Diastasis Recti or Hernia [How to Tell the Difference]

Do you feel a bulge in your belly and not sure if you have diastasis recti or a hernia?

In short, diastasis recti is a separation of your abdominal muscles whereas a hernia is a protrusion of an organ.

In this post I will explain:

  • how to tell if you have diastasis recti,
  • how to tell if you have a hernia, and
  • what your treatment options are.

Let’s get started.

diastasis-recti-or-hernia

Disclaimer

***READ FIRST***

Although I am a doctor, I am not your doctor. This information is for informational purposes only and should not substitute the advice from your healthcare professional. All kinds of exercise and dietary changes are potentially dangerous, and those who do not seek counsel from the appropriate health care authority assume the liability of any injury which may occur. Please read my full Disclaimer for more information. Also, this post may contain affiliate links: meaning I may receive a commission if you use them.

Ok, moving on.

Do you have Diastasis Recti or a hernia?

Diastasis recti occurs when your abdominal muscles separate along the midline. You may notice your abdomen takes on the shape of a cone. A hernia occurs when an organ or tissue protrudes through a defect or hole in one of the tissue layers of your abdominal wall.

If an abdominal organ protrudes from your diastasis abdominal separation, you also have a hernia.

How do you tell if you have a hernia in your abdomen?

Your belly button is one of the most common places for a ventral hernia to occur also known as an umbilical hernia.

If you notice a bulge around your belly button, especially when you increase your abdominal pressure, you may have an umbilical hernia.

You may not see the hernia bulge at all times. It all depends on how big the defect is in your abdominal wall, and how much tissue is protruding through it.

If you believe you have an abdominal hernia you should make an appointment with your physician.

I don’t recommend checking for a hernia at home in case you have bowel that is trapped in the defect.

Your physician will perform a physical examination in which she/he will palpate the area and possibly order an imaging study like an ultrasound, CT scan of your abdomen, or MRI of your abdomen.

Do you always get a bulge with a hernia?

You may or may not have a bulge present at all times when you have an abdominal hernia.

If the defect is small, you might not have a significant amount of tissue protruding through it.

Any bulge can be worsened with any of the following activities:

  • lifting heavy objects
  • straining on the toilet
  • coughing or vomiting
  • performing sit-ups or crunches, and
  • lying down

What does a hernia feel like after pregnancy?

The most common symptoms of an abdominal hernia after pregnancy include:

  • mild pain in your abdomen
  • pressure
  • bloating
  • pain that worsens with an activity that increases your intra-abdominal pressure
abdominal-hernia

It’s also important to note that there are many different types of hernias you can get such as :

  • An epigastric hernia (above your belly button)
  • An inguinal hernia (in your inguinal region)
  • An incisional hernia (if you had a c-section) and even
  • A femoral hernia (near your upper inner thigh)

They can all present with similar symptoms. The only difference is the location.

Are abdominal hernias hard or soft?

Abdominal hernias are usually soft and squishy. That’s because the most common thing to protrude from them is bowel.

Your small bowel is very soft and malleable.

Does a hernia hurt all the time?

An abdominal hernia should not hurt all the time.

The hernia can cause some discomfort when performing exercises that significantly increase intrabdominal pressure such as heavy weightlifting.

If you ever experience severe abdominal pain with a known diagnosis of hernia, you should seek immediate medical attention to rule out any sort of emergency.

Unfortunately, it is possible for the bowel inside the hernia to get stuck in your abdominal wall and become incarcerated.

The risk with incarcerated bowel is that they can pinch off their own blood supply causing strangulation.

This is a surgical emergency and can result in needing to have a portion of your bowel removed.

What Treatment Options Are there for a hernia?

Treatment for hernias are primarily surgical – especially if you are symptomatic.

The good news is, a hernia repair can often be done via laparoscopic surgery.

With that said, there are a few non-surgical things you can do to try and prevent hernias from getting worse.

NOTE THIS IS ONLY IF YOU ARE ASYMPTOMATIC.

These include:

  • consuming a fiber-rich diet to help prevent staining on the toilet
  • drinking 6-8 tall glasses of water every day
  • avoiding heavy lifting, and
  • avoiding sit-ups and crunches

You should always follow closely with your doctor if you are diagnosed with a hernia.

They will be able to give you more information on whether you are a candidate for surgery depending on the size and symptomatology.


Now let’s switch gears and talk about rectus diastasis quickly.

What Causes Diastasis?

Diastasis recti is due to a weakening of the connective tissue (known as the linea alba) that sits in between your rectus abdominal muscle.

During pregnancy, the growing uterus places a lot of pressure on your abdominal wall. This results in a stretching of the connective tissues of your abdomen which can lead to weakness and separation of the rectus abdominis muscle.

Research shows that almost 2/3rds of all postpartum women develop the condition.

What does Diastasis recti feel like?

Diastasis recti feels like a physical separation in the middle of your abdomen.

You may also feel like you have a flabby or weak stomach as your rectus muscle or “6 pack” muscles are stretched apart.

How to tell if you have Diastasis recti?

To tell if you have diastasis recti you could get into a modified curl-up position.

Here is what it looks like:

how-to-tell-if-you-have-diastasis-recti

To check if you have diastasis recti:

  • Lie down on your back with your knees bent and your feet flat on the floor.
  • Using one hand, place your fingers right above your belly button. (Depending on the separation you may need 1 or more fingers.)
  • Now, lift your head off the floor as if you were getting into a crunch position. Be sure to not lift your shoulders off the floor.

Unfortunately, there is no actual medical standard for diagnosing diastasis recti as there is much controversy on how much muscle separation is actually pathologic.

I explain how to interpret the results and other ways of testing yourself in this post: How to tell if you have diastasis recti.

Also, the amount of abdominal wall separation does not always correlate with symptoms.

Can Diastasis Recti cause A hernia?

Diastasis recti can cause a hernia as there is an intrinsic weakness of the abdominal connective tissue that keeps the abdominal organs in place.

If you have a large enough defect, and you increase your intrabdominal pressure significantly, your small intestines or your omentum can potentially poke out.

Interestingly, a study of over 650 women with diastasis recti found that 97 of them also had an umbilical hernia.

What Treatment options are there for Diastasis recti?

What you may not know is that in some cases diastasis recti can get better on its own..

One study showed that more than half of postpartum women had resolution of their diastasis recti by 6 months.

If your diastasis recti does not heal on its own, you can try conservative treatment options.

This can be accomplished through a combination of exercise and weight loss.

You must be careful with the exercises and only perform ones that don’t worsen your diastasis.

Be sure to check out The Postpartum Trainer’s Safe Diastasis Recti Exercise Program for New Moms that can be done at home!

rocking-planks

It is important that you do your best to AVOID any abdominal exercise that causes pain or worsens the diastasis recti.

Diastasis Recti Exercises

I have created a comprehensive list of 100 exercises you could perform in the postpartum period to strengthen and rebuild your core if you suffer from diastasis recti.

There are four levels starting at a beginner and progressing to an advanced level incorporating exercises where you are lying on your back, on your side, sitting up, and standing.

For more information feel free to check it out below.

100 Exercises For Diastasis Recti: The Complete List

exercises-for-diastasis-recti-pdf

When Should You Consider Diastasis Recti Surgery?

You can consider surgical correction of DR if:

  • you have lowered your body fat levels to a healthy range,
  • you have engaged in an exercise routine to strengthen your core, and
  • more than 6-12 months have gone by and you do not notice any improvement in your symptoms

then you may need surgery.

The type of surgery that is performed is called an abdominoplasty (aka tummy tuck).

This surgery is done by a plastic and reconstructive surgeon.

Be sure to speak with your provider and do your own research to see if you are a good candidate for surgery as no surgery is without risks.

What happens if either goes untreated?

If diastasis recti goes untreated, you may experience back pain, pelvic pain and/or postural changes due to a weakened core.

If a hernia goes untreated, it can become bigger, cause worsening pain, and increase the likelihood of bowel incarceration and/or strangulation which is a medical emergency requiring immediate surgery.

Final Words on the difference between Diastasis Recti & Hernia

If you think you have a abdominal hernia or diastasis recti, make sure you speak with your provider as every case is different.

You may be a candidate for conservative treatment!

Now I want to hear from you.

Did you suffer from diastasis recti or hernia after pregnancy?

What has helped you the most?

Comment below and let me know!

signature

Related Articles

signature

Get Four Free Workouts To Help Strengthen Your Pelvic Floor & Heal Your Mommy Tummy!


brittany-robles

Brittany N Robles, MD, MPH, CPT

Brittany Robles is a full-time OBGYN, a NASM certified personal trainer, and health & fitness, expert. She holds a Masters of Public Health degree in maternal health with a special interest in exercise and nutrition. She is also the co-author of The White Coat Trainer. Learn more about her here.



Sharing is Caring – Send This To A Mom In Need!

References:

  1. Dabbas N, Adams K, Pearson K, Royle G. Frequency of abdominal wall hernias: is classical teaching out of date?. JRSM Short Rep. 2011;2(1):5. Published 2011 Jan 19. doi:10.1258/shorts.2010.010071
  2. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Hernias: Overview. 2016 Sep 21 [Updated 2020 Jan 30]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK395554/
  3. Sperstad JB, Tennfjord MK, Hilde G, et alDiastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic painBritish Journal of Sports Medicine 2016;50:1092-1096.
  4. Ranney B. Diastasis recti and umbilical hernia causes, recognition and repair. S D J Med. 1990 Oct;43(10):5-8. PMID: 2149203.
  5. Fernandes da Mota PG, Pascoal AG, Carita AI, Bø K. Prevalence and risk factors of diastasis recti abdominis from late pregnancy to 6 months postpartum, and relationship with lumbo-pelvic pain. Man Ther. 2015 Feb;20(1):200-5. doi: 10.1016/j.math.2014.09.002. Epub 2014 Sep 19. PMID: 25282439.

4 thoughts on “Diastasis Recti or Hernia [How to Tell the Difference]”

  1. Amanda Castagna

    I have both and my Doctor is concerned because i’m now getting pain in my stomach, iv’e seen to general surgeons and they’re only wanting to fix the Hernia, my Doctor is getting quite frustrated as the seperation is 4 fingers wide. Do you have any advice please?

    1. Brittany Robles, MD, MPH, CPT

      Hi Amanda,

      Thank you for your comment.

      Unfortunately, because I am not your doctor and do not know your exact situation, I cannot provide any specific advice.

      I think you should follow the recommendations of your doctor and come to a joint decision while understanding the risks, benefits and alternatives to the treatment options being prescribed.

      I wish you the best of luck!

  2. I have DR and have already had one hernia repaired only to get another a short while later right above the old one. Since I’ve already gotten 2 because of it will I likely get others after this one is repaired as well?

    Also, I know this surgery isn’t normally covered by insurance but shouldn’t getting multiple hernias qualify as a medical reason? It doesn’t seem safe to repeatedly be put under for surgery when I could possibly prevent them with 1 surgery.

    1. Brittany Robles, MD, MPH, CPT

      Hi Christina,

      Thank you so much for the comment.

      Having surgery can definitely put you at risk of developing another hernia as a hernia is basically a defect in one of the abdominal layers.

      Regarding insurance coverage, you should try speaking with your physician to determine if it is covered because it can vary depending on your carrier.

      Hope this helps!

Leave a Comment

Your email address will not be published. Required fields are marked *