, FYI.) But this is a vertical split down the middle of your “6-pack abs” (rectus abdominus).

Diastasis_Recti-2

Diastasis recti is caused by the weakening of the inner layer of abdominal muscles called the transverse abdominus, that runs horizontally around your trunk like a corset and holds everything in, underneath the ab muscles you’re probably more familiar with, like the obliques and “6-pack” muscles. Without the strength of that underlying transverse muscle, my reasonably strong outer ab muscles just splay out and give me that 2nd trimester look, as well as cause lower back/upper glute pain. (From what I understand, the weak abs put more strain on the back to compensate.)

I did the test that I found online to check if I had it, and by my measurements I had about a 4-finger-width separation. (It should be zero.). I called my OB’s office to ask what I should do about it, and after disagreeing with the nurse’s over-the-phone assessment that I’d probably need surgery…(I’ve had two c-sections, that’s quite enough surgery for me)…she spoke with the doctor and he referred me to a physical therapist.

the physical therapist confirmed that I have a 4-4.5 finger gap, and that this is a legitimate medical issue — I’m not just being vain about my stomach being poochy!  She said that left untreated, the gap can widen, especially when you try to do traditional ab workouts.  I’ve had four PT sessions so far, and my exercises are mostly squeezing core muscles, either my abs or my back, and squats. Crunches actually make it worse, and my PT recommended to avoid most core work (planks etc) until I closed the gap to at least 2 finger widths.

I am still able to run, but I’m really supposed to pay attention to keeping good posture/alignment, and she recommended not doing long distances because generally you get too tired to keep your core engaged.

After learning so much about diastasis recti, I’ve come to the conclusion that it’s much more common than most people realize. I hope that sharing my experience here might help someone else.

I took some pictures of myself at the beginning of my PT, but I don’t quite have a successful “before and after” to share with you yet.  I’ve heard it can take anywhere from a few months to a year to fully close the gap.  I’ll keep you updated!

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32 thoughts on “Beyond “losing the baby weight” — diastasis recti

  1. Good luck on correcting the problem without surgery, I think that is always the step that should be taking first. I had heard of this problem, but don’t know anyone with it, so thanks for sharing the information.

    • Thanks Steph! I am a little frustrated with how long it’s taking, but I think I can get it fixed if I just keep at it. Surgery just seemed like a really extreme solution.

  2. Very interesting. I have a friend who didn’t have it treated and it ended up getting so bad that she did have to have surgery. Which she said was way worse than either of her c-sections. Her last pregnancy was twins, which her doctor said made the gap much worse than normal. It’s amazing the things they don’t tell women about pregnancy until they ask.

    • I think they do if you have the vertical cut, but most c-sections now are the horizontal kind. My doctor said they just move the ab muscles to the side and cut through the uterus.

      I wish my doctor would have checked for this or talked to me about this being a possibility! Grrr.

      • If we told you everything that can go wrong after pregnancy, no one would ever have kids! 🙂 Just don’t be afraid to bring up something that is bothering you or doesn’t feel right. If at that point your doc disregards you, poop on them. 😉

        Good luck with the PT. Keep squeezing!

        • Ha – excellent advice! And yeah, all the “side effects” of growing a human and getting it out of your body can be pretty intimidating! Honestly I’d say stretched out abs are not too bad compared to some of the things that could have happened.

          Good to hear from you, Steph! I hope you’re having an amazing time on that European vacation I keep seeing pictures of!

  3. Yikes! I just checked and I have 2 fingers width, which according to the video you posted is okay ( they said 1-2 fingers). I should try some exercises to close that up a bit! Glad you figured this out!
    jan recently posted…Hot WeatherMy Profile

    • You’re so welcome! I’m sorry I had to dash away (I realized later that we didn’t get a pic together – darn!!) but I had a great time and I would definitely do it again if you’re ever in the area.

  4. Wow that’s insane, I’ve never heard of that. Thank you for sharing Sarah! Glad you’re getting it taken care of with a pro too – these are great tips to keep in mind. You said this is common after pregnancy, does the delivery method matter? I experienced the worse low back pain after my son due to the epidural – until this day it’s very sensitive. I went to a chiropractor and had vertebral subluxation so I had to have therapy to rectify it and while it helped the PT said that strengthening the core so I’ve been working on that and it’s helping. Amazing how the core and the back are so interrelated. The wonders of post-pregnancy! Have a great one and best of luck with your therapy Sarah! Keep us posted! -Iva
    AwesomelyOZ recently posted…GTFO: The ABC’s of PhobiasMy Profile

    • Thank you, I actually thought about your deeply researched posts when I was writing this! I don’t think delivery method impacts whether you get diastasis recti, but I have a theory that people (like me) who know they’re having scheduled c-sections neglect doing their kegels, which may contribute to it.

      Yes, I am also learning that the core and back are very interrelated. A lot of my exercises are back exercises, which really surprised me.

    • I hadn’t heard of it either — thank goodness I’m good at googling things, because my doctor sure never mentioned it! =) There is a pretty easy way to test for it – check out the link to the video in my post – and if you do, I’d definitely recommend talking to your doctor about it.

  5. A coworker of mine has this. I didn’t even know you can self-test. I’m kind of scared to do it now because I might do it wrong and send me on a panic lol. I wish I knew about this before my doctor’s appointment last month, as I would’ve felt better if I asked her to check.

    I remember her checking my abs at my post-partum appointment and she said all looked good. But I hope she knew to check for this specific thing, as I didn’t ask and nor did she mention it by name (at least from what I remember).

    That’s awesome though Sarah that you’re getting this done and checked out.
    Nina recently posted…Why Motherhood Is Hard for YouMy Profile

    • I think you should test yourself — better to know than not know, right? Especially with the damage you can do if you have it and try to do traditional ab workouts.

      Thanks for stopping by, Nina!

    • I’ve had two and I had to go researching to figure out what was going on with me. It seems like it’s pretty common yet rarely talked about. Strange!

  6. I have had two vaginal births and also have suffered through some digestive issues that caused severe bloating (looking approx 4-6 mos preg). Now that my bloating is under control (gluten being the culprit) I have noticed that I have a diastisis. I’m frequently asked if I’m pregnant….Ahhhh…who does that right?! But, I know it’s because I have this pouch just in the right spot to look like I’m heading out of my first trimester. I’m a PT and was very careful during both pregnancies to avoid certain exercise (crunches, twisting, pikes-anything with both feet off the ground when flexing the abdominals). However, with the combination of constant bloating when not pregnant and both pregnancies, something went wrong. I would recommend that anyone who has a diastisis seek out some training from a PT. The transversus muscle (girdle muscle-yes we have a natural girdle somewhere deep In there!!) is really what you have to retrain to get you rectus muscle (6-pack muscle) to come back together. Contracting the tranversus muscle is very subtle and tricky, even if you just have a few visits to have the therapist train you, you will be much better off. I personally went to a woman’s heath physical therapist to assist me in retraining my body (I’m a pediatric PT), but a lot of common ortho. PTs are good at testing the muscle too. The key is endurance training, this muscle has to support you all day long!! I’m not completely there yet, but have seen results!! It’s hard work and you have to commit to it, but it’s worth it. (We’ve all birthed and raised babies so you can handle it!). Good luck ladies!

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