Abdominal separation (diastasis recti) occurs when the right and left abdominal muscles separate, and diastasis most commonly occurs during and after pregnancy. Altered appearance of the stomach after childbirth is a common occurrence, and the abdominal muscles usually return to their original position spontaneously after a few weeks postpartum.

However, a problem arises when the gap remains present even months after childbirth. At that point, it may be suspected that the change will be permanent if proper treatment is not applied in a timely manner.

It is recommended to consult a physiotherapist who will guide you and show you exercises for abdominal separation that will help promote recovery and repair the stomach after childbirth.

What is Abdominal Separation?

Postpartum diastasis (abdominal separation) occurs due to fetal growth, which puts pressure on the abdominal muscles and causes them to separate. This involves the separation of the stomach muscles (rectus abdominis muscles) located on the front side of the abdomen.

In addition to being an aesthetic problem, diastasis can cause discomfort and pain in the abdominal muscles, as well as a range of other symptoms. Diastasis should be therapeutically treated not only for aesthetics but also because the stomach, as the central part of the human body, plays a key role in supporting posture, breathing, and mobility.

Below, find out when to consult a physiatrist for diastasis, if there is prevention and effective therapy, as well as all the other details you need to know.

Causes of Abdominal Separation After Childbirth

As mentioned earlier, pregnancy is one of the most common causes of abdominal muscle diastasis. In addition to pregnancy, hormonal changes and uterine pressure contribute to the formation of diastasis.

In addition to pregnancy, improper exercise that stresses the abdominal muscles can cause abdominal separation, especially if intensive exercises are performed without adequate support.

Genetic predisposition to abdominal separation is a risk factor for the development of this health condition. If the mother had diastasis after childbirth, there is a greater likelihood that her daughter will experience the same problem.

In addition, diastasis is more common in women who have previously given birth, as well as in postpartum women over 35 years old. However, diastasis most commonly occurs in multiple pregnancies or in cases where the fetus is large.

In addition, a risk factor is if pregnancy occurs shortly after the previous one, and diastasis can also occur after a cesarean section.

When to Seek Help

Statistically, abdominal muscle diastasis is quite common, occurring in as many as two-thirds of postpartum women.

If your stomach continues to look pregnant for an extended period after childbirth, it is necessary to consider the possibility of diastasis, i.e., separation of the stomach muscles.

If you are unsure whether you have diastasis or are still in the recovery process, you can perform a self-examination that will indicate the presence of diastasis.

How to Identify Abdominal Separation Yourself?

Lie on your back with your knees bent, place your fingers on your navel, with your thumb pointing towards you, and turn your fingers as if you are trying to pierce your navel. At the same time, lift your head, making sure your shoulders remain in the same position. If you notice that your fingers sink into the soft space during this procedure, it indicates separated muscles.

Measure the space between the separated muscles; if the gap is less than 2 cm, you most likely do not have diastasis.

However, if the width is greater than 2 cm (the width of 2 fingers), there is a high probability of diastasis. This is abdominal muscle diastasis that should definitely be treated.

Can Abdominal Separation During Pregnancy and After Birth Resolve Spontaneously?

Abdominal separation, or the separation of the central part of the abdominal muscles, can resolve spontaneously in some cases, especially if proper exercises are applied under the guidance of a physiotherapist. Spontaneous resolution often occurs if there has been slight separation of the abdominal muscles.

Therefore, spontaneous resolution is directly conditioned by the degree of muscle separation, genetics, age, lifestyle, and proper application of exercises for abdominal muscle diastasis.

Many women who had diastasis during pregnancy have experienced spontaneous muscle retraction within the first few months postpartum, especially if they followed prescribed exercises to strengthen the abdominal muscles.

However, in a certain number of women, diastasis remains present and becomes a chronic condition. Diastasis in some cases can be reversible if the person does not adhere to recommended preventive measures.

If you suspect diastasis, it is important to seek professional help as soon as possible, from a physiotherapist or physiatrist, to receive individually tailored guidance and exercises that can help you.

Symptoms and Complaints of Diastasis

Although most women consult a doctor for aesthetic reasons, it is important to note that diastasis can lead to a range of other complaints.

When abdominal wall diastasis occurs, internal organs, the uterus, intestines, and other organs in the abdominal cavity lose the necessary support that would keep them in place. They begin to exert pressure forward, creating a bulge.

While diastasis often does not cause any symptoms, the fact is that a certain number of women experience various, very unpleasant symptoms. Be sure to seek medical help if you experience the following symptoms:

  • Lower back pain
  • Lower abdominal pain
  • Difficulty emptying the bladder
  • Difficulty breathing
  • Pain in the abdominal muscles when moving
  • Bloating
  • Pain during intercourse
  • Appearance of herniation or hernia

Is Surgery for Abdominal Muscle Separation the Only Option?

Focused exercises that strengthen the abdominal muscles help reduce abdominal separation, but it is extremely important that they are prescribed by a physiotherapist, who will provide you with a customized exercise plan for diastasis.

In certain cases, an abdominal binder, also called a diastasis belt, is recommended, which helps reduce pressure on the abdominal muscles and facilitates their healing. In severe cases of abdominal separation, when the postpartum stomach binder does not help, the only solution is surgical intervention, which allows the separated muscles to be repaired through surgery.

If abdominal muscle diastasis occurred after the first pregnancy, it is recommended that if you plan a second pregnancy, you first repair the diastasis because otherwise, the risk of developing a more severe form of this condition would increase.

Diastasis in Men

Although diastasis most commonly occurs in women during pregnancy, diastasis of the abdominal muscles in men is also possible, as well as in women who have not previously given birth.

The cause of diastasis in men is usually extremely intense and improper exercise, especially if the focus was on exercises that put pressure on the central part of the abdomen and abdominal muscles.

In addition to exercise, diastasis can occur in men who have had a significant loss of body weight.

Preventing Diastasis

Exercises targeting the abdominal muscles postpartum are not a guarantee that diastasis recti won't occur after pregnancy. In some women, the abdominal muscles were not properly positioned or were slightly separated even before pregnancy.

However, adhering to expert advice on proper posture to reduce pressure on the abdominal muscles can serve as a good preventive measure. Wearing supportive belts during pregnancy, which provide additional support to the abdominal area and promote proper posture, is also recommended as an effective way to prevent diastasis recti.




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