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“Diastasis Recti,” a separation of abdominal muscles, has become something of a buzzword in mom circles—from the playground to online support groups. We’ve seen dozens of social posts, blogs, and ads centered around “DR”—many of them extolling DIY diagnosis methods or exercise solutions for this muscular “defect” that seems to plague postpartum women. In order to sort fact from fiction, we turned to SMH Physical Therapist Shayna Shefrin, who specializes in pelvic-floor dysfunction.
Q: What is diastasis recti (DR)?
A: A diastasis recti is a separation of the vertical abdominal muscle, otherwise known as the rectus abdominus or the “six-pack muscle.” This gap between the muscles can occur with any increase in intra-abdominal pressure, which is why women often experience it toward the end of pregnancy or after childbirth. Some studies actually show that all pregnant women will have a diastasis recti by their third trimester. The condition can self-correct after childbirth as the muscles grow back together, but when it doesn’t, a woman might experience such problematic symptoms as urinary incontinence or pelvic pain.
Q: What should I do if I suspect I have DR?
A: You can try a simple self-diagnosis process at home to get an idea of whether you have DR, but if you’re experiencing symptoms or plan to seek treatment, it’s best to see a physical therapist for a proper diagnosis.
For a quick, DIY check for a diastasis recti, try this: Lie on your back with your knees bent. Place your fingertips at your belly button, palm facing toward your body. Lift your head a few inches off the ground as you press your fingers down. If you feel a gap, and your fingers can sink deeply into your belly, you might have a diastasis recti. Repeat this procedure 1 inch above your belly button and 1 inch below it.
If you find a gap, don’t panic. New research shows that it is not so much the gap that matters, but rather the proper functioning of your deep abdominal muscles, namely the transverse abdominus. If you are able to properly stabilize using your deep abdominal muscles, closing the gap might not be necessary. However, if you’re using abdominal exercises to try to close the separation, be sure to avoid exercises like crunches, as they will only make the diastasis worse.
If you are having symptoms such as bulging in the middle of your abdomen, urinary incontinence, pelvic organ prolapse, or pelvic pain, we recommend getting an evaluation by a physical therapist to accurately diagnose and treat your specific symptoms. Research has found that a higher percentage of women with a diastasis recti will also have pelvic-floor dysfunction.
Q: Do those exercise methods like the Mutu System that are advertised online actually work to close the gap and resolve a diastasis recti?
A: It depends. Exercise methods like the Mutu System can be great. They work by stabilizing the deep abdominal muscles and using them in functional activities such as squats and lunges. The Mutu System also avoids exercises such as crunches, which can exacerbate the diastasis, or muscle separation.
If you are using the Mutu System or something similar, are getting positive results, and do NOT have any negative symptoms, then it is working for you. However, if after trying these methods, you find that you are still suffering pain or incontinence—or any other related symptom—then you likely have a muscle imbalance, and it is time to visit a physical therapist to determine the source of the dysfunction.
Physical Therapist Shayna Shefrin joined SMH’s Outpatient Rehabilitation Center in 2016, after a decade of teaching yoga and practicing massage. With a doctorate in Physical Therapy, she now specializes in treating patients who suffer from pelvic floor dysfunction.