Diastasis Recti 101: Understanding Abdominal Separation
What is Diastasis Recti?
Diastasis Recti Abdominus (DRA), or known as abdominal separation is the stretching and thinning of the tissue between the two sides of the abdominal muscles (called the linea alba). Towards the end of pregnancy, every woman will have a diastasis. It is a natural part of pregnancy in order to make room for the growing baby. The severity of abdominal separation is measured based on how far apart the two sides of the abdominal muscles are, and how taut the linea alba is.
What are diastasis recti symptoms?
Diastasis recti can cause a bulge or doming appearance at the middle of the abdomen especially during core exercises. Many patients with abdominal separation worry that they “still look pregnant”. Diastasis recti causes core weakness which can then cause discomfort in the back, or symptoms of pelvic floor dysfunction.
Should I use a brace for my diastasis?
We never recommend waist trainers or braces for diastasis. Even though they are very popular among influencers, wearing a brace/waist trainer can have negative impacts on your core strength and pelvic floor health for a few reasons:
In order of your core to get stronger, treatment must include strengthening exercises. Wearing a waist trainer is not a form of strengthening and thus will not help get your core muscles stronger.
Waist trainers disrupt the normal movement of our core and ribcage. This can also significantly affect core strength.
Waist trainers put a lot of pressure down on the pelvic floor. All of the tissue that is getting pulled in has to go somewhere and it usually goes down and puts added pressure on the pelvic floor. This can leads to other pelvic floor symptoms like prolapse, pain and leakage.
What are diastasis recti exercises?
Any exercise can be a diastasis recti exercise. With diastasis recti, it is important that you challenge the core enough to lead to strength gains, but not too much to lead to worsening of the diastasis.
Diastasis recti exercises should be individualized. What is an appropriate challenge for one person, is not necessarily appropriate for someone else.
Many worry about “closing the gap” and bringing the two sides of the abdomen closer together. This is one piece of the puzzle, however with diastasis we also worry about how taut or tense the linea alba is. When touching the linea alba, we want it to feel taut and rigid. We don’t want our fingers to sink into the abdomen too much. Diastasis affects the function of the entire core. Therefore, only focusing on “closing the gap” or making the diastasis smaller, is usually not effective at improving core strength.
What are exercises to avoid with diastasis recti?
There is no one exercise that you should absolutely avoid with diastasis recti. Having said that, you may not be at the point in your strengthening journey that certain exercises are appropriate right now. That doesn’t mean that in the near future you’ll never get there, it just may mean that right now you should avoid them. However, there will be people that sit ups and planks are a totally fine thing to do. A pelvic floor physical therapist can help you determine what exercises are appropriate for you to do right now.
Should I avoid every exercise that causes my belly to bulge?
When we are looking at bulging, we look at whether the bulge is a hard bulge or soft bulge (does the bulge feel firm or can you sink your fingers into it). If you can sink your fingers into it, the exercise is likely fine to do. If however, when you push your fingers into the bulge it feels hard, the exercise might be too challenging for you to do right now. Pelvic floor physical therapists can help you determine if the amount of bulging is safe or not, and can also try out different cues to see if the bulge can be minimized by moving a little bit differently.
What are treatments for diastasis recti?
Physical therapy is the recommended treatment for diastasis. The goal of diastasis recti physical therapy is to address core muscle weakness and retrain your body to activate the deepest muscles of your abdominal wall to improve tension and strength of the linea alba and core muscles.
Physical therapists that specialize in diastasis recti provide hand-on manual treatments, individualized exercises and discuss ​lifestyle modifications in order to reduce abdominal pressure that could be contributing to your diastasis recti. The key with DRA is to address all of the factors that are contributing to it, including core weakness, posture and joint mobility restrictions. Please note that not all physical therapists are trained to treat diastasis recti.
Vivid Women’s Health is a women’s health physical therapy practice located in Newtown, PA. We provide unmatched pelvic floor physical therapy to help women resolve pelvic floor symptoms.
If you are local to the Newtown, Bucks County, PA area, please click here to find out more about our in person services. If you are visiting our site from afar, we offer virtual services to help you overcome your pelvic health concerns. For virtual services, please click here.
We proudly put our patients first by offer one-on-one appointments for a full hour. You will have time to be heard and we will take time to listen to your whole story. You won’t be passed between different professionals and we will work to get you a holistic solution to your pelvic health concerns. We choose to participate in a private pay model so that we can focus on putting patients first. To find out more about the private pay model, click here.
