Diastasis Rectified

My journey to heal postpartum diastasis recti

Looking to the research to answer my burning questions about diastasis recti

21 Comments

Ladies, I’ve been quiet over here because I’ve been doing some serious homework!

I love the work that women like Wendy Powell and Katy Bowman are doing to bring information to the masses. I read and study and practice it every day. Sometimes, though, I have questions that I need to find the answers to myself. That’s what this post is: information from primary research I found pertaining to my burning questions about diastasis recti and postpartum health.

I am very much not a doctor and this is not medical advice. I am just another mom in the middle of this mess trying to figure things out. I’ve included links to the studies so you can make your own decisions and hopefully find encouragement like I did!


Is my body ever going to go back to the way it was before baby?

In a word: no. In three words and a contraction: no but there’s hope!

Women who’d had babies were compared to women who’d never had babies in a study in 2008. Their abs were measured for stiffness, thickness, and for diastasis recti at 0, 1, 2 and 12 months postpartum. The women who’d grown humans inside their bodies showed improvement over the 12 month period (and markedly by the two month mark) but they never regained the characteristics of the non-baby-having control group.

My “artistic” rendition of an ultrasound from the study. It depicts what the rectus abdominis and linea alba looked like between the two groups. Muffin top vs. pancake.

My “artistic” rendition of an ultrasound from the study. It depicts what the rectus abdominis and linea alba looked like between the two groups. Muffin top vs. pancake.

Baby mamas had thinner muscles, more distance between the halves, and more lax abdominal walls. My abs are more or less flapping in the wind so this does not necessarily come as a surprise. I hold out some hope that they study stopped measuring at 12 months and maybe further improvement happens over more time.

In similar studies with stretched/thinned out muscles, the muscles’ power was significantly decreased permanently. So, it’s definitely possible that we’ll never get back the full strength of the rectus abdominis (which does NOT mean we won’t ever have a strong core). I mean, look at all these other muscles working to keep things in place:

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You can see here why the transverse and obliques are called the “waist-making” muscles.

The authors of the study said that “exercises that target the return of a normal IRD (inter-recti distance), rectus abdominis width, thickness and length without loading and compressing the lumbar spine are required.” I’m pretty sure that sums up Mutu System and Restorative Exercise!

* I should note I’m not affiliated in any way with either of those companies, but I love what they do and I haven’t found anything more trustworthy and research based.


Is exercise really effective in reversing a diastasis recti or should I just do my best with it now but eventually get surgery?

If you’re up for more good news, women who did begin training (“training” in this study meant isometrically engaging the transverse abdominis, strength training, and cardio with a personal trainer) to correct a diastasis recti postpartum achieved the same reduction in diastasis as those who trained to prevent diastasis recti during pregnancy.

So, if the damage is already done – it’s not too late! And if the diastasis recti I have is present during pregnancy, I can still start doing work to prevent it worsening and then continue the regimen after birth.

Surgery to correct diastasis recti, on the other hand, had many associated complications according to a comprehensive literature review (hematomas, wound infection, dying skin, scarring) and about a 40% recurrence of the diastasis. Laparoscopic surgery had less complications than open abdominoplasty, though (aka little holes vs. the big cut).

I found out that different surgeons have different techniques (really tight folding of the connective tissue, looser folding, venetian blind folding, origami crane folding…just kidding, I made that last one up). Some techniques, like the really tight folding, are suspected to be more vulnerable to recurrence.

This same article also said that surgery to repair a diastasis recti should be considered cosmetic only, not functional like a hernia surgery. Surgery won’t restore muscle tone – that’s up to you and me to do.


Oookay, but this is more than “unsightly.” I have a bulging, lumpy, temperamental abdomen and it is a big deal, dangit!

Try this on for size: the severity of the diastasis recti is not the problem!

Laxity in the abdominal wall is the problem, and that laxity is indicated by the extent that innards poke through the abdomen. The force with which innards are pressing themselves into that lax abdominal wall has everything to do with alignment.

The biggest separation was usually around the belly button but that was not necessarily where the abdominal wall was most lax. Meaning, those pesky protrusions of innards did not necessarily happen where the biggest split was. I know this is true in my own body.

Straight from the horses’ mouths, “significant abdominal wall protrusions may occur without diastasis and flat abdomens may exhibit a diastasis. …the decision to perform diastasis repair should be influenced primarily by the evaluation of the protrusion rather than the diastasis.”

It's not just the linea alba's stretching that matters, but how lax the abdominal wall is and how much it lets poke through.

It’s not just the linea alba’s stretching that matters, but how lax the abdominal wall is and how much it lets poke through.

  • Significant abdominal wall protrusions may occur without a diastasis recti
  • Patients with a diastasis recti can have a flat tummy (Wendy told us this a long time ago!)
  • The linea alba has a maximum stretch of 1-2 inches, regardless of how big the abdomen has swollen to (I’m looking at you, fetus!)
  • Abdominal wall protrusions are caused by the stretching of the entire abdominal wall.

There are still more questions I have left unanswered. I would love to know about the nature of connective tissue and whether there is truth to the rumor that it’s more “shrinkable” in the first six months post partum. Does any one have information about this?

We’ll save the 18 pages I read about abdominal bloating for next time, so get your party hats on!

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Author: diastasisrectified

I am charting my progress as I recover from a diastasis recti and get back to an active lifestyle.

21 thoughts on “Looking to the research to answer my burning questions about diastasis recti

  1. Loved this post and how informative it is. I am interested in the answer to that question too and unfortunately I don’t have any info to help. can’t wait to learn more from you.

  2. I love your research and the questions you tackled. And your artistic rendition! Thanks for this.

  3. Fantastic info! I really didn’t realize that the entire abdominal wall was to blame, but that totally makes sense. Really looking forward to the bloating article. I’ve been MuTu’ing for about 12 weeks now and definitely have a stronger core… and had a nearly flat stomach for about a week and a half, then went back to the gym for a class and came back out with a pooch again. I hope you’ll perhaps touch on internal pressure too because I’m guessing that’s what’s ailing me at the moment. I’m thinking some alignment snacks and/or Restorative Exercises might be good for me next as well…

  4. Hmm WordPress seems to have lost my previous comment…. thank you for sharing all of your research! I’m trying my best to learn everything I can but with a job, a 2 year old and a 5 month old I’m a little over-whelmed. In the meantime I’ve been doing MuTu core every day for 12 weeks and have definitely seen a huge improvement in my core strength. I even had a flat stomach for about a week and half… but then came back from vacation, went to the gym, and my pooch above my belly button came back (hello stress? internal pressure? who knows). I’m reading Alignment Matters and will probably try some alignment snacks next. Really looking forward to your bloating post!

    • Hey Bethany! WOW – for you to be so busy (and sleep deprived!) and stick to Mutu every day for 12 weeks says volumes about your awesomeness. Way to go! You are an inspiration. I think you are touching on something that has been very frustrating for me – our healing progress is fluid. One wrong move can be very damaging, which leads me at least to be fearful of almost anything in the traditional exercise realm (which stinks, because I really enjoy exercise even if now I know a lot of it is “movement dessert”). I am on a “big belly” swing at the moment and I think it’s due to my installing a pull up bar to hang from and then getting a terrible idea to start doing pull ups. I later read on Wendy’s blog that’s a big no-no. Ugh. Anyway, I hear you! I think once our routines are more alignment-friendly and the more holistic problems are addressed, these pendulum swings will be less severe, too (barring something like crunches). Please let me know how things go with your journey!

  5. Great research! Don’t like the 40% reoccurrence stat after surgical correction. Interested to learn of your findings on abdominal bloating (a bookmarked google search for me).

    • Hey Jamie! I know, I am not a fan of that stat either. The good news is that (to my knowledge) they haven’t evaluated reoccurrence in exclusively laparoscopic surgeries and that article seemed to have hope that the reoccurrence may be less. Hope you are doing well. 🙂 I will work on that bloating post!

  6. Awesome! I am accepting the idea that my body will forever be different and it is actually helpful to me to see that research supports that. Good to have realistic expectations…

    • Thanks, Tanya! I hate to admit this but I really thought I was going to be totally back to the exact same body after about two weeks. How tragically hilarious is that? I agree with you that there is a certain freedom in realizing that some things are changed for good, even if there are many many other things that can be improved!

  7. Love this post…it was very informative. I do have one question that I am hoping maybe you know the answer to…Once an abdominal muscle has been stretched or thinned can it shrink back to some degree or is the muscle permanently damaged?

    • Thanks, Moca! Based on the research I read, the muscle can absolutely shrink back (at least during the postpartum period that they measured, which was 12 months). It’s just that it didn’t shrink back all the way to the control group levels. What I wish I knew was if connective tissue also can do that – I haven’t yet found a definitive answer. I hope that helps!

  8. Just found your blog and I’m so excited to go back and read through it. I think I got DR with my first baby but it didn’t become really evident until after I had my second… my worst symptom (other than looking poochy!) is back pain…I am confident I can train my muscles back into some kind of decent shape even if my stomach is never flat again (after 2 c-sections, I really don’t want another surgery) but did you research show anything about back pain? I assume it’s back muscles compensating for weak front core muscles?

    • Hi Sarah! I’m sorry your comment somehow slipped by me. I hope your back is feeling better! What I’ve learned so far is that back pain is complex but it is probably a more holistic problem that the lack of core musculature then exacerbates. Like, maybe you (like most of us) sit with your pelvic tucked under and have really tight hamstrings and calves. That can create a strong downward pull that puts strain on your lower back. Or you may possible kind of “wear” your ribs out in front of you (what’s called “rib shear”) – I do this a LOT – and that can crunch up your lumbar spine. There are other factors, too, and obviously I’m not an expert but I know for sure that if you seek overall alignment that you will see at least some benefit. Definitely check out restorativeexercise.com for the “alignment snacks” if you’re looking for a place to start. Thanks for stopping by!

  9. hi! i found my way here from looking into tuppler technique, then a youtube video that mentioned mutu, then a comment you left on a blog. anyway…i’m SO happy i found your blog. i enjoy reading through your posts and seeing your progress using mutu. i have a few questions for you regarding mutu and restorative exercises…. do you find mutu and RE are similar or would you recommend doing mutu first and then RE? i have checked out some of RE youtube videos, and while i find it cute that katy is able to balance the filming and her kids, i would find that distracting if it was in her dvds…are they more professional with better sound quality? lastly, did you purchase the online mutu or the dvds…i saw a post that you mentioned you like wendy’s updated videos and compared them to some of the RE practices so i was assuming the online purchase came with free updates…is that accurate? thank you for all of your help in advance!! it’s amazing to me how little people know about DR…i actually learned about it in my stott pilates class years ago before the thought of being pregnant ever entered my mind. i dismissed it because i felt that my core strength was optimal. fast forward a few years, i became pregnant 5 months after my having my 1st child, and the fact that my abs never really had a chance to restore (and i wasn’t working on them during 2nd pregnancy like i was the 1st time) i found myself with DR. although it’s not a a severe case, i would like to address it. i now have lower back hip pain which i learned from physical therapy was due to being slightly twisted which was due to poor core strength (ahhh alignment issues…). my youngest just turned 3 years old, so i’m hoping i can improve my DR and strengthen my overall core. i am find inspiration and hope in your blog, and i want to thank you for writing about your journey!!

    • Hi Kari! I so appreciate your comment and you joining me here. I am so sorry for the comment lag and I hope you will still find my answers helpful even if you’ve already made some decisions. To answer your questions:

      Mutu or RE?
      Wendy Powell from Mutu at least started the RE certification process, so she pulls a ton from RE in her core exercises. I found it helpful to do Mutu first just because it’s so well done and structured and “bite sized” and Wendy is so empathetic and encouraging. However, it’s extra cost and RE really has the meat of the information you need to apply. So if you need a little hand holding like I did, Mutu might be right for you.

      RE bad quality?
      I agree about the quality of the RE videos on youtube – I think Katy is balancing a million things and it’s kind of amazing she is able to make videos at all. Her DVDs were done in a professional studio and are of excellent quality. The classes are kid-free but the recording quality is sometimes distracting to me. Then again, I have really high standards just based on my previous job. After awhile, you kind of forget about the quality issues because the information is so good. The Alignment Snacks are a good balance of pretty good recording and no distractions.

      Mutu online or DVD?
      I purchased online and got the new program for free.

      I, like you, had heard of DR in passing but thought I was immune because my core was rock solid and I was really active. Hah! Oh, what I didn’t know I didn’t know. I wish you the best in your healing journey and I hope you are finding hope as you put one foot in front of the other (with optimal gait pattern, of course). 😉

  10. I really enjoyed your research and your photos. I agree that both Mutu and Restorative Exercise are great resources and I am so glad that you are getting the word out! A good physiotherapist that is a pelvic floor specialist is a must as well. Most women have some trigger point issues, so inter-vaginal work can really help as well. I will be following your blog!

  11. Pingback: It’s Been Dark Under This Rock, or an Update FAQ | Diastasis Rectified

  12. I loved your research and the way you write. I surely will come back more often.

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