Diastasis Rectus Abdominus

Diastasis rectus abdominus (DRA) is a common concern that is getting much more media attention lately, as many people struggle with it. DRA is also referred to as ‘ab separation’. It commonly occurs in pregnant and postpartum people but can be present in males, children and babies as well. For this blog, we will discuss DRA as it pertains to the pregnant individual. So firstly, what is DRA? 

Diastasis rectus abdominus is the stretching or thinning of the connective tissue that runs between the abdominal muscles. For most people it is easiest to think about your ‘six pack’ muscles (also known as the rectus abdominus muscles). Your left and right six pack muscles come together via a thick and fibrous tissue down the midline of the abdomen. This tissue is called the linea alba. You can see this represented by the dark grey line that runs down the middle through the belly button and down to the pelvis in the image below.

During pregnancy, the abdomen will stretch and distend over time, thus also stretching the linea alba. When this tissue is stretched it becomes thin and malleable. As a result, any increase in pressure through the abdominal wall can cause this tissue to move, shift, dome or bulge. A good way to think about this is to imagine a water balloon and if you pressurize one side of the balloon, it will bulge or protrude further over the other side of the balloon to compensate for the pressure increase. DRA’s can behave in a similar manner.

Should someone increase pressure through the abdomen, for instance by coughing of bearing down or lifting a heavy weight, the pressure will go to the area of least resistance which in many cases is through the linea alba. As a result, you may see a doming or tenting of the skin in this area or it may also create a gully or invagination into the abdomen.

Below you can see an example of DRA. You may notice that stretch can occur anywhere along the whole linea alba but it most commonly presents around the umbilicus (belly button).

Research shows that into the third trimester of pregnancy, up to 100% of pregnant people will have a DRA. This is normal! If it is present we want to monitor it and, should it persist over time or should you feel that you are not having success with rebuilding your core after baby (or no matter how hard you try it just feels like you continue to be weak and vulnerable over the abdomen), then seek help so you can better understand what you can do to improve it. Good luck!

You may also find this video helpful: What is DRA?

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