Makenzi Magiera: Diastasis recti: The pooch that is not fat

Have you ever noticed a bubble-like pooch right in the middle of your belly that shows when you get up from lying down, when baring down, or while doing your daily crunches? If so, you might have a condition called diastasis recti.

Diastasis recti occurs when there is too much pressure on the abdominal muscles, causing the abdominal wall to separate in the middle. This might cause a soft spot at the midline or the classic protruding pooch with strain activities. While this condition itself is generally painless, it has associated symptoms, such as low back, pelvic or hip pain, a perceived weakness in the midsection, and might make it difficult to maintain good posture. There is a high correlation between having diastasis recti and low back pain in postpartum women, as well as with people who frequently lift heavily, either at the gym, working out or through manual labor. Excess weight and obesity can also place undue stress on abdominal muscles and cause them to separate and weaken. Family history, age and even cirrhosis are other classic contributing aspects associated with diastasis recti. A new study from October 2021 showed that the prevalence of diastasis recti in adults can be as high as 57%.

People often wonder how they can tell if they have it. If you want to do a quick screen you can lay on your back on a comfortable surface, place your fingers right above your belly button, lift your head about an inch without lifting your shoulders. If you feel a soft gap that pokes up into your finger in between the muscles and see a little bulge, you might have diastasis recti.



So, what does one do if they have diastasis recti? There are some positioning changes that can be applied immediately in day-to-day activities. Select core, back, pelvic floor, and diaphragm exercises have been shown to significantly decrease diastasis recti along with showing a significant decrease in low back pain with people that present with both. There are also specialists in the fields of physical therapy and bodywork that can manually help to reduce diastasis recti. Surgical intervention is possible as well, yet, only considered for severe cases where all other measures failed.

GETTING OUT OF BED

You might want to consider using the log roll technique to get in and out of bed to avoid excess strain. In a log roll, you bend your knees and turn onto your side facing the edge of the bed. Then, from your side, push up onto your elbow and swing your legs off the bed until you find yourself in the upright sitting position. Apply the opposite when getting into bed. This avoids extreme pressure on your stomach muscles that would occur if you did a sit-up from your back when getting into or out of bed.



BRACING

Strain activities such as lifting, coughing or sneezing, can put great forces on the weak connective tissue, causing the diastasis to widen further or to reverse the work being done to correct the diastasis. Knowing to use your deep abdominal muscles to support your core during these moments is essential. The abdominal muscles have multiple functions. Most everyone knows about the “six-pack”, which helps bend the trunk. The deepest abdominal muscles, however, work more like a back brace and can help keep the core together. It is helpful to learn to draw in, instead of pushing out, your stomach muscles, so you can brace your core in moments of heavy strain.

FOOD AND ALLERGIES

Bloating, gas or constipation causes the belly to swell, which can also cause the diastasis to stretch further apart. These symptoms might also suggest allergic reactions to certain foods, such as gluten, grain or daily, as the body is not able to digest them properly. If you are having these symptoms, you might want to talk to your doctor or naturopath, who can lead you on a path to a healthy and well-functioning digestive system.

To really learn more, consult with your doctor or physical therapist, as they can educate and teach you what positions or activities to avoid until strength is adequate to not make diastasis recti worse. They can also help with posture education and training along with giving a specific home exercise program that will help you strengthen your muscles in your core.

Move better, live better!

Makenzi Magiera, DPT received her Doctorate of Physical Therapy from Rocky Mountain University of Health Professions in Utah. She is a valued staff physical therapist at Fit for Life Physical Therapy (www.fitforlifencpt.com)

Diastasis recti occurs when there is too much pressure on the abdominal muscles, causing the abdominal wall to separate in the middle. This might cause a soft spot at the midline or the classic protruding pooch with strain activities.
Photo by Tetiana Mandziuk

Makenzi Magiera

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