Why is my Diastasis Recti Getting Worse?

The majority of moms will see an improvement in their diastasis naturally within 6 months postpartum, but for others, there could be a worsening, even with core strengthening. Find out why and what to do about it.

Stephanie Stamas, PT, DPT, ATC, PRPC
Stephanie Stamas, PT, DPT, ATC, PRPC
Mom of a 2yo and 4yo. Doctor of Physical Therapy. Pelvic Floor Expert.
Last updated
January 26, 2023

If you’ve noticed a gap down the middle of your abs, known as Diastasis Recti or Mummy Tummy, and it’s getting worse with time, you’re not alone. The good news is that even if it’s worsening or it’s been years since you’ve given birth, you can still fix it. If things seem to be going in the wrong direction, here are 5 reasons you may have not considered:

Posture

Posture changes during pregnancy to accommodate the growing baby. This typically looks like a tilted back rib cage and rolled forward pelvis. After birth, it’s common for this posture to become even more exaggerated. 

This sustained position is problematic for several reasons. A tilted back rib cage leads to a tight lower back and jutted-out stomach, potentially exaggerating a diastasis recti. It also pushes forward the internal pressure that’s inside the trunk through the gap. This position also makes it difficult to engage the ab muscles, which are needed to counteract the pressure pushing out. Overall, the common “pregnancy posture” which turns into “mommy posture” is no good for a Diastasis Recti and could worsen the gap if not addressed. 

 

Breathing Patterns

Another common change during pregnancy is how one breathes. Especially in the late third trimester, there is less room for normal breathing. This may sound like a benign issue, but the main muscle of breathing - the diaphragm - is a major part of the deep core system. The deep core is a group of muscles that work together to provide circumferential stability around the trunk, similar to a corset. These muscles need to work together to counteract the pressure pushing outwards. If one muscle is weak, the whole system is affected and pressure management is altered. 

 

Breathwork, which are exercises that retrain the diaphragm and help to reconnect the deep core system, is essential for diastasis healing. If you’ve been working on strengthening your abs without first starting with breathwork, you’re building strength on an unhealthy foundation. This is a major reason why you might be seeing a worsening of your gap.

 

Muscle Tightness

Remember how mommy posture can cause lower back tightness? Well, that’s not good news for your diastasis recti. When the ribcage is tilted back and the pelvis is rolled forward, the muscles and connective tissue in the low back tighten, specifically the erector spinae, quadratus lumborum, and thoracolumbar fascia.  When the thoracolumbar fascia is tight, it pulls on the fascia in the front of the stomach. You can think of a shirt as an example. If you grab the fabric in the lower back of the shirt, you can see how it creates lines of tension all the way around to the front. This line of tension from the tight fascia can further pull at a Diastasis recti and make it worse if the tightness is not addressed. Thankfully muscles and fascia can be loosened. Check out this video on how to loosen up lower back tightness. 

Progressing Too Fast

During pregnancy, your abs don’t just stretch, they grow.  The muscles add more fibers—called sarcomeres—that allow the muscle to lengthen around the baby. After delivering the baby, your abs remain long which is why it’s common to feel like a popped balloon. 

The deepest core muscle, the transverse abdominis (TA), is your body’s natural corset. As it heals it should start drawing everything back in. Unfortunately, this doesn’t always happen. Imaging shows that even at four months postpartum, the TA muscle is thinner and weaker. 

Without an intentional focus on slowly re-engaging the deep core (which also includes the diaphragm and pelvic floor), larger muscles will compensate for the weaker deep muscles. The problem is that it’s the deep muscles that are responsible for re-creating the corset and closing the gap, not the larger, more superficial muscles. 

Diastasis Recti healing requires a sequential and gradual progression. A strong foundation of breathwork, pelvic floor strengthening, and TA activation needs to be laid first. If you’ve progressed too quickly without that strong foundation, you may see your gap getting worse instead of better. If you’re looking for an expert-led step-by-step program to fix your diastasis recti, sign-up for our Heal Diastasis Recti course and to start streaming today.

 

Constipation

You may not have considered your toilet habits to be a significant factor in your Diastasis Recti, but constipation and bloating play a major role. When you’re constipated, that causes distention in the belly and a relaxing of the corset muscles. This helps to decrease pain and discomfort but is not great for a Diastasis Recti. Constipation also typically goes hand-in-hand with straining on the toilet, which also causes a lot of excessive pressure through the gap and in the pelvic floor, negatively affecting the deep core system. If you’re constipated, consider adjusting your positioning on the toilet and try out a colon massage to help improve bowel function.

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