Why Do I Look Pregnant When I’m Not? A Primer on Diastasis Recti

Why do I look like I am four months pregnant when I gave birth over a year ago?

Why does it look like a football is coming out of my belly when I do crunches?

Is it diastasis recti? And what is that, anyway?

I wish I had known all about posture, alignment, and diastasis recti well before my kids were born — they’re now 13 and 16 years old. Despite all my fitness training, I didn’t know about their importance and impact until I was eight months pregnant with my second — and jackknifing off the OB exam table.

What was that bulge above and beyond my pregnant belly? It looked like a scene from “Alien”! “It’s a normal part of pregnancy and will go back to normal post-delivery,” my OB said. OK, file that away for “must research.”

My healthy baby boy was born, and I went back to teaching and running. Then my symptoms started. Every time I ran, I could barely walk the next day due to hip pain. Leaking had started with impact. I ran a road race at three weeks postpartum and peed my pants all the way to the finish line.

Something was not right. My fact-finding brain decided to research all I could. I self-diagnosed and figured it was diastasis recti. I had not been aware of my muscle imbalances or the impact of pushing my fitness so soon after childbirth. My posture and alignment were off. I was breathing incorrectly and holding my breath upon exertion. Little did I know then that all of this had an impact on my diastasis.

Everyone is different. Symptoms are different and diastasis recti does not occur with all pregnancies. Sometimes a diastasis is not always the cause of symptoms but the result of something else going on in the body.

So what is it? Diastasis = Separation.

With diastasis recti, the connective tissue in the midline is stretched thin, allowing the outer abdominal muscles, the recti or “six pack” muscles, to separate. This separation and weak connective tissue fail to protect the organs or support the back. If the separation is large enough, the organs will protrude, creating that bulge in the belly. One is more prone to hernias with a diastasis! I developed an umbilical hernia after my second pregnancy.

A diastasis can be caused by the continuous forward forceful pressure on the weak part (belly button) of the connective tissue of the rectus abdominis. This intra-abdominal pressure can be from a growing uterus, improper lifting, or improper breathing — especially upon exertion. It can also be due to over-toned muscles, such as oblique dominance. I was notorious for holding my breath during exertion and stress! A diastasis can occur only above the belly button, or just below the belly button, or all the way from your sternum to your pubic bone, like mine was.

How is it diagnosed and measured?

I self-diagnosed, and since diastasis recti is measured by finger width, I thought mine was only two fingers, which is the minimum for diastasis recti. Not bad — I’m fine, I thought. But I went to an RN/personal trainer/diastasis recti specialist, and she assessed me at four fingers at my belly button. It also ran all the way up to my sternum and down to my pubic bone. I was not diagnosing myself correctly.

If you want to attempt a self-check before being seen by a professional, take a look at this helpful video by Dr. Sarah Duvall.

How can someone heal from diastasis recti?

If you find you have a diastasis, contact your OB/PT — especially if you have symptoms. Meanwhile, back off to easier levels of any exercise that is giving you symptoms. Try to recognize what movement makes your symptoms worse, and decrease the stress and the load on the body. Keep a list. Educate yourself. Seek help. 

I used my body as a case study. After meeting with many experts, learning, studying, and getting more specialized certifications, I healed my own diastasis recti with exercise. Healing with exercise is not the case for all, and sometimes, depending upon the severity of the diastasis, surgery can be required. However, surgery won’t fix incorrect movement patterns.

In seeking healing, be mindful of your daily movements, whether you’re exercising or not. Anything that causes exertion can be a trigger — like lifting, twisting, sitting, standing, having a bowel movement, sneezing, coughing, or blowing your nose.

Learn effective strengthening exercises that will help bring the separated muscles closer together and help heal the connective tissue.  And address movement patterns and muscle imbalances. Look at ALL of your movement patterns, how you breathe, how you breathe with your movements, how you stand, and how you sit.

In addition, it is like any other injury — you will always have a weakness if you are not mindful of your breath, form, and movement — especially when you are tired (no sleep with little ones, work, life, etc.) and not as apt to be mindful of these things.

Closing a diastasis does NOT guarantee it will stay closed. (It is ongoing, like dirty laundry!) But working to heal from diastasis recti is life-changing behavior!

Kim Raubenheimer grew up in Franklin, Massachusetts and lives in Belmont with her husband and two busy teen boys. Kim has been passionate about Health & Wellness since she was in her early 20's. Now in her mid-50's, Kim has an abundance of knowledge from her personal journey and numerous certifications which she’s eager to share (especially with Moms!).  Kim started Your Health Sense in 2001, a Nutrition and Fitness Coaching business, while working full-time as a Print Producer and raising two boys.  Kim understands the challenges of maintaining self-care and now juggles her Nutrition and Fitness business while being a Mom and working part-time for her husband's Managed Services IT company as the Hiring and Compliance manager.