Aging & Menopause

Ask Sofia: What is Diastasis Recti?

While not everyone is familiar with this condition or big name, it is something we see almost every day at Clinic Sofia. Diastasis is typically defined as a separation of the rectus abdominus muscle of 2 centimeters or more. Some women are born with a congenital condition, which can lead to abdominal wall weakness, although this is less common, while others acquire it due to pregnancy, obesity or age-related tissue defects.

“At 36 weeks of pregnancy, almost everyone has diastasis recti,” said Dr. Jewelia Wagner, who faced this condition after having twins four years ago. She experienced back pain and instability in her core and focused on various exercises and physical therapy to strengthen and tighten the abdominal wall and pelvic floor. “Due to a lack of reduction after four years, I elected for surgical repair of my abdominal wall. I was told they fixed a six-inch separation of my rectus muscles!!

Diastasis happens when a sheath of tissue called the linea alba, located between the rectus muscle, is stretched or weakened, allowing for an “outpouching” appearance. Fortunately, there are no other medical conditions associated with diastasis, although some women find it uncomfortable or frustrating when they are asked “how far along are you?” months or even years after delivery. In addition, it can also cause back pain and weakness.

To treat diastasis recti, patients can consider the following options:

  • Controlled weight loss, in the case of excess weight causing the separation;
  • Pre-pregnancy exercise and strengthening of the abdominal wall for women who are hoping to get pregnant in the near future;
  • A safe exercise program postpartum that strengthens the abdominal wall without extenuating the abdominal bulge; this often includes movements that draw the belly button towards the spine to prevent protrusion as well as an abdominal support belt;
  • Physical therapy for anyone struggling with the condition and surgery as a last resort.

 While Dr. Wagner notes that recovery from abdominal surgery takes time, she is pleased that she can now “enjoy doing a plank without looking down to see a large bulge in my stomach.”


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