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Diastasis Recti Physical Therapy: Understanding the Basics & Its Importance in Recovery

Updated: Sep 7, 2023

I receive questions nearly every single day about diastasis recti (DR) – and it’s no wonder, given how common the condition is and the amount of conflicting information that can be found about it! In this blog post, I’ll clarify what DR is and what causes it and provide an overview of what diastasis recti physical therapy entails. We’ll also look at the benefits of targeted physical therapy in promoting healing and restoring core strength. Let’s get to it!

What is Diastasis Recti, & What Causes It?

Diastasis recti is a condition characterized by the separation of the abdominal muscles, specifically the rectus abdominis muscles. These muscles, often called the "six-pack" muscles, run vertically down the front of the abdomen and are responsible for core stability and support. The core muscles converge on the linea alba, which is a connective tissue line down the front of your abdomen.

During pregnancy, diastasis recti occurs as the uterus expands and puts pressure on the abdominal wall. This is a good thing! Hormonal changes during pregnancy can also contribute to stretching and weakening the connective tissues that hold the abdominal muscles together. (the linea alba.) This tissue is designed to stretch so our growing uterus does not push through muscle tissue! As a result, the right and left sides of the rectus abdominis muscles can separate, creating a gap between them.

Hear me, though: diastasis recti does not mean your abdominals are torn! This is one prevalent myth out there. Instead, your connective tissue has been stretched and isn’t providing good tension, so you see and feel the two sides of the rectus abdominis pull away from each other instead of staying in position. Your abs are not torn or split, and (in most cases) the connective tissue is not torn or split either.

Did you know that every woman has a diastasis recti after she gives birth? It’s true! Remember, that’s how the tissues are designed to respond! It is possible, however, that this tissue will take longer to heal and tighten back up, and you will see a gap during this healing process. Here’s where trouble can arise, though: if you improperly work - or overwork - this tissue as it heals, it’s possible to end up with a long-lasting and persistent diastasis recti.

While pregnancy is a common cause, it's important to note that diastasis recti is not limited to pregnant women, or even women at all. Diastasis recti can occur in individuals who are not pregnant, even men (particularly those who have experienced significant weight gain or abdominal trauma).

Other factors that can contribute to its development include:

1. Excessive intra-abdominal pressure: Activities that involve heavy lifting, improper weight lifting techniques, or straining during bowel movements can increase pressure on the abdominal muscles and contribute to diastasis recti.

2. Age: The natural aging process can weaken the connective tissues and contribute to diastasis recti.

3. Weak core system: A weak core system can result from a sedentary lifestyle, lack of exercise, or simply a lack of awareness – and it can make the abdominal muscles more prone to separation. However, it's crucial to recognize that your core system includes more than your abs, and abdominal strength is not the sole factor! Your core system includes your pelvic floor, low back stabilizers, and breathing diaphragm. It is the job of our entire core to control the normal intra-abdominal pressure that builds up with our daily activities. Additionally, a “strong core” is not about brute strength. A strong, healthy core is about coordination, form, muscle timing, strategy, and a system that works well together to do its job. When something in that system is off, the resulting forward pressure pulls on the connective tissue, making a gap. That is why strong, fit women can also struggle with diastasis recti.

To effectively treat and heal a diastasis recti, you must get to the root cause. The root cause often includes some combination of imbalanced muscle recruitment, improper breathing patterns, and/or inefficient habitual movement patterns. Therefore, resolving these issues is paramount when healing your abdominal separation, which leads me to our discussion of diastasis recti physical therapy!

What is Diastasis Recti Physical Therapy?

Diastasis recti physical therapy is a specialized form of therapy aimed at addressing and treating the separation of the abdominal muscles. It involves targeted exercises, stretches, and techniques designed to strengthen and restore the function of the abdominal muscles, pelvic floor muscles, and other supporting muscles.

Key Benefits of Diastasis Recti Physical Therapy

Abdominal muscle restoration

Physical therapy can help bring the separated abdominal muscles back together, reducing the width of the gap between them. This promotes better alignment and improved function of the core muscles. Also, it can help improve the way the core is engaging, which is the key component. Sometimes, people think they have diastasis recti when in fact they have a linea alba that can effectively create tension and transfer force, BUT they have a system that is pushing all the abdominal pressure forward into the abdominal wall, creating a doming effect.

Core strength and stability

Physical therapy exercises focus on strengthening the deep core muscles, including the transverse abdominis, pelvic floor muscles, breathing diaphragm, and obliques. This helps restore core stability, which is essential for proper posture, spinal support, and overall body mechanics. For example, check out these videos, where I do a quick core description and explain a properly coordinated core engagement pattern.

Improved pelvic floor function

Diastasis recti is often associated with pelvic floor dysfunction. Physical therapy can address pelvic floor muscle weakness or dysfunction, which may manifest as urinary incontinence, pelvic pain, or other related issues.

Postural correction

Diastasis recti can contribute to poor posture, as the abdominal muscles play a crucial role in maintaining proper alignment. Physical therapy can help correct postural imbalances, reducing strain on the spine and improving overall body mechanics.

Prevention of complications

Diastasis recti can lead to problems such as back pain, pelvic pain, hernias, digestive issues, and compromised core stability. However, by addressing the condition through physical therapy, individuals can potentially prevent or minimize these complications.

Individualized approach

Diastasis recti physical therapy is tailored to each individual's specific needs and condition. As a physical therapist, I assess the severity of each patient's diastasis, evaluate muscle strength and function, and create a personalized treatment plan to address the specific issues of the individual.

It's important to consult with a healthcare professional or a qualified physical therapist experienced in treating diastasis recti to receive an accurate diagnosis, guidance, and an appropriate exercise program for your specific situation. For more helpful information, check out my list of 10 Myths of DR Debunked!

If you’re ready to move toward healing your diastasis recti and establishing greater strength and stability, I would love to hear from you. Contact me here to schedule an appointment or to book a free phone consultation.

Written and medically reviewed by Dr. Brenda, DPT


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