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What is diastasis recti?

For women who don't see their stomach flatten out by eight weeks postpartum, they can face a magnitude of health issues.
/ Source: TODAY

Sarah Tar knew something was wrong when, at four weeks postpartum, she fell back into her usual workout routine and was shedding the pregnancy weight everywhere — except her stomach.

No matter how much she worked on her core muscles, her stomach wouldn't flatten.

"I was having a really tough time performing lifts and performing the movements that I was used to be able to do while I was pregnant," she said.

Along with the difficulty of falling back into her old workout routine, Tar experienced pelvic and back pain — something the mother of three had never gone through before.

What is Diastasis Recti?
Diastasis recti can be corrected with physical therapy and breathing exercises.TODAY

"I was active each pregnancy, working out before, during and after each child," Tar said.

While her doctor told her to take it easy and just "listen to her body," Tar wasn't convinced. So she went online and diagnosed herself with diastasis recti — the separation of the abdominal muscles.

And while it's normal for muscles to separate during pregnancy, most women's muscles return to normal by eight weeks postpartum.

"So there was a wide, gaping hole where it still looked like I was significantly pregnant several months after giving birth," she said.

What is diastasis recti?

Although diastasis recti is normal for pregnant women, according to Marianne Ryan, a New York-based physical therapist, for some women, the muscles don't shrink back down on their own.

"Hormones during pregnancy cause your muscles to loosen up to pass the baby and accommodate stretching skin and bone separation," Ryan said. "Your six-pack muscles essentially separate in two halves."

And for those who don't see their stomach flatten out by eight weeks postpartum, they can face a magnitude of health issues.

"It can be pretty painful," said Ryan. "Women can experience pelvic pain, pelvic organ prolapse and painful sex."

And although OB GYNs are beginning to educate women on the issue, many (like Tar) are still in the dark about the risks of leaving the condition untreated.

Diagnosis and treatment

According to Ryan, diastasis recti is relatively simple to diagnose.

Ryan recommends women lay on a flat surface and with their fingers parallel to their body, have them lift their head and feel for two things: separation of the six-pack muscles and tension in the connective tissue.

"If more than two fingers can fit in between the stomach muscles, it needs proper rehab," Ryan said.

"When a woman is pregnant, the top part of the body bends backwards to make room for the baby," Ryan said. "Rehab is where they learn to essentially re-stack their rib cage over the pelvis."

And that rehab is largely made up of breathing exercises and working on proper posture. The breathing exercises continue to stretch out the core muscles.

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One important thing to note is that it's never too late to address distastis recti. Dr. Taraneh Shirazian, a gynecologist at NYU Langone Health in New York City, explained that physical therapy is the easiest and best way to fix the problem. Though if it doesn't improve, and you are done having children, you could consider surgery.

Although the condition is now being widely talked about, it wasn't always that way. Many OB GYNs credit the symptoms that come along with diastasis recti to pregnancy itself, without checking their patient's progress.

But Dr. Christine Greves, a Florida-based OB GYN, said it's hard to tell whether or not diastasis recti is present in pregnancy patients at the six-week checkup.

"Your body is still healing and repairing," she said. "What usually happens is people notice it later on, and that's when we're able to diagnose it."

"Sometimes it gets better on its own, which is a gift," she added.

But even for women who didn't experience problems with the condition directly after pregnancy, Ryan warns that jumping back into workouts too quickly can exacerbate the problem.

"If you go back to vigorous exercise, you can really make diastasis recti a problem," Ryan said. "The system isn't always strong enough after birth, and added pressure to the core muscles can cause the symptoms to get even worse."

Tar hopes more women will realize that this is an issue, and talk to their doctors about it.

"You should never have to go through life having issues like pelvic pain, incontinence (or) having this issue that takes away from the fitness that you enjoy or doing things that you love," Tar said. "There is help out there — and you just have to ask those questions."