Diastasis in Men and Women

Diastasis is the separation of your rectus abdominis due to stretching of the connective tissue, the linea alba, which seams the two halves together. Diastasis can occur in men, women and babies. It is most commonly associated with postpartum women. It can also be caused by obesity, history of vigorously straining the muscles, pregnancy or pressure on the connective tissue. In diastasis, the linea alba stretches out and ends up supporting the weight of your organs and contents of your torso rather than your abdominal muscles. 

What does it look like?

Diastasis is a ridge that may appear anywhere along the midline from sternum to pubic bone. It may pop up when the abdominals are engage -- especially in flexion -- and disappear when the abdominals are relaxed. 

Diastasis is present on the left and not on the right. 

Diastasis is present on the left and not on the right. 

We asked Physical Therapist Nadia Chopra, PT, DPT, COMT, OCS, for some more answers on diastasis. 

What should you do if you think you have a diastasis?

If you think you have a diastasis, the best thing to do is to go to your health care provider so they can confirm that you do or do not have one and send you to the appropriate person to address the issue.

How do you test for diastasis and what kind of information comes from the test?  

I have the client laying down on their back with their knees bent. The client is then instructed to lift head and shoulders off the table with arms extended, reaching towards their knees until the superior aspect of the scapula comes off the table. Then I measure with a measuring tape the width of the diastasis. This measurement is taken at 3 levels: at the belly button, 4.5cm above and 4.5cm below. The test is positive if the client has greater than 4.5cm separation, indicating  that a diastasis rectus abdominis is present . This test is great because we can use it to measure progress as the diastasis closes. I also use it to teach my clients how to feel the diastasis, and then they always feel the diastasis while performing their exercises to make sure it is closing as they are doing the exercise.

What are long term complications of diastasis?

Long term complications can range from low back pain, pelvic girdle pain, Sacroiliac (SI) Joint dysfunction, or even pubic symphasis dysfunction.

Why does pulling the abdominals in help correct diastasis?

Contracting SPECIFICALLY the transverse abdominals literally draws together the muscles. When the transverse abdominals contract, they tighten the thoracolumbar fascia (connective tissue going from the abdomen to the back of pelvis), which provides stability to the SI Joint, pelvis, and lumbar spine. It is necessary for every joint to have the appropriate amount of compression (not too much, and not too little) to stabilize the lumbo-pelvic girdle.

How long does it take to heal?

Honestly, it depends with each person. It varies based on the degree of the separation, how long they have had a separation, if they have other or multiple injuries/problems in the lumbo-pelvic girdle, and how compliant they are with the home exercise program.

What is the splint or belly band? 

Think of an abdominal splint as a corset. It literally helps to provide external stability via compression to your lumbo-pelvic girdle. Should one be worn all the time if you have a diastasis? No. Your health care provider can help you to determine what binder is right for you, how to wear it, and when to wear based on your individual symptoms.  

We asked Nadia what else comes to mind that is important to know, that we haven't asked?  She replied with the following common questions. 

Why can't I just do crunches to help this problem?  

If you work the wrong the muscles, specifically the rectus abdominals, that can actually make your diastasis worse. That is why it is crucial to get an educated health care professional (PT, Pilates instructor,etc) to help develop a home exercise program for you and make sure you are doing the exercises properly.

If I have had a diastasis for 10 years, can it be fixed?  

YES!!!

Are all diastasis able to be fixed with exercise?

Unfortunately the answer to this one is no. Generally a doctor will recommend PT, but sometimes, this can not fix the problem 100% and the person will have to have surgery to correct the separation.