Diastasis Recti is a prevalent condition that can impact women both during and after pregnancy. It is
characterized by the separation of the rectus abdominis muscle, which causes the connective tissue to stretch and leads to weakness in the midsection. A visible and palpable gap in the abdominal muscle is also common.
To address diastasis recti, physical therapy offers a safe and effective treatment option. The goal is to enhance strength, control, and function of the abdominal muscles.
Diastasis Recti occurs when the left and right sides of the outermost abdominal muscle, known as the rectus abdominis, separate. This separation stretches the connective tissue called the linea alba.
Typically, this condition arises during the second and third trimesters of pregnancy, as the baby grows and the uterus expands. The increased pressure on the stomach wall prompts the tissue to widen and expand the gap between the left and right sides of the rectus abdominis muscle.
Symptoms of Diastasis Recti include weakness in the midsection, a visible and palpable gap between the rectus abdominis muscle, and a dome-like appearance in the middle of the stomach when lifting or
engaging in certain activities. Additionally, individuals may experience pelvic floor muscle dysfunction, such as urinary or bowel issues (incontinence, leakage, or constipation), poor posture, and low back, pelvic, or hip pain.
Several factors increase the risk of developing diastasis recti, including older age, a pregnancy with twins or triplets, and multiple pregnancies. Although most women experience diastasis recti by the end of the third trimester, approximately 70% of women will have this condition resolve on its own postpartum.
However, for the remaining 30 % in whom diastasis recti does not resolve naturally, physical therapy can be beneficial.
Physical therapy treatment for diastasis recti focuses on the core muscles, which play a vital role in providing postural support, movement, breathing, and protecting internal organs. Pregnancy brings significant changes and adaptations to a woman\’s body as it accommodates the growing baby.
Therefore, a safe and personalized approach to addressing diastasis recti and associated postpartum
issues is crucial. Physical therapy not only provides effective and individualized treatment for diastasis recti but also improves the strength and function of core muscles for long-term health. These core muscles encompass the abdominal and pelvic floor muscles.
When a patient seeks treatment for diastasis recti, the physical therapist conducts a comprehensive patient history assessment, evaluates movement patterns, and performs a musculoskeletal evaluation of several areas, including the pelvic floor, mid-low back and hips, as well as abdomen and neck. Based on the findings, the therapist designs a tailored treatment program rooted in evidence-based treatment protocols.
Physical therapy treatments for diastasis recti include:
- Posture training: Restoring postural control is vital in treating diastasis recti. Physical therapy helps stabilize the core without overusing the rectus abdominis muscles by focusing on strengthening other core and pelvic floor muscles. The therapist provides guidance on proper lifting techniques and
performing daily activities to avoid excessive stress or pressure on the rectus abdominis muscle. - Breathing techniques: The therapist instructs patients in engaging, releasing, and stretching the
diaphragm to restore normal breathing patterns, particularly during activities that involve lifting. This approach reduces pressure on the rectus abdominis. - Stretching exercises: In cases where specific muscles have become weak or overstretched,
compensatory muscle groups can become overactive and tight. A physical therapist assists patients in targeting and stretching these tight, overactive muscles to improve posture and restore strength and muscular balance. - Targeted strengthening exercises: Guided by the therapist, patients engage in a progressive
strengthening program that targets other abdominal muscles (such as the transverse abdominis muscle, internal and external obliques), pelvic floor muscles, and back muscles. This approach enhances trunk stability and improves core strength, reducing pressure and overuse of the strained rectus abdominis muscle. Muscle imbalances are also addressed, and the therapist provides guidance on engaging in appropriate types and intensities of exercise. - Bracing or Taping: To provide external support during the early stages of rehabilitation, bracing of the
lower back and abdominal region, or taping of the abdominal region, is employed. This helps with proper positioning of the mid-section and assists in teaching the patient the correct posture.
By employing these physical therapy interventions, individuals with diastasis recti can experience
improved strength, control, and function of their abdominal muscles, leading to a better quality of life and enhanced overall well-being.