We’ve all heard how important it is to “strengthen the core,” from assorted fitness pros, and for so many reasons beyond just looking taut. Not only does core strength promote stability and balance, but it can help protect you from lower back pain, future muscle injury, and a common condition called diastasis recti, aka diastasis or diastasis recti abdominis (DRA), which is most frequently caused by pregnancy. Here, we dive into all things diastasis recti, including how to know if you have it, the potential health risks associated with it, and how to repair it—both at home and in the doctor’s office.

What is diastasis recti?

“Diastasis recti is a separation of the six-pack muscles that run down the middle of the abdomen,” explains Dr. Ruth Celestin, a board-certified plastic surgeon based in Riverdale, Georgia. Those six-pack abdominal muscles, aka rectus abdominis, are divided by a tough band of connective tissue known as the linea alba, which connects the rectus abdominis from the breast bone down to the pubic bone. (You’ve seen it—it’s that vertical line that runs down the center of particularly toned abs.) “Normally, that connection is less than about two centimeters wide,” says Dr. Lisa J. Peters, a board-certified plastic surgeon in Oak Park, Illinois. This is known as the inter-recti distance. “In some people, it can stretch, resulting in the rectus abdominis muscles’ being positioned too widely apart,” she adds.

That stretching is caused by excessive, built-up pressure behind the abdomen, so it’s logical that DRA most typically occurs during pregnancy. In fact, it affects about 60% of pregnant women. “As the uterus enlarges, it pushes on the rectus muscles, which flatten and separate in the midline, to accommodate the increased size of the uterus,” explains Dr. Gerald Imber, a board-certified plastic surgeon in New York City. He points out that those carrying a larger baby or multiples are at greater risk for abdominal separation. However, DRA can also be caused by weight gain, especially if a person is prone to carrying their fat viscerally (around their muscles, like a hard beer belly) rather than subcutaneously (pinchable, squishy fat).

If you think you could have diastasis recti, try doing a sit-up while observing yourself in the mirror. “The abdomen tends to look round, as the muscles can flex and have tone, but the stretched-out connection between them doesn’t,” explains Dr. Peters. If you have DRA, you may see an obvious vertical bulge protruding from your abdomen during your sit-up, above the belly button, at the umbilicus, or below it. “It kind of looks like a large sausage,” says Dr. Peters, adding that if a relatively thin person has an especially round tummy while standing yet it flattens out completely once lying down, this is likely an indication of diastasis recti.

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