Physical Therapy for Postpartum Diastasis Recti
Diastasis Recti is a common condition that can affect women during and after pregnancy. It involves the separation of the rectus abdominis muscle, causing the connective tissue to stretch and resulting in weakness in the midsection and a visible, palpable gap in the abdominal muscle. Physical therapy offers safe, effective treatment for diastasis recti to improve strength, control, and function of the abdominal muscles. Today, physical therapist, Jen, and PTA, Patti, demonstrate safe exercises to address diastasis recti.
What is Diastasis Recti?
Diastasis Recti is a common condition involving the separation of the left and right sides of the outermost abdominal muscle (the rectus abdominis) that stretches the connective tissue (the linea alba). It often occurs during pregnancy in the second and third trimesters as the baby grows and the uterus expands, which increases the pressure on the stomach wall forcing the tissue to widen and expanding the space between the left and right sides of the rectus abdominis muscle.
Symptoms of Diastasis Recti include:
Weakness in the midsection
Visible, palpable gap between the rectus abdominis muscle
Doming or tenting in the middle of the stomach when lifting or engaging in certain activities
Pelvic floor muscle dysfunction
Urinary or bowel issues, such as incontinence, leakage, or constipation
Poor posture
Low back, pelvic, or hip pain
Factors that increase the risk of developing diastasis recti include older age, a pregnancy of twins or triplets, and having had many pregnancies. Most women do experience diastasis recti by the end of the third trimester; seventy percent of women will have the diastasis recti resolve postpartum, but for the 30% in which it does not resolve on its own, a physical therapist can help.
Physical Therapy Treatment for Diastasis Recti
Your core muscles play an important role in providing postural support, movement, breathing, and protection of internal organs. During pregnancy, a woman’s body undergoes significant changes and adaptations to accommodate the growing baby. As a woman’s body heals postpartum, it’s important to take a safe and customized approach to any issues, like diastasis recti. Physical therapy offers not only effective and personalized treatment for diastasis recti and associated postpartum issues, but also helps to improve the strength and function of a woman’s core muscles (which include abdominal and pelvic floor muscles) for long-term health.
When a patient comes to the clinic for treatment of diastasis recti, the physical therapist completes a comprehensive patient history, an assessment of movement patterns, and a musculoskeletal evaluation of the hips, low back, pelvic floor, abdomen, mid-back, and neck. From there, the therapist designs a treatment program specific to the patient’s needs and built upon evidence-based treatment protocols.
Physical therapy treatments for diastasis recti include:
Posture training: Restoring postural control is a key part of treating diastasis recti. Physical therapy helps patients stabilize the core without overusing the rectus abdominis muscles through targeted strengthening of the other core and pelvic floor muscles. The therapist provides instruction for how to properly lift and perform daily activities without placing too much stress or pressure on the rectus abdominis muscle.
Breathing techniques: The therapist provides instruction in engaging, releasing, and stretching the diaphragm to restore normal breathing patterns, particularly when lifting to reduce pressure on the rectus abdominis.
Stretching Exercises: When certain muscles have become weak or overstretched, other muscles compensate by becoming overactive and tight. The therapist helps the patient target and stretch those tight, overactive muscles to improve posture and restore strength and muscular balance.
Targeted Strengthening Exercises: The therapist guides the patient through a progressive strengthening program, targeting other abdominal muscles (transverse abdominis muscle, internal and external obliques), pelvic floor muscles, and back muscles to provide trunk stability and improve core strength. This helps to reduce pressure and overuse of the already strained rectus abdominis muscle. The therapist addresses muscle imbalances and guides the patient in engaging in the right type and intensity of exercise.
Bracing or Taping: Bracing of the lower back and abdominal region or taping of the abdominal region helps to provide external support in the early stages of rehabilitation, helping to teach the proper positioning of the mid-section.
In the video below, physical therapist, Jen, and physical therapy assistant, Patti, demonstrate safe exercises to address diastasis recti and improve overall strength and function. Avoid exercises like crunches and sit-ups as these exercises can aggravate and worsen diastasis recti.
