Not all abdominal bulges are excess fat that’s settled around your tummy. If you’ve ever been pregnant or even if you haven’t, you could have a common condition called diastasis recti. Up to two-thirds of women develop this condition to varying degrees, yet you can have it even if you’ve never been pregnant.
What is It?
As you know the rectus abdominis muscle, the two so-called “six-pack” muscles that run vertically from the sternum to the pubic bone are the ones most abdominal exercises target. Between these two muscles lies a sheath of connective tissue called the linea alba. When this tissue becomes weak or stretched, the two rectus abdominis, or six-pack muscles, can separate from each other. This separation allows the underlying tissue and fat to bulge outwards, creating a “pot belly.”
What Causes Diastasis Recti?
The “classic” way women end up with diastasis recti is pregnancy. Anything that stretches the connective tissue layer, the linea alba, between the two rectus abdominis muscles weakens them and allows the abdomen to bulge outwards. A growing baby inside you can certainly do that. Also, the hormonal fluctuations that happen during pregnancy can cause the linea alba to weaken and stretch. You’re more likely to develop this problem after pregnancy if you’re over the age of 35, have a large baby or multiple births, and if you have babies close together in time.
You might wonder how diastasis recti differ from a hernia. Diastasis recti are caused by a weakness in a specific piece of connective tissue, the linea alba. A hernia is also created by a weakness but can happen anywhere along the abdominal wall. The wall can become so weak that a piece of tissue, usually a portion of the intestine, pokes through the defect and creates a soft bulge. Diastasis recti is NOT a hernia.
Although pregnancy is the most common cause of diastasis recti, you can also get it from carrying too much weight in the tummy and by doing abdominal exercises incorrectly. Lifting heavy weight using incorrect technique, especially holding your breath as you lift, also increases the risk. You’re also more susceptible to this condition if you’re over the age of 35, irrespective of whether you’ve ever been pregnant. Some women have diastasis recti and don’t even know it.
It’s normal to have separation of the two rectus abdominis muscles right after pregnancy. The separation usually narrows after a few months, although the connective tissue may remain weak and lead to a stubborn abdominal bulge. Even worse, a persistent separation of the two muscles can throw off your posture, increase your risk for injury when you lift, and cause back pain.
How Do You Know if You Diastasis Recti?
If you have diastasis recti, you might notice an abdominal ridge that runs vertically down the midline of your abdomen. The ridge typically gets worse when you strain or rise from a lying down position and becomes less prominent when you relax your abdominal muscles. In general, a separation between the two muscles that’s greater than 2 centimeters is significant.
Not sure whether you have one? Try this at home:
. Lie flat on a mat with your back against the floor and bend your knees.
. Place the fingers of one hand above your navel and the other hand below.
. Lift your head and shoulders off the floor just enough to engage the abdominal muscles. Do you feel a separation or gap between the two muscles when you lift up?
. How many fingers can you fit into the gap? If it’s more than two, you have a significant separation.
This test will give you an idea of whether you have diastasis recti but it’s best to let a doctor check it to make sure you don’t have a hernia instead.
The Role of Exercise
Certain types of abdominal exercises can make diastasis rectus worse, particularly abdominal crunches, but reverse curls, planks, and oblique curls can too. If you have significant diastasis rectus, avoid traditional abdominal training and heavy lifting since these can increase intra-abdominal pressure and further stretch the already weak band of connective tissue.
Are there exercise that can help? Most health care professionals will tell you that exercise can’t correct diastasis recti since it’s weakening of the connective tissue rather than the muscles themselves. You can strengthen your core and abdominal muscles through resistance training but there’s little evidence this will strengthen or reinforce the connective tissue enough (linea alba) enough to reduce the gap.
Some fitness trainers say that core exercises, especially those that focus on the deep abdominal muscle called the transverse abdominis reduced diastasis rectus. Exercises they recommend include pelvic tilts, bridges, and abdominal compressions. These exercises are safer than traditional abdominal exercises for people with diastasis rectus but usually aren’t always enough to heal the separation. One approach is to exercise while wearing a belly splint to protect the muscles and weakened area of connective tissue.
If you think you have this condition, you owe it to yourself to talk to a health care professional who works with women who have this problem. As a last resort, a tummy tuck, a procedure that sews the weakened muscles back together corrects the problems.
Exercise May Protect against Diastasis Recti Related to Pregnancy
If you plan on getting pregnant, getting into shape beforehand has its perks. Research shows having strong abdominal muscles before getting pregnant decreases the likelihood of developing this condition after birth. Outside of pregnancy, keeping your weight under control also helps protect against the weakening of the connective tissue that separates the two superficial abdominal muscles.
When you lift heavy weights, it’s important to breathe properly throughout the movement rather than hold your breath, as many people have the tendency to do. When you hold your breath, it places pressure on the linea alba and over time this can weaken it and cause it to stretch. Now, you have another reason to use good form when you do abdominal exercises.
The Bottom Line
If you have a bulging belly that just won’t go away, especially if you’ve been pregnant, it may not be fat. Get it checked out.
WebMD. “Abdominal Separation (Diastasis Recti)”
Mayo Clinic. “How Pregnancy Affects Stomach Muscles”
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