A Mom’s Guide to Diastasis Recti (mommy tummy) by an RN

When you’ve got an injury, people are gonna ask what happened… and I wish I had a story that didn’t involve a toilet. When I was about 6 months’ pregnant with our youngest, my kids informed me there was a clogged toilet. And since my husband was at work, I sighed and grabbed the plunger. Unfortunately for me, while I was trying to dislodge that turd, my muscles ripped instead. Hello, diastasis recti. I dropped to the floor in pain. Not one of my happier health moments, y’all. But… I’ve learned a ton about it since then.

Don’t want the entire guide to a diastasis? Skip ahead to The Best Diastasis Recti Exercises for Managing Mummy Tummy

Diastasis Recti: your mommy’s guide to mommy tummy

Okay, whew. There’s SO MUCH to know about diastasis recti, so let’s make sure you’ve got all you want to know. And in order to help you better navigate all of this information, here’s a little table of contents so you can skip ahead if you need to.

What is diastasis recti (or the ‘mummy tummy’)?

Diastasis recti (also known as the ‘mummy’ or ‘mommy tummy’) is what medical types call an abdominal muscle separation.

Let’s take a step back for a quick, simplified anatomy lesson, ‘mkay?

Your abdominal muscles go in a couple of different directions – they help support your core. Some go up and down along the front of your abdomen (rectus abdominis). Other muscles go side to side around your body (transverse abdominis). And others are horizontal (obliques).

Now, in the middle of any abdomen (think about that six pack we all wish we had) is a line that goes up and down through the belly button. That line is where the muscles connect to tissue – in other words, it’s a potential weak point. If your abdominal muscles are going to separate, this is where it will probably start.

And, when you develop an abdominal muscle separation, that’s what happens. Those central rectus abdominis muscles get separated too much.

Some separations are small and no big deal, provided you adjust your exercise techniques. In these cases, the separation may be mostly nonsymptomatic – and only physically visible when you have a nasty cough.

And what are abdominal separation symptoms?

Others, however, are a bigger deal because the separated muscle increases the risk for other complications like hernias. Hernias are when your inner layers of protective tissue develop tears – and things can poke through it.

Ever notice that you’ve got a little something that pokes out of your belly or belly button when you cough or sneeze? That could be a hernia. With an abdominal hernia, that little piece that’s poking out is often a small piece of your intestines. And if that gets caught and can’t pop itself back in? Big trouble, friend.

Or perhaps yours isn’t physically visible (or you don’t know it’s there because really, who stares at their own abdomen for long stretches of time?), but you have noticed some weird changes since becoming a mother. You may now experience the joys of sneeze-pee syndrome or cough-pee syndrome. Or trampoline-pee syndrome. Laugh-pee syndrome is yet another.

All of these are caused by too much pressure on your abdomen, which makes you pee. And in some cases, the reason for this is a mommy tummy muscle separation.

Your best bet is to prevent mommy belly abdominal separation is this…

If you don’t yet have muscle separation, I applaud you. You’re in the right place to try and prevent it from happening because it isn’t pleasant.

How do you prevent an accidental abdominal injury of this magnitude? I wish I could say that avoiding plunging toilets was all you had to do… but unfortunately, you can develop this doing everyday activities or giving birth.

So in order to prevent abdominal separation, you need to know that it’s a real, common thing that’s not talked about nearly enough. And you also need to know that the only way to maybe prevent it is to strengthen your core muscles – and to strengthen them the right way.

What’s the right way? Well, it’s engaging all the core and pelvic muscles – and not relying on a “traditional” exercise that only strengthens one or two muscles and skips all the others. It’s also doing those exercises right, using proper form and posture so you aren’t accidentally injuring yourself.

In other words, I wish my ballet teachers had explained to me WHY proper posture was important, rather than just drilling it into me. Because I’m a ginger, and gingers take to rebelling quite nicely when things aren’t properly explained.

So please – practice good posture. And now you know why.

But what about if you already have an abdominal muscle separation? What can you do for it?

Treating a separation: do you opt for surgery and/or physical therapy?

Generally speaking, there’s no “quick fix” for an abdominal separation. Oh, and it’s considered a physical deformity, so insurance doesn’t usually cover a surgical repair. Physical therapy is generally the best and only treatment.

In some cases, though, the muscles separate enough that you can develop hernias. And then you may need surgery.

That’s what happened to me. I managed to tear two holes (I had an umbilical and an epigastric hernia) in the tissue that lines my abdominal cavity. And my then-2-year-old liked to stick his little fingers into those holes and grab my innards. Y’all, let me assure you how much that hurts. And not in the usual way – it’s an unnatural pain because nobody should be grabbing that. It hurts just remembering it!

So in my case, I ended up needing surgery to fix the hernias before my kid made them worse. And because there were multiple hernias, the surgeon attached a mesh lining to my connective tissue to help prevent future problems. Then, because of the mesh lining, he threw in a few stitches between my abdominal muscles to further lessen the chance of those hernias recurring. A silver lining, right?

Recovery was brutal. As I understand it, recovery from hernia surgery alone isn’t awful. But when your muscles are involved? HOLY COW. It took a long time to recover.

And even after having some surgical assistance to repair the separation, I still have to do physical therapy for the rest of my life. Because I still have diastasis – it’s just much better than it was. Instead of being able to stick my fist between my muscles, it’s now down to 2 fingertips wide or so.

Even so, I’ve still got it. And I’ll always have it. It’s given me a whole new appreciation for good posture – and a good reason to keep up on my physical therapy. Because I don’t want that surgery again, y’all.

Exercises to avoid once diagnosed with an abdominal separation

And now that I’ve gotten a diastasis recti, I get to avoid certain exercises – for life. And I get to avoid others until I’m stronger.

Every diastasis program I’ve seen recommends that I no longer do these exercises:

  • Crunches, sit-ups, and other “traditional” core exercises (darn, right?)
  • Planks
  • Oblique Twists
  • Tennis and golf
  • Leg drops and scissor kicks

Why not those activities? Well, it’s because they use motions that separate or shear the rectus abdominis muscles further apart. And since that’s what makes a diastasis **worse**, those are the activities to avoid.

So I’m saying goodbye to abdominal-unfriendly movements where I’m:

  • Flaring my ribs or arch my back
  • Lying on the ground and need to lift my shoulders off the ground (crunches, sit-ups)
  • Bending over in half, or jack-knifing
  • Doing cross-body motions

I can’t completely avoid those activities, but I do try to minimize them. And, when I absolutely can’t avoid them, I concentrate extra hard on keeping my abdominal, pelvic floor, and back muscles positioned right and fully engaged. That way, I can minimize (or avoid!) any problems.

That being said, will I really be avoiding planks or tennis or golf for the rest of my life? Probably not. My kids love playing mini golf – and so do I. And planks are one of the traditional core exercises I dislike least.

But while I’m in the initial stages of my physical therapy, I’m going to follow the recommendations. Because right now it’s harder for me to do some exercises. That’s mainly because I was out of shape after a long pregnancy from being unable to do much, then giving birth, and then still being unable to do much due to my diastasis recti.

As I exercise and get stronger, I’ll be able to do more, modify fewer movements, and complete a full workout as it’s designed. And, I’ll be keeping my muscles engaged properly without as much concentration, so I’ll still be exercising safely – even as I add in the occasional plank or round of mini-golf.

The best exercises for diastasis recti

There are so many fantastic exercises! In fact, I started adding so many that I had to move them to a whole other blog post to make things easier to read.

Check it out here: The Best Diastasis Recti Exercises for Managing Mummy Tummy

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Kimberly C. Starr

I'm a ginger who loves reading, eating, being a nurse, spending time with my family, and writing about it all. I believe humor is the best medicine, followed very closely by chocolate and tacos. To read more about me, click here.

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