Understanding Diastasis Recti: What it is and how to treat it.

Diastasis recti is a thinning of the linea alba which causes a gap or separation down the center of the abdomen. This condition is common among pregnant and postpartum women, but it can also affect men and women who have never been pregnant. The separation can be throughout the whole length of the linea alba or only certain portions (shown in the image below).

Causes of Diastasis Recti

The most common cause of diastasis recti is pregnancy. As the uterus grows during pregnancy, it places pressure on the abdominal muscles, causing them to stretch and separate. It is very normal for this to occur and according to Mota et al., 2015 100% of women have a diastasis present at their due date.

How do you know if you have a diastasis

The most obvious symptom of diastasis recti is a visible separation down the center of the abdomen. This gap may be more noticeable when the abdominal muscles are engaged, such as during exercise or when lifting heavy objects.

Other symptoms of diastasis recti may include:

·       Lower back pain

·       Pelvic floor dysfunction

·       Digestive issues, such as constipation or bloating

·       Weakness in the abdominal muscles

How we as pelvic physical therapists check for a diastasis.  

• We have our patient lay on their back.

• We check in 3 locations; above, at and below your belly button. 

• We cue our patient to lift your head without thinking about engaging your abdominals and 1. feel for the width between the two rectus muscle bellies 2. then also feel for how far your fingers sink down.

• It is important to note anything at or below 2 finger widths is normal.

• It is also important to check for what happens to the separation when the correct muscles are cued. This is something we can help with.

It is important to check for both the width of the separation as well as the depth of the distortion of the deeper abdominal muscles. Appropriate activation of these muscles will create tension through the linea alba allowing for the gap to close.

We recommend having your OB or pelvic physical therapist determine if a DR is present either with palpation or with real time ultrasound.

Treatment of Diastasis Recti

Treatment for diastasis recti typically involves exercises to strengthen and regain balance back to all the abdominal muscles, manual therapy to reduce tension and tightness as well as exercises to promote 360 degree breathing mechanics. All of these help to provide appropriate tension through the linea alba to close the gap between the 2 sides of the abdomen.

There are no bad exercises for diastasis in our thoughts. It does matter however, how you perform the exercises. If a “safe” exercise is performed with poor ability to manage pressure in the abdomen, more incorrect stress with be put across the linea alba.

Therefore it is a good idea if you have had a baby, think you have a diastasis or have any of the above complaints to make an appointment with your local pelvic health physical therapist to get evaluated.

The other important thing to note is there are many factors that play into the role of a diastasis closing or not closing. Please do not think if yours does not close you are doing something wrong. Genetics play a big role as well as changes in hormones.

If you are currently experiencing any pelvic floor related issues or are unsure if you are please reach out to us either through social media @empowerptandwellness, email: Hello@WeEmpowerPT.com or give us a call or a text at 678-413-5587. You are not alone in what you are experiencing and we would love to help guide you to achieve everything you want!