What makes you more likely to have DR?
What makes you more likely to have DR?

What makes you more likely to have DR?

CW: brief discussion of BMI and weight

Here’s the good news: there has been a LOT of new research on diastasis recti (DR) within the last few years. The bad news is that the studies are all so different from one another, and many can’t even agree on what the cut-off is to diagnose DR, or how even to measure it in the first place! This makes it incredibly hard to generalize results, as you can imagine! But, some trends are emerging, including data on risk factors for developing DR.

By, Stephanie Dillon, PT, DPT, WCS

What are the most common risk factors for DR?

Here's a short-ish list:

  • Pregnancy, and especially more than one pregnancy (this is a big one that shows up consistently across the board)

  • C-sections, especially more than one

  • Diabetes

  • Larger babies, >9lbs

  • Excessive amniotic fluid

  • Age (interestingly, most studies show a HIGHER incidence of DR with increasing age, while others show LOWER)

  • And of course, everyone's love-to-hate: BMI. This really relates not to BMI generally, but to the theory (note: theory) that carrying increased weight in your midsection will put more pressure against the abdominal wall. I might consider buying into this once I see 1) research that specifically correlates higher waist circumference with DR, and 2) that decreasing waist circumference actually helps improve DR. So far we don't have evidence for either of those things.

Childcare responsibilities and repeated heavy lifting may also play a role, but the jury is still out on those two.

If I have a lot of these risk factors, will my DR never heal?

Absolutely not! And let’s be clear: everyone who is pregnant will develop a DR by week 35 of pregnancy. Everyone. The key here really is how long it takes your body to recover from that DR after the baby is out of your belly. To read more about what is and isn’t true regarding DR click here, and for more information on how to “fix” DR, click here.

I am hopeful that this knowledge may help some people who are struggling with DR and have these risk factors realize that it's not their fault! And, may eventually lead us to figure out why some people struggle with DR for so long after birth, while others do not.

References (most are open access!):

Cavalli, M., Aiolfi, A., Bruni, P. G., Manfredini, L., Lombardo, F., Bonfanti, M. T., Bona, D., & Campanelli, G. (2021). Prevalence and risk factors for diastasis recti abdominis: a review and proposal of a new anatomical variation. Hernia : the journal of hernias and abdominal wall surgery, 25(4), 883–890. https://doi.org/10.1007/s10029-021-02468-8

Iqbal, M., Hussain, T., Khalid, F., Ali, M., Ashraf, I., & Nazir, T. (2020). DIASTASIS RECTI ABDOMINIS AND ITS ASSOCIATED RISK FACTORS IN POSTPARTUM WOMEN. PAFMJ, 70(5), 1535-38. Retrieved from https://pafmj.org/index.php/PAFMJ/article/view/5600 

Kaufmann, R. L., Reiner, C. S., Dietz, U. A., Clavien, P. A., Vonlanthen, R., & Käser, S. A. (2022). Normal width of the linea alba, prevalence, and risk factors for diastasis recti abdominis in adults, a cross-sectional study. Hernia : the journal of hernias and abdominal wall surgery, 26(2), 609–618. https://doi.org/10.1007/s10029-021-02493-7

Sperstad, J. B., Tennfjord, M. K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British journal of sports medicine, 50(17), 1092–1096. https://doi.org/10.1136/bjsports-2016-096065 

Wu, L., Gu, Y., Gu, Y., Wang, Y., Lu, X., Zhu, C., Lu, Z., & Xu, H. (2021). Diastasis recti abdominis in adult women based on abdominal computed tomography imaging: Prevalence, risk factors and its impact on life. Journal of clinical nursing, 30(3-4), 518–527. https://doi.org/10.1111/jocn.15568 

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