It Might Not be a “Beer Belly”- Diastasis Recti in Men
Diastasis Recti: It’s Not Just a Postpartum Condition
When people hear diastasis recti, they often think of postpartum women. While diastasis recti is very common during and after pregnancy, women are not the only people who can experience it. Men, athletes, older adults, and even infants can also develop abdominal separation.
So, what exactly is diastasis recti, what causes it, and how can physical therapy help?
What Is Diastasis Recti?
Diastasis recti (DR) occurs when the two sides of the rectus abdominis—the muscles commonly referred to as the “six-pack”—move farther apart along the midline of the abdomen.
The connective tissue between these muscles, called the linea alba, can become stretched and thinned, creating a separation between the abdominal muscles.
Diastasis recti is especially common during and after pregnancy because the growing uterus places significant stretching forces on the abdominal wall. Hormonal and physical changes during pregnancy can also affect the connective tissues.
However, pregnancy is not the only factor associated with diastasis recti.
What Causes Diastasis Recti?
A variety of factors can contribute to changes in the abdominal wall and the development of diastasis recti, including:
Pregnancy
Changes in body weight
Age-related changes in connective tissue
Repeated increases in abdominal pressure
Improper lifting techniques
Certain types of strenuous or excessive abdominal exercises
Changes in core muscle coordination
Individual differences in connective tissue
This is why diastasis recti should not be thought of as strictly a “pregnancy problem.”
Can Men Have Diastasis Recti?
Absolutely.
Diastasis recti in men is often overlooked or mistaken for weight gain, bloating, or a lack of abdominal muscle definition.
One of the more noticeable signs may be a bulge or doming along the midline of the abdomen, particularly when performing a crunch, getting up from lying down, or engaging the abdominal muscles.
Men who regularly participate in heavy lifting or strenuous exercise may also notice changes in their abdominal wall.
However, seeing a bulge does not automatically mean that someone has diastasis recti. An evaluation by a qualified healthcare professional can help determine what's actually happening.
What Are the Signs and Symptoms of Diastasis Recti?
The appearance of the abdomen is not the only thing to consider.
Some people with diastasis recti have very few symptoms, while others may experience changes in how their core and abdominal wall function.
Possible signs and symptoms can include:
A visible bulge or “doming” along the middle of the abdomen
A feeling of weakness through the core
Difficulty coordinating abdominal muscles during movement
Changes in posture
Low back discomfort
Difficulty managing pressure during lifting or exercise
Changes in breathing mechanics
It's important to remember that these symptoms can have many different causes. Having back pain, bloating, constipation, or urinary symptoms does not automatically mean that you have diastasis recti.
This is why an individualized assessment is so important.
Can Diastasis Recti Affect the Pelvic Floor?
This is an important piece that often gets overlooked.
Your abdominal muscles, diaphragm, pelvic floor, and deep core muscles work together as part of your body's pressure-management system.
When one part of that system isn't coordinating effectively, it can affect how the rest of the system functions.
For some people, this may contribute to difficulty with activities such as lifting, exercising, coughing, breathing, or managing pressure through the abdomen and pelvis.
This doesn't mean that diastasis recti directly causes every pelvic floor symptom. Instead, it means that the abdominal wall and pelvic floor should be considered together when evaluating someone's movement and pressure management.
Can Diastasis Recti Be Treated Without Surgery?
In many cases, conservative rehabilitation can be an important part of treatment.
Treatment depends on the individual and should be based on their symptoms, goals, abdominal wall function, and overall movement patterns.
A physical therapist may work with you on:
Deep core coordination
Breathing mechanics
Abdominal wall function
Pressure management
Posture and movement patterns
Strengthening and exercise progression
Pelvic floor coordination
Strategies for lifting and other daily activities
There are countless exercises online claiming to “fix” diastasis recti. But there is no single exercise that works for everyone.
In fact, certain exercises or techniques may not be appropriate depending on your symptoms, strength, movement patterns, and stage of recovery.
Your treatment should be individualized to you—not based on what worked for someone else on social media.
Do You Need Surgery for Diastasis Recti?
This is one of the first questions many people have after discovering they may have abdominal separation.
The answer is: not necessarily.
Surgery may be considered in certain circumstances, but many people can benefit from conservative care and rehabilitation first.
A pelvic health physical therapist can evaluate how your abdominal wall is functioning and determine whether physical therapy may be appropriate for your goals.
If you are experiencing significant symptoms or have concerns about your abdominal wall, it's important to discuss your options with an appropriate healthcare professional.
When Should You See a Physical Therapist?
You may want to consider an evaluation if you've noticed:
A persistent abdominal bulge or doming
Core weakness that isn't improving
Difficulty returning to exercise after pregnancy
Pain or discomfort with certain movements
Difficulty lifting or exercising without abdominal pressure or bulging
Pelvic floor symptoms along with changes in your core
Concerns about your abdominal separation
A physical therapist can help determine what's contributing to your symptoms and whether diastasis recti is actually part of the picture.
Diastasis Recti Isn't Just About Your Stomach
One of the biggest misconceptions about diastasis recti is that treatment is simply about “closing the gap.”
Your abdominal wall is part of a much larger system involving your core, breathing mechanics, pelvic floor, posture, and movement patterns.
Rather than focusing only on the distance between the abdominal muscles, treatment should also consider how your body is functioning as a whole.
At Arancia Physical Therapy, our goal is to help you understand what's contributing to your symptoms and develop a treatment approach that is specific to your body and your goals.
Whether you're postpartum, an athlete, someone who lifts weights, or simply noticing changes in your abdominal wall, you don't have to figure it out on your own.
Think You May Have Diastasis Recti?
If you've been diagnosed with diastasis recti or are experiencing abdominal, pelvic, or other unexplained symptoms, we'd love to help you determine whether pelvic health physical therapy may be right for you.
At Arancia Physical Therapy, we work with patients to address pelvic health and movement concerns so they can get back to doing the things they love.
Ready to learn more? Contact Arancia Physical Therapy to schedule an evaluation or give us a call at 401-602-7006.
You don't have to live with discomfort, uncertainty, or limitations. Let's figure out what's going on and create a plan to help you move forward.