Why is there a gap in my abdomen? Understanding Diastasis Recti

Up to 60% of women experience diastasis recti postpartum, a condition that can be the answer to the question: Why is there a gap in my abdomen? This guide offers an authoritative look at abdominal separation, its causes, and effective solutions for recovery and prevention.

Quick Summary

A gap in the abdomen is often caused by diastasis rectis, a separation of the abdominal muscles and connective tissue. It can result from pregnancy, obesity, or improper exercise techniques that create excessive pressure on the core.

Key Points

• Diastasis Recti: A gap in the abdomen is most commonly caused by diastasis recti, or the separation of the rectus abdominis muscles due to a stretched linea alba.

• Not Just for Pregnancy: While most prevalent postpartum, diastasis recti can also affect men, children, and people with significant weight changes or those who perform improper exercises.

• Self-Check is Easy: You can check for a separation by lying on your back and feeling for a gap of two or more finger widths while performing a small crunch.

• Safe Exercise is Key: Focus on deep core exercises like pelvic tilts and transverse abdominal breathing, and avoid traditional crunches and planks that can worsen the condition.

• Distinguish from Hernia: A hernia is a tear in the abdominal wall, whereas diastasis recti is a muscle separation. Though distinct, severe diastasis recti can sometimes lead to a hernia.

• Comprehensive Healing: For best results, consider consulting a physical therapist who can provide a tailored plan focusing on strengthening the deep core and improving posture.

What is Diastasis Recti?

Diastasis recti, also known as abdominal separation, is a condition where the right and left sides of the rectus abdominis muscle, or "six-pack" muscles, pull apart. This occurs because the linea alba, the connective tissue that runs down the midline of your abdomen, becomes stretched and thinned. While the muscles themselves don't tear, the weakened linea alba can cause the abdomen to bulge, especially during strenuous activity. This condition is most often associated with pregnancy, but it can affect anyone, including men and infants.

Common Causes of Abdominal Separation

Several factors can contribute to the development of diastasis recti, primarily revolving around increased intra-abdominal pressure. Understanding these causes is the first step toward effective management and prevention.

Pregnancy and Childbirth

Pregnancy is the most common cause of diastasis recti. As the uterus expands to accommodate the growing baby, it places significant pressure on the abdominal wall. Hormonal changes, such as the increased production of relaxin, also contribute by softening connective tissues throughout the body, including the linea alba. The risk increases with multiple pregnancies, carrying multiples (e.g., twins), having a large baby, or being over the age of 35.

Improper Exercise Techniques

Performing core exercises with poor form can put excessive strain on the abdominal muscles and the linea alba. Certain exercises, particularly traditional crunches and sit-ups, can force the abdominal muscles to bulge outward, exacerbating separation. This is common in both men and women who engage in heavy weightlifting or intense fitness routines without proper core engagement.

Other Contributing Factors

Diastasis recti can also be caused or worsened by factors not related to pregnancy. These include:

• Significant Weight Changes: Rapid weight gain or loss, particularly around the midsection, can stretch and weaken the abdominal connective tissue.
• Obesity: Excessive abdominal weight puts constant pressure on the core muscles.
• Chronic Straining: Repeated straining from things like constipation or chronic coughing can gradually weaken the linea alba over time.
• Genetics: Some individuals may have naturally weaker connective tissue, making them more prone to abdominal separation.

Symptoms Beyond the 'Pooch'

While a visible midline bulge is the most prominent symptom, diastasis recti can present with other issues, signaling a compromised core. These symptoms arise from the lack of support the core provides to the rest of the body.

• Lower back pain
• Poor posture
• Pelvic or hip pain
• Urinary incontinence or pelvic floor dysfunction
• Constipation
• Feeling of core weakness or instability
• "Doming" or "coning" of the stomach when engaging core muscles

How to Perform a Self-Check for Diastasis Recti

You can perform a simple at-home test to check for abdominal separation. If you are unsure, or if you suspect your case is severe, you should consult a healthcare provider or a physical therapist for a definitive diagnosis and treatment plan.

1. Lie on your back with your knees bent and your feet flat on the floor.
2. Place one hand behind your head for support and put the fingertips of your other hand just above or below your belly button, pointing toward your feet.
3. Relax your abdominal muscles, then slowly lift your head and shoulders slightly off the ground, as if doing a mini-crunch.
4. Press your fingertips gently into your abdominal midline. You are feeling for a gap or separation between the two muscle bands. Note how many finger widths fit into the gap.
5. A separation of two or more finger widths is generally considered diastasis recti.

Treatment Options and Management

Healing diastasis recti typically involves a conservative approach, though surgery may be an option for severe cases. The goal is to restore core function and stability by strengthening the deeper abdominal muscles.

Physical Therapy

Working with a physical therapist, especially one specializing in pelvic health, is a highly effective treatment. A PT can assess the severity of your separation and create a customized plan of exercises that focus on engaging the transverse abdominis, the deepest core muscle. These exercises help to cinch the abdominal muscles together from the inside out.

Targeted Exercises

Not all core exercises are safe for diastasis recti. Avoid exercises that cause your abdomen to bulge or "cone," such as traditional crunches, sit-ups, and planks. Instead, focus on safe movements that promote core engagement without excessive strain.

• Transverse Abdominis Breathing: A foundational exercise that focuses on deep core engagement.
• Pelvic Tilts: Helps strengthen the deep abdominal muscles and improve posture.
• Heel Slides: Engages the lower abdominal muscles in a controlled motion.
• Bridges: Works the glutes and core, improving stability.

Lifestyle Modifications

Adjusting daily habits can significantly aid in recovery and prevent worsening the condition.

• Use Proper Form: Always engage your core and use proper form when lifting heavy objects, including a baby or groceries.
• "Log Roll" Out of Bed: To avoid putting pressure on your abs, roll onto your side and use your arms and legs to push yourself up.
• Wear Support Garments: Abdominal binders or supportive underwear can provide external support to the core, especially postpartum.

Diastasis Recti vs. Hernia: Key Differences

While both conditions can present as a bulge, they are fundamentally different. A hernia occurs when an organ or tissue pushes through a weak spot or tear in the abdominal wall, which can sometimes be a complication of diastasis recti. The following table highlights the key distinctions:

Feature	Diastasis Recti	Abdominal Hernia
Core Issue	Stretching and weakening of connective tissue (linea alba) between the abdominal muscles.	A hole or tear in the abdominal wall through which tissue protrudes.
Appearance	A ridge or bulging down the midline, especially with exertion.	Typically a localized lump, sometimes becoming more prominent with coughing or straining.
Risk Level	Not inherently dangerous but can cause pain and functional issues.	Can pose a risk if the tissue becomes trapped or loses blood flow; often requires surgical intervention.
Treatment	Primarily conservative (physical therapy, specific exercises).	Often requires surgical repair to fix the tear in the abdominal wall.

The Role of Posture and Pelvic Floor Health

Diastasis recti often exists in tandem with other core and pelvic floor issues. Poor posture, for example, can put extra strain on the core, making separation worse. Conversely, a weakened core from diastasis recti can lead to poor posture. The core and pelvic floor muscles work together to provide stability, so dysfunction in one area can affect the other, leading to issues like urinary incontinence or pelvic pain. A holistic treatment approach, often provided by a physical therapist, addresses these interconnected issues. For more information on pelvic health, you can consult an authoritative source like the Cleveland Clinic.

Conclusion: Moving Toward a Stronger Core

A gap in the abdomen is a common occurrence, but understanding that it's likely diastasis recti empowers you to take action. With the right knowledge and a consistent, safe approach to core strengthening, many people can significantly improve or resolve their abdominal separation. Always remember to consult a healthcare professional for a proper diagnosis and guidance. By focusing on deep core engagement, modifying your daily movements, and being patient with your body's healing process, you can regain core strength and stability for a healthier, more functional you.

Frequently Asked Questions

Can men get a gap in their abdomen?

Yes, men can get diastasis recti, though it is less common than in women. Causes for men often include significant weight gain, obesity, improper heavy lifting techniques, or chronic straining from conditions like constipation.

Is a gap in the abdomen dangerous?

Diastasis recti is not life-threatening. However, if left unaddressed, it can lead to complications such as chronic lower back pain, poor posture, core instability, pelvic floor dysfunction, and in rare cases, an umbilical hernia.

What exercises should be avoided with diastasis recti?

It is best to avoid exercises that cause the abdomen to bulge or dome, as they put too much strain on the weakened midline. Examples include traditional crunches, sit-ups, planks, and any heavy lifting that causes straining.

Can diastasis recti go away on its own?

In many cases, especially after pregnancy, the separation will decrease on its own over time. However, it may not completely resolve without intervention. Physical therapy and targeted exercises can greatly improve the condition and restore function.

How long does it take to heal diastasis recti?

The healing time for diastasis recti varies depending on the severity of the separation and individual consistency with treatment. It can take several weeks to many months. Consistent practice of targeted core exercises is key to recovery.

What is the difference between diastasis recti and a hernia?

Diastasis recti is a separation of the abdominal muscles and connective tissue. A hernia, on the other hand, is a hole in the abdominal wall through which an internal organ or tissue protrudes. A severe diastasis can sometimes lead to a hernia.

Can I prevent a gap from forming during pregnancy?

While some abdominal separation is normal and expected during pregnancy, you can reduce the risk or severity by focusing on safe core exercises, maintaining good posture, avoiding excessive weight gain, and using the "log roll" technique when getting out of bed.

When should I see a doctor about the gap in my abdomen?

You should consult a doctor if the gap is wider than two finger widths, if you experience pain (especially in the lower back or pelvis), or if you suspect you may have developed a hernia. A healthcare provider can confirm the diagnosis and recommend a treatment plan.