Diastasis Recti is a term used to describe separation of the abdominal wall muscles that typically occurs during pregnancy. Abdominal muscles are made up of 4 muscle groups. From superficial to deep, they are named rectus abdominis, external obliques, internal obliques, and transverse abdominis. These muscles, under normal circumstances, meet in your midline called your linea alba. During pregnancy, these muscles are stretched laterally as the belly grows to make room for baby, which is completely normal. In fact, there is recent research that sites that 100% of women will have some sort of diastasis by 36 weeks of pregnancy. This separation can become problematic on the postpartum side if the tissue doesn’t heal appropriately and continues to stay separated.
Our abdominal wall functions to hold in intestinal contents and stabilize the body during movement. It is also part of our core, along with our diaphragm, pelvic floor and back muscles. If there is dysfunction in the abdominal wall, it can lead to problems such as umbilical hernias, pelvic floor dysfunction, breathing problems and poor movement strategies.
When a health professional assesses for diastasis, they will ask the person to do a partial curl up off the surface. The practitioner is looking for any doming or dipping through that midline tissue called the linea alba. They measure the width and the depth of the tissue using their fingers to assess the severity of the separation. Typically, they will then ask the patient to engage through their transverse abdominis and retest to see how well the abdominal wall can produce tension.
If there is a diastasis present, physical therapy is typically indicated. Therapy options include manual therapy to promote bringing the tissue back towards midline, education on proper engagement of core muscles, education on proper breathing mechanics, and instructing the patient how to properly recruit the muscles during functional movement. We also provide education on exercises and movements to avoid that may increase the intra-abdominal pressure and strain through the abdominal tissue. The biggest indicator for improvement is the ability to correctly produce tension through the core, as the tissue will often remain separated. In some rare and severe cases, surgery may be indicated.
If you feel you have a diastasis recti, you should be evaluated by an appropriate health care provider. It is important to know there is something you can do to help yourself. Our experienced and well trained pelvic health physical therapists here at Pelvic Health Solutions are available to treat any issues with diastasis recti.