Diastasis recti is a condition that normally occurs in pregnancy but can be seen in other populations of adults and even infants. The hormones associated with pregnancy, which soften the connective tissue, as well as the stretching of the uterus and abdomen to accommodate a growing fetus, is what causes the widening of the linea alba and a separation between the two rectus abdominis muscles. These abdominal muscles are the two superficial muscles that many know as the “six pack muscles.” These muscles are two of the most visible muscles but only comprise one part of the “core”. The inner core muscles such as the diaphragm, pelvic floor, transverse abdominis and multifidus are responsible for creating stability and control around the spine and pelvis and assisting with normal posture and breathing.

Diastasis recti is normal in pregnancy and usually resolves on its own in the postpartum period. A diastasis recti that does not resolve can contribute to decreased pelvic floor and abdominal muscle function and in some cases, lumbopelvic and abdominal pain. This is more common in multiparous women due to the repeated stretching. Some individuals notice a tenting or coning of their lower abdomen upon sitting up as a result of the changes in abdominal wall support and many of those individuals consider this an unwanted side effect of diastasis recti.

The exact amount of widening of the linea alba that is considered “pathological” is controversial, but if you are experiencing symptoms that might be associated with a diastasis recti and your therapist can observe and palpate a separation between the abdominal muscles, you will likely benefit from physical therapy.

If you decide to work with a physical therapist to help with Diastasis Recti issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY INTERVENTIONS FOR DIASTASIS RECTI

Treatments for diastasis recti will always be individualized but several physical therapy interventions have been shown to be helpful in the management of this condition:

Patient education: Physical therapists can help you understand this condition and how it can be managed. Diastasis recti is a normal and necessary part of pregnancy and is nothing to be feared. Your PT can help you understand what to expect and what steps you can take in the ante- and postpartum periods to help optimize function of the abdominal wall.

Taping and bracing: Taping and bracing of the abdomen can be helpful for some individuals to support the abdominal walls in an optimal position and also provide a cue for activating the muscles correctly. Your therapist can determine if you are a good candidate for bracing and taping and teach you how to wear the tape or abdominal brace correctly.

Exercises: Exercise is an important tool to help optimize abdominal muscle function, reduce the width between rectus abdominis muscles and to increase the tension in the linea alba. Many women will benefit from beginning an exercise program in the prenatal period which, while not preventative of a diastasis recti (remember, this is a normal part of pregnancy), can support optimal performance and function of the inner abdominal muscles. Your physical therapist can teach you which exercises are safe to perform during pregnancy and which you should avoid. In the early and late postpartum period your therapist can monitor your degree of separation and progress your exercise program in a safe manner to help you safely return to your prior activities.

Posture and activity modification: Optimizing postural alignment during the early and late postpartum time period can help with recovery from a diastasis recti. Holding and carrying an infant and toddler often leads to postural alignment that is not optimal for abdominal activation and your therapist can teach you about your posture as well as how to perform activities like lifting, safely.

While a diastasis recti is not to be feared, it is a good idea to work with a knowledgeable physical therapist who can help you take steps during pregnancy and afterward to support your body’s healing process. If your diastasis recti is not associated with pregnancy, the same concepts apply to helping you optimize abdominal function. In either case, the physical therapists at Evolve are here to show you how to safely address symptoms of a diastasis recti. Call to schedule an evaluation today.