Learn about various therapies for diastasis recti and finding the right solutions.

Diastasis recti is a common concern during postpartum recovery. Nearly 100% of women will have a diastasis recti at the end of their pregnancy and diastasis recti doesn’t just go away after you have your baby. It takes a lot of work, and time to reconnect with your core again after having a baby. 

Diastasis Recti is a separation of the two sides of the abdominal muscles at an area called the linea alba. The linea alba is similar to a tendon and when it stretches during pregnancy sometimes it doesn’t always “go back to normal”. Diastasis recti can occur anywhere along the linea alba (from up by the ribs, to down by the pubic bone). 

Part of improving diastasis recti and the abdominal separation includes looking at some of the things that might be contributing to diastasis recti. During pregnancy, the ribs and pelvis widen to accommodate the growing baby. The ribs and pelvis don’t always go back to normal postpartum and by staying wide, can contribute to why the diastasis recti isn’t improving. In addition, lack of hydration, lack of sleep, stress, a rotation in the back, and lifestyle habits including keeping the core sucked in can all be reasons why your diastasis recti isn’t improving. 

Sometimes we have to address things like pelvic rotations, rib flare and proper sleep and nutrition prior to starting core strengthening and diastasis recti exercises. 

There are several types of diastasis recti therapies for you to pursue if you are struggling with diastasis recti. Different types of diastasis recti therapies include: at home diastasis programs, training with a personal training, working with a diastasis recti physical therapist, and surgery.

The first type of program at an at home diastasis recti programs including YouTube programs, and postpartum at home strength training programs that are marketed to moms. Many of these programs however often overpromise and underdeliver. That’s because they give diastasis recti exercises that are not person specific, but rather apply to a general population. 

When programs include exercises for diastasis that are not specific to you and all the things that might be contributing to your diastasis, they many not be beneficial for you.

Also, a lot of the online programs and search results when searching for an at home diastasis recti program create a lot of fear. Patients are told that there are diastasis recti exercises to avoid. However, treatment has to be patient specific. To learn more about diastasis recti exercises to avoid, click here.

In order for muscles to get stronger, they have to be challenged. If we want our core to get stronger after baby, we have to perform challenging core exercises, yet ones that are not too challenging, which can cause damage. This is an art and often where many of these at home diastsis recti programs are not beneficial. 

Working with a trained professional and having them give you an exercise program that is safe, and applicable to the things that are contributing to your diastasis is key.

Another type of treatment for diastasis recti includes working with a certified postpartum personal trainer. However bear in mind that not all personal trainers are qualified in working with moms and people with diastasis recti. In addition, often personal trainers are not able to spend one on one time with you and may not be trained or qualified to look at all of the things that might be contributing to your diastasis including pelvic rotations, rib flare, or postural abnormalities. 

Diastasis recti physical therapy is done with specialty trained physical therapists. Typically, these physical therapists are pelvic floor physical therapists that have training in diastasis recti therapy. Pelvic floor physical therapists can investigate all of the things that might be contributing to your diastasis including: posture, weaknesses, muscle compensations, lack of hydration, lack of sleep, stress, and lifestyle habits including keeping the core sucked in. 

A key aspect to a good diastasis recti therapy is one that helps you reconnect with the deepest layer of the core, including the transverse abdominus muscle. This muscle helps to provide tension to the area that is separated (the linea alba) and helps to improve core strength and stability. 

The gold standard for diastasis recti therapy is therapy with use of a real-time ultrasound. Using a real time ultrasound involves using an ultrasound image to see the muscles contracting in the core while you perform various exercises. The ultrasound also allows us to accurately measure the diastasis, and allows us to see if the diastasis gets bigger or smaller while you are doing certain exercises. This is key when it comes to exercise prescription because then we can tell patients which exercises are safe or not safe, for them.

The last option for diastasis recti therapies involves surgery. A plastic surgeon is someone who can help with abdominal reconstruction and abdominoplasty. Surgery should only be considered after you have tried to rehabilitate the core consistently for at least 18-24 months. 

Please note that even if you have an abdominoplasty, you should still see a physical therapist. The incision from an abdominoplasty is large, and having an abdominoplasty doesn’t help retrain the muscles on how to function. You will still need to work with a physical therapist to improve coordination and function. 

When it comes to diastasis recti therapy, reconnecting with you core is key. Proper muscle activation and engagement is essential when it comes to improving the function of the abdominal wall. Talking to a physical therapist that specializes in diastasis recti therapy can absolutely benefit you and help guide you to the right treatment. Interested in learning more about how Vivid can help you with diastasis recti treatment, click here.