Belly muscle separation (diastasis recti)

Overview

As the belly stretches, the connective tissue between the right and left belly muscles thins and widens.

You may see a ridge or bulge down the middle of the belly, especially when you sit up. It's different from a hernia, though both can happen.

Symptoms

Common signs:

• A bulge in the belly, down the middle
• A soft gap you can feel above or below the belly button
• Bulge in the groin or belly

Less common

• Low back pain
• Belly that sticks out months after birth
• Leaking urine

When to get medical care

Causes

Pressure from pregnancy stretches the tissue between the belly muscles. Weight gain and heavy lifting can also play a role.

Does it spread or run in families?

• It isn't contagious. You can't catch it from someone else.

Who is more likely to get it

• More than one pregnancy
• Twins or a large baby
• Being over 35 during pregnancy

Possible complications

• Hernia: Can happen alongside it

Diagnosis

A healthcare professional checks with a simple exam.

Questions you may be asked

• Pregnancies and births
• Back pain or bladder leaks

The exam

Lying on your back, you lift your head while they feel the gap above and below the belly button.

Tests

Tests, if needed:

• Ultrasound: Measures the gap if needed.

Treatment

Most gaps shrink in the months after birth. A physical therapist can teach safe exercises.

Self-care

• Try gentle core work: deep belly breathing and pelvic tilts
• Avoid crunches and heavy lifting early on: they can make the bulge worse
• Roll to your side to get up instead of sitting straight up

Surgery to close the gap is an option for a large gap that doesn't improve, or with a hernia.

Prevention

To help prevent it:

• Keep core muscles strong before pregnancy
• Lift with good form

Which doctor treats this

• Start with your primary care provider (family doctor or internist).
• They may send you to a physical therapist.

Children, pregnancy, and older adults

• Newborns: Babies can have a small gap that closes on its own.

Pregnancy and breastfeeding

• If you're pregnant or planning to be, tell your prenatal provider about this condition.
• Don't start or stop any medicine on your own. Some are safe in pregnancy and some need to be changed.
• Ask before taking any pain reliever. The FDA advises avoiding ibuprofen and naproxen after 20 weeks unless your doctor says to.
• Breastfeeding: Most medicines are fine, but ask. The NIH LactMed database lists what's known about each one.

Outlook

Most people improve with time and exercise.

Getting ready for your visit

Bring a list of your symptoms and medicines.

Questions to ask

• Should I see a pelvic floor physical therapist?
• Which exercises are safe now?

Research studies

Research studies test new ways to find and treat health problems. Some are looking for volunteers. Talk with your doctor before joining one.

Search ClinicalTrials.gov for studies on Belly muscle separation (diastasis recti)