Diastasis Recti Abdominis (DRA): Part 2, Evaluation

Now that we have a better understanding of what a Diastasis Recti Abdominis (DRA) is, let’s talk about what physical therapy can do for you. Physical therapy is a conservative treatment option, because there is no surgery involved and you allow the body to heal itself with specific exercises.

Diastasis Recti are diagnosed measuring how many cm or mm of separation there is on the linea alba (i.e. the midline of your six-pack muscle). The research, however, shows there is no uniform standard for a DRA diagnosis, which makes the prevalence in the literature a very wide percentage varying between 32.6-82.6% during the first postpartum year. 1, 2 Within this range there is a large percentage of women that continue to have a DRA into postpartum with other symptoms such as prolapse, low back pain, and incontinence. This is why being assessed by a pelvic floor therapist is imperative, so these conditions don’t continue to progress. 

Not only will the separation of the linea alba be assessed in the evaluation, there are other things to consider. A DRA affects the entire core system which includes much more than just your abdominals. Visualize your core as a cylinder. The top is our diaphragm, the front is our abdominals, the back are our spinal extensors, and the bottom is the pelvic floor. If any of the sides of this cylinder (i.e. DRA/front) is experiencing dysfunction, the other sides have likely been compensating. So it’s crucial we evaluate the surrounding structures of the spine, hips, pelvic floor, and breathing mechanics to make sure the core is working properly. 

How to assess for a DRA at home:

1. Lie on your back with knees bent and feet flat on the floor. 

2. Place your fingertips along the midline of your abdomen, above and below your belly button. 

3. Now bring your head and shoulders off the floor, like a mini-crunch. 

4. Things to look for: 

  • Is there any coning or doming?
  • How deep or wide can you feel the separation of the linea alba?
  • Is there tension along the muscle fibers?

Try this self-assessment and if you’re concerned you may have a DRA or have any questions, please contact us.

REFERENCES:

Fei, H., et al, 2021. The relationship of severity in diastasis recti abdominis and pelvic floor dysfunction: a retrospective cohort study. BMC Women's Health, [online] 21(1).

Sperstad, J., Tennfjord, M., Hilde, G., Ellström-Engh, M. and Bø, K., 2016. Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine, [online] 50(17), pp.1092-1096.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Check out our pregnancy & postpartum page to learn more about this topic.

Dr. Kristine Godsil

Physical Therapist / Doctor of Physical Therapy
Kristine Godsil is a Doctor of Physical Therapy practicing in sports, general orthopedics, pediatrics, and pelvic health. She works at Activcore in Castle Rock, CO (inside Optimal Health Chiropractic), located in between Denver and Colorado Springs. 
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