Physical Therapy For Diastasis Recti.
Discover all the benefits of physical therapy for addressing concerns associated with Diastasis Recti.
As pelvic floor physical therapists, diastasis recti is one of the top concerns that we treat. We commonly get asked about how PTs can help with diastasis and what treatment looks like.
What is diastasis recti?
Diastasis recti (commonly known as abdominal separation) is a thinning of the tissue in the front of the core, between the two sides of the rectus abdominus (or 6-pack muscles). This thinning of tissue then causes the two sides of the rectus abdominus muscles to be separated. This separation can occur above, at, or below the belly button. Diastasis Recti can occur in anyone (it can occur in children and males) however it is synonymous with pregnancy and postpartum. The two sides of the abdominal muscles must stretch and thin in order to make space for the growing baby. Therefore, diastasis recti is 100% normal at the end of pregnancy and will continue into the immediate postpartum time period. Because of the thinning of the tissue, some patients will notice a prominent bulge or divot when attempting to do a core exercise. Diastasis recti is not painful in and of itself, however it can cause some lower back pain and core weakness might be noticeable in those that have a diastasis recti.
What is the difference between diastasis recti and a hernia?
Diastasis recti is a thinning of the tissue, but no tear is present. With a hernia however, there is a tear or hole in the tissue. Having a hernia though doesn’t always mean that you will need surgical intervention to fix it. Some hernias can be completely harmless.
What is entailed with physical therapy for diastasis recti?
Physical therapists will assess your diastasis and determine the size of the separation and the degree of stretch within the tissue. Some pelvic floor physical therapists have an ultrasound that they can use to visualize the tissue. Your therapist will then determine an appropriate program of core exercises to help you strengthen the core muscles. These core exercises differ person to person because they need to be challenging enough to be able to strengthen the core without doing damage (the difficulty of the exercise will differ between people). Your physical therapist will also assess whether there are compensations in other areas of the body that might be playing a role in your diastasis.
What types of exercises should I avoid if I have a diastasis?
There is no one exercise that is bad for a diastasis. You’ll read online that those with a diastasis should avoid sit ups or planks, but that simply isn’t true. A PT will assess you doing those exercises and determine if they are too aggressive for you at this time, but that doesn’t mean that you should never perform them for the rest of your life. As you get stronger, exercises that might be too difficult right now will be achievable. In general, anything that causes your stomach to bulge at midline should be looked at by a pelvic PT to determine whether or not that exercise is safe for you to perform at this time.
Can I do at home diastasis exercises?
We caution that you may not see the results that you are aiming for. Those programs are a one size fits all, and unfortunately diastasis isn’t a one size fits all diagnosis. There is so much variability in what each person finds challenging and what exercises are appropriate for each person. We also caution against anything that advertises on just “closing the gap” as opposed to those that focus on strengthening the entire core. Often, patients will bear down on their pelvic floor when their focus is on closing the gap, which can cause or contribute to pelvic floor dysfunction.
What about waist trainers?
We typically advise against waist trainers. Diastasis recti will improve by actively strengthening the core muscles. Waist trainers don’t allow for natural expansion of the core which is necessary for the muscles to function properly. In addition, waist trainers put a significant amount of pressure on the pelvic floor which can contribute to pelvic floor dysfunction.
If you are struggling with diastasis recti, give our office a call. We can help you with in person and remote consultations.
Other resources for Diastasis Recti: