Written and medically reviewed by Dr. Brenda, DPT
Diastasis Recti “DR” (abdominal separation) is one of the things that I get asked questions about almost on a daily basis. And it is evident that there is a lot of conflicting and misleading information out there which can lead to feelings of fear and helplessness, but it doesn’t have to be that way! So let’s debunk some of these common myths that I hear all the time (and give you back some of the control and power over the direction of your health!)
Myth #1: "My abdominals are torn". No….you are not broken! So what’s actually going on? There are of course no bones in your abdomen, so your abdominal muscles come together in the front and make this nice connective tissue matrix, called your linea alba - it runs from your ribs to your pubic bone and it’s job is to create tension to give the muscles something stable to pull from and transfer loads side to side in your body. It also gives support in the front to your abdominal organs. You have 2 muscle bellies of your rectus abdominus (think 6-pack muscles) which run down either side of this linea alba. If your connective tissue is stretched or not providing good tension, when you do something that uses your abdominal muscles (almost everything in life) and your muscles go to work, they pull on the tissue that is not pulling back effectively. So you are seeing and feeling the 2 muscle bellies of the rectus abdominus pull away from each other instead of being able to stay in their position. They are not torn or split. The connective tissue is not ripped or split either (in most cases). Also, as a result of the stretched tissue in the front, your muscles and organs don’t have the support they need, hence the doming abdomen, or “pooch”. When pregnant, this tissue is designed to stretch so our growing uterus does not actually push through muscle tissue! After birth, due to a variety of factors, it’s possible this tissue takes a longer time to heal and tighten back up. In fact, 100% of postpartum women have a DR after they give birth (it’s the way we’re designed!) and you will see a gap as this tissue heals. But…..when we continue to put forces through this tissue that it can’t control as it heals, it is possible to get a persistent or long-lasting DR.
Myth #2: “The size of my gap matters”. This is one of the most common misconceptions. I’m here to tell you that the size of the gap actually does not matter. There are very strong and functional people who have a gap - have you ever seen a really toned model, one where you can see the entire six pack, and noticed a gap? Sometimes there is a gap present with no weakness or problems. Conversely, sometimes there is no gap with troubles and symptoms! We actually look more at the depth of the gap and the ability of that tissue to transfer tension and load when the core is firing as a predictor of success. It’s all about functionality! What does that mean? It means that the work can be transferred between the muscles of your core creating stability and strength and effective pressure control when you try to do something. You may be rock solid stronger than you ever were before and still have a “gap” on testing. Now yes, we do pay attention to the width of the gap to note progress and see how the muscles are approximating when they work, and a very large gap does take some extra focus and training to get the system coming together and controlling the pressure…..but it is not the only factor (or even the main factor) that matters.
Myth #3: “I have weak abs so i got a DR”. It’s not necessarily about strength, and if there is a weakness, it almost always is never the only factor going on! There are a variety of factors that may lead to DR. Your core system actually includes not only your abs, but also your pelvic floor, low back stabilizers, and breathing diaphragm. It’s job is to control the normal intra-abdominal pressure that builds up with our daily activities. It’s not about brute strength - it’s about coordination, form, muscle timing, strategy, and a system that is working well together to do it’s job. When something is off, you can get forward pressure which pulls on the tissue and makes a gap. And by the way, very strong, fit women, struggle with this as well sometimes. Getting to the root cause, which often has to do with imbalanced muscle recruitment, improper breathing patterns, and/or inefficient habitual movement patterns, is the key!
Myth #4: “There is nothing i can do to fix it except have surgery”. This one makes my heart hurt because it is a very common thought, yet there are TONS of things you can do! And many chances to make a change! It’s just not well known in the medical community. Because of what I have already mentioned above, this is not a one-factor problem that has a one-factor solution. It is NEVER too late to heal and people can make a difference in their strength, control, and appearance even YEARS after birth. It’s about teaching the body to use this core system effectively so it stops leaking pressure and power out the front of your abdomen! There are of course cases where surgery is very appropriate and very successful, but many times, learning about your body and what is happening is the first step in figuring out how to make a change. And actually, surgery is often much more effective when women go through this understanding and work first because their body will learn how to not stress the tissue that just got repaired.
Myth #5: “My pregnancy gave me a DR”. No, not necessarily. Yes, pregnancy is something that causes changes in your body, but there are some women who struggle with this post-pregnancy and some who don’t, so pregnancy is not the only factor. There are women who struggle with this who have never been pregnant. There are even men who struggle with this! Many factors affect this core system and the integrity of our connective tissue, including pregnancy, injury, surgery, postural changes, breathing patterns, activity level, pain patterns, etc. Let’s move away from the “my baby destroyed my body mindset” because it can be defeating and upsetting……there is NO REASON why you can’t, and won’t, be a strong, fit, and vibrant mama - it just may take some time and dedication!
Myth #6: “There is no point in getting checked or working on this now because I want to get pregnant again so i’ll just get stretched out again”. No! - It is so important to learn the concepts now, no matter where you are in your journey, because it will minimize pressure during pregnancy, and foster a more healthy recovery! Give yourself some tools. If you had a knee injury after running a marathon, you wouldn’t just ignore it and not train it for your next marathon because “well, it’ll get destroyed anyway”…… you would strengthen, stabilize, and train to try to minimize pain, to enhance your performance, and to recover more quickly! And giving birth is a little more intense than a marathon, am I right? The concepts that you learn to help a DR also help things like back/hip/pelvic pain, hernia, prolapse, incontinence, and make you stronger and more stable overall because you are giving your core system more power! There isn’t a good reason to just let it go. No matter what stage you are in, there are things you can do to help.
Myth #7: “I just need to do harder “ab work””. As I mentioned above, the function of your core is not all about brute strength…… Sometimes it’s finding out what’s going on to re-coordinate the system, adjusting form, or using your breath and finding a pelvic floor and deep core lift. Sometimes it’s addressing alignment issues or posture habits. Sometimes it’s addressing soft tissue and joint mobility restrictions. Sometimes it’s addressing the stability of the surrounding structures. Don’t just put harder exercise on a faulty foundation! If the deep core system is not firing effectively, beating up your abs won’t be doing you any good because whatever compensations are occurring and causing that doming abdomen will continue to happen. Your body is very smart and will get tasks done whatever way it is able to. A general rule of thumb is if you can’t do an exercise without doming/bulging in your lower abdomen (or leaking, pain, heaviness, whatever your symptoms happen to be) then you should modify to a level you can control and start there to build up.
Myth #8: “I can never do crunches or planks or burpees again”. There is a lot of conflicting information on the internet that can be scary. It is very common to see this type of statement when searching for DR solutions. It’s true - these exercises ARE more intense, so require more coordination because of an increase in intra-abdominal pressure that your body needs to effectively control. That makes them risky if you jump back into them without considering form or whether your core system can effectively control them, but there is no reason why you can’t build up the strength and coordination to do them again! It’s all about form and strategy and knowing when and how to modify to bring your body to an exercise it can control and then building up strength and intensity from there.
Myth #9: “I will never get better”. I hate to hear this one. I’m a mom of 3…..so I KNOW it’s easy to feel defeated, or that your body let you down, or that you don’t have time or energy to focus on yourself. The mind and body are so connected that this mindset easily sneaks in and can take a toll. Thoughts and emotions have a powerful effect on healing. But here’s the cool thing: there are so many steps you can take, small or big, to take yourself a little more toward your goal, once you learn about your body and the way it is designed. You will find your path. And then that mind-body connection can be put toward better use and spiral in a positive direction once you really realize that. Being pregnant and birthing a baby is probably one of the most intense things you will have to do in your life and is surrounded by emotion that is different for everybody. And even though I don’t know you or your story, I absolutely KNOW that you did it in the best way you knew how to in that moment. Because that’s all you could have done. And yes, sometimes we are left with some really annoying and difficult things to have to work on in our bodies and minds, and it can be tough. But there is always a way….please give yourself some grace and forgiveness as you figure things out and move through your journey.
Myth #10: “She recovered so easily so why am I not?” As you can see above, the reasons why you may be struggling with DR can be different for everyone, so a solution must be based on your own individual body to be successful. It could be a weakness, a muscle coordination issue, a habitual posture, a tightness in the hips or spine, a breathing pattern, amongst other things. And there are other factors not even considering the muscle system that are largely impactful, including hydration (dehydrated tissue can be thinner, weaker, and not regenerated at the same rate), nutrition (food gives us our building blocks and energy), and sleep (our body actually does most of it’s healing when we are sleeping). The healing journey is very individualized and what works for one person may not work for someone else.
Well there you have it, the most common myths that I hear about DR and their truths. DR is actually one of my favorite things to work on with clients because I see the shift from taking something that can have the potential to be scary, frustrating, and defeating and turn it into empowerment and strength. What would it feel like to feel great in your capable body and to know there’s a path? Just taking action on one of the above points causes a change where all of a sudden you can feel confident and in control of your health. Knowledge is power!
Want to explore more in your own body? Contact me!