Diastasis rectus abdominis is a condition in which the two sides of the abdominal muscle separate, as the tissue connecting them stretches. This typically happens during and following pregnancy due to the stretching of the abdominal wall, as the uterus expands. Physical therapy has been shown to be a highly effective disatasis recti treatment, helping to prevent and address diastasis recti pain.

What is diastasis recti?

Diastasis recti is the separation of the rectus abdominis muscles during and after pregnancy. The rectus abdominis runs vertically along the front of your stomach. It's divided into left and right sides by a band of tissue called the linea alba that runs down the middle of your abdominals. As your uterus expands during pregnancy, the abdominals are stretched and the linea alba thins and pulls apart. This band of tissue gets wider as it is pushed outward.

Once you deliver your baby, the linea alba can heal and come back together. It's highly elastic and retracts backs (like a rubber band). Diastasis occurs when this tissue loses its elasticity and the gap in the abdominals will not close as much as it should. If you have diastasis, your belly may appear to stick out just above or below the belly button.

Why does diastasis recti happen?

Pregnancy puts a lot of pressure on your abdomen (abs). The abdomen is made up of left and right ab muscles and a thin band of connective tissue (linea alba) in between. They are pushed outward and stretched to make room for the growing baby. Diastasis recti occurs when the linea alba is overstretched and doesn't come back together. The left and right sides of the abdominals stay separated. It's also referred to as an "ab gap" or abdominal separation.

Who gets diastasis recti?

Diastasis recti is most common in people who are pregnant and postpartum. Diastasis recti usually develops in the third trimester. There is increased pressure on the abdominal wall because the baby is growing quickly during this time. Most people don't notice diastasis recti until the postpartum period.

How common is diastasis recti?

Diastasis recti is extremely common in those who are pregnant and during the postpartum period. It affects 60% of people. It usually resolves itself within eight weeks of delivery. About 40% of those who have diastasis recti still have it by six months postpartum.

What are the symptoms of diastasis recti?

Most people don't notice signs of diastasis recti until they are postpartum. You can have diastasis recti during pregnancy, but it's hard to distinguish because your abdomen is stretched.

Symptoms beyond diastasis recti

The following symptoms ay be present if you have diastasis recti but are not directly caused by it and may be signs of other pelvic floor issues:

• Pain during sex

• Pelvic or hip pain

• Low back pain

• Poor posture

• Urine leaking when you sneeze or cough

• Constipation

• Feeling weak in your abdominals.

What does diastasis recti feel like?

Diastasis recti is not painful. You may feel weakness in your core when doing once easy tasks, like lifting a laundry basket. Some people feel a jelly-like texture in the space between the left and right abdominals when contracting the ab muscles.

How Can Physical Therapist Help With Diastasis Recti?

Because diastasis recti is a condition in which an abdominal muscle fascial line has weakened, physical therapists play a large role of improving it. Pelvic floor physical therapists help build core strength while offloading the linea alba through core control and breathing strategies, and help those with diastasis recti take these strategies into their daily lives.

What to expect with Diastasis Recti physical therapy

In many cases, diastasis recti self-resolves after your baby is born or when significant weight loss occurs. That said, in many cases, pelvic floor therapy may be necessary to treat this condition. Physical therapy is a very effective diastasis recti treatment, helping to manage symptoms and improve functional capacity when DRA is diagnosed. Your physical therapist may help you with:

• Postural Training: Improving postural control is one of the most important components of treatment for those who are dealing with diastasis recti pain. Your physical therapist will help you learn how to stabilize your core without overuse of the rectus abdominis muscle. This will involve training your other core muscles, such as your transverse abdominis (a deep abdominal muscle), and your pelvic floor muscles. Your physical therapist will show you how to perform daily activities, such as lifting and carrying your baby, while using proper posture.

• Stretching: When certain muscles become weak and overstretched, other muscles may become overactive and tight. Your physical therapist will help you learn which of your muscles needs to be gently stretched to improve your strength and posture.

• Bracing: Sometimes taping or bracing of the low back and abdominal region can provide soothing external support for diastasis recti in the early phases of rehabilitation. This method of diastasis recti treatment will help teach you the proper position for your midsection, as it provides support and decreases any pain you may be feeling.

• Education: There are factors that you may not even know about relating to your pain or movement challenges that your physical therapist can help resolve. Your physical therapist can help you understand the movements or activities that are best to avoid as you recover from DRA. Your physical therapist will be able to teach you safe and effective ways to regain your full function.

Advanced Pelvic and Spine

Advanced Pelvic and Spine provides people experiencing pelvic pain with expert care in a comfortable environment. You will speak to a pelvic health PT who is a knowledgeable, experienced specialist who stays up to date on the latest treatment options for pelvic floor pain. If you would benefit from pelvic therapy, book an appointment today or reach out with any questions.