Diastasis is the colloquial term for a medical condition that is also known as rectus abdominis diastasis (RAD), or more commonly, diastasis recti. It refers to the separation of the two large, vertical bands of abdominal muscles, the rectus abdominis, which meet in the midline of the abdomen. This separation occurs when the linea alba, the connective tissue that joins these muscles, becomes stretched and weakened. While it is most frequently discussed in the context of pregnancy, it can affect men, newborns, and non-pregnant individuals as well.
Understanding the Anatomy of Abdominal Separation
The rectus abdominis muscles are what people often refer to as the “six-pack abs”. They run vertically from the pubic bone to the sternum. Down the center of these muscles runs the linea alba, a band of fibrous connective tissue. This tissue is designed to stretch to accommodate the body's movements and changes. During pregnancy, the expanding uterus pushes against the abdominal wall, causing the linea alba to thin and stretch to its limit. In many cases, this tissue loses its elasticity and doesn't fully retract after delivery, resulting in the abdominal separation characteristic of diastasis recti.
Common Names for Diastasis
Rectus Abdominis Diastasis (RAD)
This is the precise medical term used by healthcare professionals. It directly translates to the separation of the rectus abdominis muscles.
Abdominal Separation
This term is widely used to describe the condition to patients and the general public. It simply and accurately describes the partial or complete separation of the abdominal muscles.
Mummy Tummy or Postpartum Pooch
These informal terms are used to describe the visible bulge or pooch that can persist in the abdominal area for weeks, months, or even years after giving birth due to unresolved diastasis.
Divarication of the Rectus Abdominis
This is another, less common medical term that refers to the same condition.
Causes and Risk Factors
The primary cause of diastasis recti is excessive internal abdominal pressure. While pregnancy is the most common cause, other factors can also contribute:
- Chronic Strain: Excessive or improper heavy lifting, repeated abdominal crunches, or a chronic cough can place too much stress on the linea alba.
- Obesity: Carrying excessive weight, especially around the abdomen, puts constant pressure on the abdominal muscles.
- Genetics and Age: Some individuals may have weaker connective tissue due to genetics, and the natural decrease in muscle tone with age can also be a factor.
- Newborns: Premature newborns may have underdeveloped abdominal muscles that haven't fully joined at the midline. This typically resolves on its own.
Risk factors for developing or retaining diastasis after pregnancy include:
- Having multiple pregnancies, especially with less than a year between them
- Being over 35 years old during pregnancy
- Carrying multiples (twins or triplets)
- Delivering a large or heavy baby
- Being very petite
- Straining during a vaginal delivery
Symptoms and Health Implications
Symptoms of diastasis recti can range from cosmetic to functional and can significantly impact daily life.
- Visible Abdominal Bulge: A soft bulge or a jelly-like feeling around the belly button is a common sign, especially when contracting abdominal muscles. This can result in a "doming" or "coning" shape along the midline.
- Core Weakness: The separated muscles can no longer provide stable support, leading to feelings of weakness in the midsection and difficulty performing everyday tasks.
- Back Pain: A weakened core can place extra strain on the back and pelvic muscles, causing persistent lower back or hip pain.
- Pelvic Floor Dysfunction: The core and pelvic floor work together. When the core is compromised, it can contribute to issues such as urinary incontinence, pelvic pain, and pelvic organ prolapse.
- Digestive Issues: Weakened abdominal muscles can affect internal organ support, potentially leading to constipation and bloating.
- Hernia Risk: In severe cases, the stretched connective tissue can tear, creating a space for internal organs to protrude, which is known as a hernia.
How Diastasis Recti is Diagnosed
A healthcare provider can diagnose diastasis recti with a simple physical exam. They will palpate the abdominal area to feel for the gap between the muscles. An abdominal gap wider than 2 centimeters (or about two finger-widths) is typically considered diastasis recti. For a more accurate measurement, or in cases where excessive belly fat is present, a medical professional may use an ultrasound.
You can also perform a basic self-test at home:
- Lie on your back with your knees bent and feet flat on the floor.
- Place one hand behind your head and the other on your abdomen, with your fingertips pointing toward your toes just above your belly button.
- As you slowly lift your head and shoulders slightly off the ground (as if starting a crunch), press your fingertips gently into the midline of your abdomen.
- Feel for a gap or separation between the rectus abdominis muscles. Note how many fingers can fit into the gap.
Treatment Options for Diastasis Recti
Management for diastasis recti can be approached in two primary ways: conservative methods or surgical intervention. Most cases can be managed effectively with conservative treatment, with surgery reserved for more severe, persistent cases.
| Feature | Conservative Treatment | Surgical Repair |
|---|---|---|
| Methods | Physical therapy, targeted core exercises, posture correction, abdominal binders. | Abdominoplasty (tummy tuck) involves suturing the separated connective tissue to bring the muscles together. |
| Typical Use | Mild to moderate cases; first-line treatment for most individuals, especially postpartum women. | Severe cases that don't respond to conservative methods, or when complications like hernias are present. |
| Risks | Low risk; improper exercises can potentially worsen the separation. | Higher risk due to anesthesia and surgery; includes risks of infection, scarring, and longer recovery. |
| Recovery | Gradual improvement over weeks to months with consistent and correct exercise and lifestyle changes. | Significant recovery time, with restrictions on lifting and activity for several months. |
| Cost | Lower cost; may involve physical therapy sessions. | Significantly higher cost, though potentially covered by insurance for functional issues. |
| Outcome | Often leads to improved core function and reduced cosmetic bulge, but results vary based on severity and adherence. | Can offer more dramatic cosmetic and functional improvement in severe cases. |
Conservative Management
Working with a physical therapist specializing in pelvic health is a recommended first step. They can guide you through appropriate exercises that focus on engaging the deep core muscles, especially the transverse abdominis, without putting excess pressure on the midline. Avoid traditional crunches and sit-ups, which can worsen the condition by creating coning or doming. Abdominal binders can also provide temporary support but do not strengthen the muscles.
Surgical Repair
If conservative treatments are ineffective, or if a hernia is present, surgery may be necessary. The most common surgical procedure is an abdominoplasty, or tummy tuck, which involves suturing the stretched linea alba to reapproximate the rectus abdominis muscles.
Prevention Strategies
While some degree of abdominal separation during pregnancy is normal and expected, certain practices can help reduce its severity and promote postpartum healing.
- Maintain Good Posture: Consciously standing up straight with shoulders back helps support the core and prevent excessive strain.
- Practice Safe Lifting: Avoid straining when lifting heavy objects, including children or groceries. Use proper form by engaging your core and lifting with your legs.
- Use Proper Movement: When getting out of bed or a chair, roll onto your side and use your arms to push yourself up, rather than doing a sit-up motion.
- Safe Core Exercises: Focus on deep core exercises rather than traditional crunches or planks, particularly during and after pregnancy.
Conclusion
What is diastasis also known as? It's rectus abdominis diastasis or abdominal separation, a common and treatable condition. While it is most frequently associated with pregnancy, it can affect a wide range of individuals. Understanding the alternative names, causes, and symptoms is the first step toward effective management. With conservative options like physical therapy or, in more severe cases, surgical repair, it's possible to regain core strength, address related discomforts, and improve overall abdominal function. Seeking guidance from a healthcare professional, especially a physical therapist, is recommended for the best results. Learn more about diastasis recti and treatment options at the Cleveland Clinic.
