Diastasis Recti After Pregnancy: Causes, Exercises & Treatment

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Diastasis Recti: Causes, Symptoms, Diagnosis & Management

Introduction

Diastasis Recti is a condition in which the rectus abdominis muscles (six-pack muscles) separate along the midline of the abdomen due to stretching and weakening of the connective tissue (linea alba). It is most commonly seen in pregnant and postpartum women, but it can also affect men, newborns, and people who lift heavy weights improperly.

What is Diastasis Recti?

Diastasis Recti occurs when the left and right abdominal muscles separate, creating a visible or palpable gap in the midline of the abdomen. This can lead to a bulging belly, poor posture, and core weakness.

Causes

  • Pregnancy (especially multiple pregnancies)

  • Rapid weight gain or obesity

  • Improper abdominal exercises

  • Heavy lifting without core support

  • Weak abdominal muscles

  • Aging

  • Cesarean delivery

  • Chronic coughing or straining

Risk Factors

  • Multiple pregnancies

  • Large baby or twin pregnancy

  • Poor core strength

  • Advanced maternal age

  • Obesity

Signs and Symptoms

  • Bulging or doming of the abdomen

  • Soft or jelly-like belly

  • Lower back pain

  • Poor posture

  • Weak core strength

  • Difficulty lifting objects

  • Pelvic floor dysfunction

  • Constipation or bloating

Diagnosis

1. Physical Examination

  • Patient lies on the back and lifts the head slightly

  • A gap of more than 2 finger-widths indicates diastasis recti

2. Ultrasound

  • Confirms the width of muscle separation

  • Used in severe or unclear cases

Management & Treatment

1. Conservative Management (First-line Treatment)

✔ Physiotherapy exercises

  • Pelvic tilts

  • Heel slides

  • Abdominal bracing

  • Transverse abdominis activation

  • Kegels

❌ Avoid

  • Sit-ups and crunches

  • Planks (early stage)

  • Heavy lifting

  • Twisting movements

2. Lifestyle Measures

  • Maintain proper posture

  • Avoid straining

  • Use abdominal support belt

  • Maintain healthy body weight

  • Practice safe lifting techniques

3. Surgical Management

Indicated when:

  • Severe separation (>5–6 cm)

  • Persistent pain

  • Hernia present

  • Failure of conservative treatment

Surgical options:

  • Abdominoplasty (tummy tuck)

  • Laparoscopic repair

Prevention Tips

  • Strengthen core muscles before pregnancy

  • Avoid excessive weight gain

  • Perform pregnancy-safe exercises

  • Practice proper breathing techniques

  • Start postnatal exercises gradually

Complications (If Untreated)

  • Chronic lower back pain

  • Poor posture

  • Hernia formation

  • Pelvic floor dysfunction

  • Reduced functional strength

Conclusion

Diastasis Recti is a common but manageable condition. Early diagnosis, proper exercises, and lifestyle modification can significantly improve core strength and quality of life. Surgical treatment is reserved for severe cases only.

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