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Diastasis Recti

Physical Therapy for Diastasis Recti – Information, Exercises, and More

Is your diastasis recti causing you low back pain, discomfort with daily tasks, and a lower belly bulge that makes you still look six months pregnant?

Diastasis recti is common, and also treatable.

Here you will learn:

  • What causes diastasis recti
  • Symptoms you might be suffering from diastasis recti
  • How to get a proper diagnosis; and
  • How physical therapy for diastasis recti can help

Contents

What Is Diastasis Recti?

Diastasis recti is the separation of the rectus abdominis muscles from the linea alba, which most often occurs during middle to late pregnancy and during the postpartum period. Although diastasis recti is common during pregnancy — around 60%  — it is typically healable postpartum.

The elasticity of the linea alba allows it to retract back and close the gap caused by diastasis recti after a baby is delivered. In some cases, the tissue of the linea alba is overstretched and doesn’t retract fully, leaving a permanent separation in the abdominal muscles. 

Diastasis recti isn’t only possible in pregnant and postpartum women, though. Men and newborn babies are also prone to abdominal muscle separation.

What Causes Diastasis Recti?

Because of the immense pressure put on your abdominal muscles during pregnancy, the connective tissue — linea alba — begins to stretch to push the left and right abdomen muscles outward and make room for a growing baby.

Diastasis recti is common during pregnancy but generally not painful. However, nearly 40% of women still have signs of abdominal muscle separation six months or more postpartum, which can cause painful and unwanted side effects if not addressed.

There is nothing you can do to avoid developing diastasis recti during pregnancy, but there are some factors that could increase your risk, like:

  • Carrying multiples (twins, triplets, or more)
  • Multiple pregnancies back-to-back with little time to heal in between
  • Being overweight
  • A larger or heavier baby
  • Having an extremely petite body frame
  • Pressure from a vaginal delivery

Although diastasis recti is most often associated with a pregnant or postpartum woman’s body, men and newborn babies are also at risk for developing abdominal separation.

Diastasis Recti in Men

In men, ab muscle separation is most present in those who do heavy weightlifting, are bodybuilders, or are professional athletes. The excess pressure put on the abdominal muscles during activity causes them to separate and the inner contents to protrude. 

Men can also develop diastasis recti:

  • From excess weight gain
  • Due to family history
  • Because of age
  • From certain medical conditions

Generally, in men, diastasis recti develops gradually and might appear as weight gain. But the vertical bulge that appears when getting up from lying or sitting down is a tell-tale sign of ab separation. 

Diastasis Recti in Newborn Babies

Diastasis recti is most common in premature newborn babies because of the weakness between the two rectus abdominis muscles from being born early. The intra-abdominal pressure creates a vertical bulge from the breastbone to the belly button that heals over time.

Diastasis Recti Symptoms

For pregnant women, noticing diastasis recti can be difficult. That’s why many women don’t realize they have abdominal separation until they are postpartum. Women might experience:

  • Coning or doming when contracting the ab muscles
  • Softness around the belly button
  • Difficulty lifting, walking, or performing normal daily tasks
  • Painful sex
  • Low back pain
  • Urinary incontinence
  • Constipation
  • Weak abdominals
  • A bulge or protruding belly just above or below the belly button; or
  • Pelvic pain

Men might experience some similar symptoms like:

  • Constipation
  • Low back pain
  • Urinary incontinence
  • Discomfort when moving
  • A bulge around the belly button
  • Weak abdominals; or
  • Difficulty breathing

How Do You Know if You Have Diastasis Recti?

If you’re experiencing any of the above symptoms, chances are you have some level of diastasis recti. Not all diastasis recti is severe and requires major intervention, but it’s important to notice the symptoms and take the time to learn how to rehab your abdominal muscles.

Of course, medical professionals can help diagnose your diastasis recti, but you can also check for separation of the abdominal muscles on your own to learn how severe your case might be.

Here’s how:

  1. Lie flat on your back with your knees bent.
  2. Place your fingers on your belly button pointing towards your pelvis; press down.
  3. Lift your head while keeping your shoulders on the ground.
  4. Feel for a gap between the muscles.

Typically anything greater than two fingers wide or deep is considered diastasis recti. 

Who Can Diagnose Diastasis Recti?

If you have suspicions of diastasis recti, many healthcare professionals can give you a sure diagnosis. 

You can visit your primary care doctor, obstetrician-gynecologist, pelvic floor physiotherapist, or regular physical therapist.

Your healthcare professional of choice will evaluate you similarly to the evaluation you might’ve done on your own, checking above, below, and at the belly button for abdominal muscle separation. Some may use other methods like…

  • Ultrasound
  • Measuring tape; or
  • Calipers

… to get an accurate measurement of the width and depth of the gap.

Diastasis Recti Treatment

Luckily, diastasis recti is treatable and usually simple to do on your own, depending on the severity of your separation. In most cases, at-home exercises can help heal diastasis recti while strengthening your core muscles.

If your diastasis recti is more severe or you are unsuccessful with at-home treatment, physical therapy for diastasis recti is a great option. 

In the most severe cases, surgery can help fix diastasis recti.

Healing Diastasis Recti at Home

Many workout programs are designed to help heal diastasis recti or are safe to perform once cleared by your doctor. Fitness professionals trained to treat diastasis recti have created many programs that teach you to perform movements correctly, how to properly breathe and engage your pelvic floor, and lead you through progressively challenging movements.

However, to avoid worsening your diastasis recti, you should modify some movements like:

  • Lifting weights heavier than recommended
  • Rolling onto your side to get out of bed or sit up
  • Skipping crunches or movements that create intra-abdominal pressure and push your abdominals outwards

Healing Diastasis Recti With a Healthcare Professional

There are many great options for diastasis recti physical therapy treatment that can be done with either a pelvic floor physical therapist or a regular physical therapist.

Physical therapists can help to:

  1. Educate and teach you safe and effective ways to move your body, regain full function of your core and pelvic floor, safely progress in your healing, and help return to normal activities.
  2. Train your posture, so you’re correctly engaging your deep core muscles and breathing properly. This helps you recognize muscle imbalances and focuses on your transverse abdominis muscles, diaphragm, low back muscles, and pelvic floor.
  3. Train the four layers of stomach muscles — transverse abdominis, internal and external obliques, and rectus abdominis — using the correct intensity of exercise to help you progress your strength.
  4. Provide support through bracing or taping the abdominal region either during pregnancy or early postpartum to remind you to safely use your core muscles during activities that increase your intra-abdominal pressure.
  5. Activate rectus abdominis muscles through electrical muscle stimulation to help improve function and reduce ab muscle separation.

Healing Diastasis Recti With Surgery

If your diastasis recti is so severe that exercises and physiotherapy have not been successful in closing the gap, surgery can be done to permanently repair the abdominal muscles. 

Normally an abdominoplasty — a tummy tuck — is done to:

  • Strengthen the abdominal walls
  • Tighten the belly
  • Remove excess skin; and
  • Fix any hernias present

Medical professionals typically only suggest an abdominoplasty if:

  • You’re not planning to be pregnant again
  • You’re more than 12 months postpartum
  • You’ve had stable weight for at least 6 months
  • You don’t smoke
  • You’re generally in good health; and
  • You have realistic surgery expectations

Diastasis Recti Physical Therapy – Will PT Help?

Looking into PT for diastasis recti is highly recommended because your core plays a major role in the movement, support, breathing, and functioning of your internal organs. When you take the time to ensure the abdominal muscles are healed correctly and working properly, you are helping to improve the function and strength of your core for long-term health.

Physical therapy for diastasis recti will vary from patient to patient, but generally diastasis recti PT includes a combination of:

  • Breathing techniques
  • Strengthening exercises
  • Stretching exercises 
  • Postural training; and
  • Bracing or taping

At In Motion O.C., our physical therapists take the time to complete a proper and comprehensive assessment, including questions of family history, musculoskeletal evaluations, and watching movement patterns. From there, we work to create an individualized physical therapy treatment to help heal your diastasis recti and minimize your symptoms.

Best Diastasis Recti Exercises

Different exercises, including…

  • Breathing exercises
  • Strengthening exercises; and
  • Stretching exercises

… are beneficial to a person attempting to heal their diastasis recti when done safely and correctly. 

Breathing Exercises for Diastasis Recti

Practice the Connection Breath to help re-establish the connection between all of the components in your core:

  1. Either sit upright with your posture stacked or lay on your back with your knees bent.
  2. Inhale into your ribcage, being careful to keep your shoulders down. Your ribcage should expand 360° and your belly expands outwards.
  3. Exhale and gently contract your pelvic floor – your belly should draw inwards.
  4. Repeat.

TVA Elevators: Imagine the hardest you can contract your pelvic floor and use that as your “level 3” for your elevator.

  1. Sitting upright, relax your pelvic floor muscles and inhale fully.
  2. Slowly exhale for 10 seconds. As you exhale, contract your pelvic floor at a “level 1” for two to three seconds, a “level 2” for two to three seconds, and a “level 3” as you finish your exhale.
  3. Relax the pelvic floor and repeat.

TVA Holds:

  1. Sitting upright, press one palm against the top of your belly and the other below your ribs.
  2. Inhale into your belly so it expands against your hand.
  3. Exhale while making a “shh” sound. 
  4. Contract your pelvic floor on your exhale, drawing your abdominal muscles in towards your spine.
  5. Once your exhale is complete, hold for 5 to 10 seconds.
  6. Repeat.

Stretching Exercises for Diastasis Recti

Pelvic Tilts: 

  1. Start on your hands and knees with a neutral spine.
  2. Inhale into the sides of your ribcage.
  3. Exhale while performing a kegel, drawing your tailbone down under a curled (cat position) spine.
  4. Inhale and return to the neutral spine.
  5. Repeat.

Kneeling Leg/Arm Extensions (Bird Dogs):

  1. Begin on hands and knees.
  2. Exhale, drawing your core towards your spine.
  3. Holding your core contraction, inhale and reach your right arm ahead and left leg straight back.
  4. Exhale and bring your right elbow to your left knee under your core.
  5. Inhale, bringing your limbs long again.
  6. Return to neutral position, switch sides.
  7. Alternate and repeat 10x each.

Toe Taps:

  1. Lying flat on your back, bring your knees up over your hips, creating a 90° angle at your hips and your knees.
  2. Inhale into your ribcage and exhale as you tap one foot down to the floor. Draw your core inward as you perform the tap.
  3. Inhale and return to neutral.
  4. Repeat alternating legs for 10 counts.

Strength Exercises for Diastasis Recti

You can perform any of the following strength exercises and add weight as long as your core maintains correct form and there is no bulging.

Glute Bridge:

  1. Laying on your back, bring your feet under your knees, keeping them flat on the floor. 
  2. Driving through your heels, lift your glutes straight up as if someone was pulling your pelvis up off the floor.
  3. Repeat.

Lunges:

  1. Stand in a split stance with one foot two to three feet in front of the other. Keep a straight torso, shoulders back and down, and your core engaged.
  2. Bend your knees while lowering your body until your back knee is just above the floor. Your front leg should be parallel to the ground with weight evenly distributed between both legs.
  3. Push back upwards to the starting position.
  4. Repeat and switch legs.

Squats:

  1. Stand with your feet shoulder-width or slightly wider apart.
  2. Bend at your hips and knees simultaneously creating a 90° angle at the back of the knees. Keep your head and spine in a neutral position.
  3. While keeping your core and glutes engaged, stand up and repeat.

How In Motion O.C. Can Help With Diastasis Recti

If you’re battling with unwanted and uncomfortable diastasis recti, you don’t have to live in pain and discomfort any longer.

At In Motion O.C., we are trained to help minimize and heal symptoms of diastasis recti and many other frustrating ailments. 

How can you be so sure? We’ve helped dozens, if not hundreds, of other people going through the same thing and have testimonials to prove it. And because our patients are pleased with our work over and over again, we’ve been rated the #1 Physical Therapist in the entire country on Yelp.

Before committing, you can request a free screening to:

  • Help determine your source of pain
  • Devise a plan
  • Receive information; and
  • Receive guidance on how we can help

Interested? Contact us today to get started.

The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.

In Motion O.C.