As a pelvic floor physical therapist, I get this question a lot. Although diastasis recti abdominis (DRA) can affect anyone, I see it most often in clients who are pregnant or have been pregnant. Unfortunately, I hear so many women telling me that their health care provider told them the only way to treat a DRA is through surgery. I’m here to bust that myth.
So what is a diastasis recti?
In the middle of our abdomen we have connective tissue called the linea alba. It connects the abdominal muscles (commonly referred to as the "six-pack" muscles) to each other. A diastasis is a thinning of this connective tissue, causing separation of the core muscles.
Diastasis is common during pregnancy when the line alba gets stretched out to accommodate a growing fetus. Studies show that 40% of women still have a diastasis at 6 months after giving birth. But it's never too late to correct this, even years after having babies.
Is a diastasis dangerous?
No, it’s not necessarily dangerous but it can lead to increased risk of low back pain and pelvic floor dysfunction. Our abdominals play an important role in pressure management. Having an abdominal separation and a weak core can contribute to poor posture leading to pain, and increased pressure down on your pelvic floor potentially leading to incontinence or leaking.
How do I know if I have a diastasis?
Follow these 5 steps to check for yourself:
1. Lie on your back with knees bent and feet flat on the floor (i.e., hook-lying position).
2. Take your hand and place your fingers on your abdomen perpendicular to your belly button.
3. Lift your head up.
4. Feel for any separation (you should feel a muscle belly on both sides of your finger).
5. Measure how many fingers are between the muscle bellies and to what knuckle you can sink your hand into your abdomen.
Anything over 2.5 fingers width is considered a diastasis. Here's a video with some more information on how to check for diastasis:
How can I treat my diastasis without surgery?
1. Abdominal massage. Side tightness can pull on the muscles leading to a bigger separation. I will often do 5-10 minutes of side abdominal massage on my clients and see at the very least a one finger width improvement of the diastasis.
2. Posture. Standing with an anterior pelvic tilt and ribs flared out position can cause a greater separation or make it more difficult to close a separation. You want to think about stacking your rib cage over your pelvis as to not lengthen your abdominal muscles even more.
3. Breathing. Diaphragmatic breathing can help to improve your rib cage mobility and create intra-abdominal pressure to support your spine. You want to think of 360 degree breathing- there should be equal movement of your front, back, and side rib cage with an inhale and exhale. Most of us are stuck in an “inhalation pattern” and not getting a good full exhale. This can cause our infrasternal angle, the angle between the bottom of your sternum or chest bone and your rib cage, to widen leading to more abdominal separation.
4. Exercise. There is not necessarily a list of exercises to do and NOT to do with a diastasis. Instead, always think about pressure management. If during an exercise, you notice a lot of abdominal bulging or doming, you want to turn on your deep core muscle or your transverse abdominis to try to flatten out the doming. If you’re not able to do this, the exercise may be too challenging for you at this time.
Here's a video on how to do a simple diastasis crunch exercise to get you started:
A pelvic floor physical therapist can help you identify abdominal bulging and modify exercises for you. I will teach you how to tap into your deep core muscles for better pressure management.
Engaging your deep stabilizer muscles can be challenging, especially post pregnancy. I will often use the Redcord suspension system to help my clients turn on these muscles. With repetition, engaging your deep core muscles will become automatic and you won’t have to think about it every time you do an exercise.
Surgery should never be the first option for a diastasis. If you’re having difficulty managing it on your own, a pelvic floor physical therapist can help immensely.
Contact us to start feeling and moving better.
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.