Diastasis Recti Abdominis

Diastasis Recti Abdominis (DRA) is not a term most people have heard of.  If you have, it is most likely because you currently are or have been pregnant. The truth is, you do not need to be a pregnant nor female in order to have it.  DRA is common in women and men, in fact, most of us are actually born with it.

What is it and who is at risk of getting it? 

Photo Credit: freestocks.org

Photo Credit: freestocks.org

To put it in simple terms, DRA is the stretching of connective tissue between the abdominal muscle called rectus abdominus, aka six pack.  Although the separation is in rectus abdominus, it is the weak transverse abdominus, aka the human corset, that is overstretched and weak which causes the rectus abdominus to separate.  

Many babies are born with DRA.  It is most visible when a baby tries to sit up and their belly widens and something protrudes through the middle.  As their bodies grow and the nervous system develops, DRA usually goes away.  In rare cases when it does not go away, these kids have a hard time doing a sit up and may need help strengthening the muscles.  Children and teenagers can develop DRA if they do activities that require a lot of sit-up motion or overarching of the low back, like dance and gymnastics.  As an adult, DRA is generally associated with pregnant or postpartum women.  As the uterus grows the abdomen is stretched out from the inside, and so are the abdominals, causing a separation in the linea alba.  Repeated day-to-day movements can make DRA worse if one is unaware of this condition. However, many people, both men and women, have DRA and do not even know about it. In addition to pregnancy, causes for DRA could be due to:

- Enlarged abdomen due to being overweight 

- Too many sit-ups/crunch type of motion

- Hyperextension of the low back

- Abdominal hernia or surgery

How does DRA affect the body? 

The abdominals are an integral part of our core strength.  If they are weakened, they can result in:

- Poor posture

- Chronic back pain

- Abdominal hernia

- Digestive problems

How is it diagnosed?  

Photo Credit: BabyCenter, Amy Paturel

Photo Credit: BabyCenter, Amy Paturel

The diagnosis is fairly simple: while lying down on your back with knees bent, feel the linea alba and then lift your head.  Depending on what you feel, width and depth of the separation will let you know the degree and quality of the connective tissue.  Other common indicators of DRA are bulging abdomen, tenting in the middle of your abdomen when you sit up, and an outie bellybutton.

Unfortunately, it is not common practice for medical, paramedical, or fitness professionals to assess DRA on everyone and most are not trained to do it.  

Who should be checked for DRA? 

The following populations are at higher risk of having a DRA:

- chronic back pain

- weak abdominals

- tight hip flexors

- outtie belly button

- hernia, especially umbilical

- hernia repair - the repair may not hold if the DRA is not addressed

Photo Credit: Braceability

Photo Credit: Braceability

- other abdominal surgery 

- pregnant and postpartum women

If any of the above apply to you, you should avoid sit up/crunch motion.  This means no more sit up, crunches, including sitting up to get out of bed.  Sit ups and crunches are not great functional exercises for your abdominals.

Can DRA heal?  

Yes! The good news in most cases, the diastasis can be closed with 3 exercises that strengthen your transverse abdominus, which approximate and heal the connective tissue.  Although the exercises are simple, their success depends on proper execution and frequency of they being done and if they are taught and supervised by an appropriate health care or exercises professional.

If you'd like more information, Katerina Shamliyan will be happy to answer any of your questions at katerina@one80health.com.

Katerina Shamliyan, BSc, MPT