Understanding Diastasis Recti: A Guide to Abdominal Separation and Recovery

Overview

Diastasis recti is a common condition that occurs when the abdominal muscles separate along the body's midline, creating a visible gap between the right and left sides of your "six-pack" muscles. This separation happens when the linea alba - the connective tissue binding these muscles together - stretches and thins under pressure. While this condition is often associated with pregnancy, it can affect anyone experiencing increased abdominal pressure.

Research indicates that diastasis recti affects all pregnant women by their 35th week of pregnancy, with about 39% still experiencing it six months after giving birth. However, this condition isn't limited to those who've been pregnant - it can impact people of all genders and ages, including men who lift heavy weights, individuals who've undergone abdominal surgery, or those with chronic breathing pattern disorders.

At Mendwell Pelvic Health, we specialize in treating diastasis recti through expert pelvic floor physical therapy. Our approach combines evidence-based techniques with personalized care to help restore your core strength and function, whether you're recovering from pregnancy or dealing with abdominal separation from other causes.

Symptoms

Understanding the signs of diastasis recti is crucial for early intervention and successful treatment. The condition manifests through several noticeable symptoms that can significantly impact daily life:

The most visible sign is often a bulging or "doming" along your abdomen's midline, particularly when performing activities that engage your core muscles. This bulging may be accompanied by a soft, jelly-like feeling in your midsection and difficulty engaging your abdominal muscles effectively.

Many people with diastasis recti experience:

• Persistent back pain and core instability that makes everyday activities challenging, from picking up children to performing exercise routines
• Postural changes that can lead to alignment issues throughout the body, potentially causing discomfort in the hips, back, and pelvic region
• Functional limitations during daily activities, especially those requiring core strength like lifting objects or getting up from lying down
• Pelvic floor dysfunction symptoms, including bladder control issues or pelvic pressure sensations

Causes

The development of diastasis recti often stems from sustained pressure on the abdominal wall, though the specific causes can vary significantly among individuals. Understanding these causes helps both in prevention and creating effective treatment strategies.

Common causes of diastasis recti includes:

• ‍Pregnancy and Childbirth: The most common cause of diastasis recti is pregnancy, where the growing uterus naturally stretches the abdominal muscles. During pregnancy, hormones like relaxin increase tissue elasticity, while the expanding uterus creates progressive pressure on the abdominal wall. This combination of hormonal changes and physical pressure can lead to separation of the rectus abdominis muscles, particularly during the third trimester.
• Improper Exercise Technique: Performing high-intensity core exercises without proper form or excessive abdominal pressure can strain the linea alba, leading to muscle separation. This is particularly common in weightlifting or intense fitness programs.
• Chronic Core Pressure: Conditions that create sustained internal pressure on the abdomen can gradually weaken the connective tissue, including:
  • Chronic constipation requiring repeated straining
  • Chronic coughing or breathing pattern disorders
  • Regular heavy lifting with poor body mechanics
• Physical Factors: Several physical conditions can increase the risk of developing diastasis recti:
  • Rapid weight gain or loss
  • Multiple pregnancies, especially close together
  • Large babies or multiple births
  • Genetic factors affecting connective tissue strength

How Pelvic Floor Physical Therapy Can Help

At Mendwell Pelvic Health, we take a comprehensive, evidence-based approach to treating diastasis recti through specialized pelvic floor physical therapy. Our treatment program addresses not just the abdominal separation, but the entire core system, recognizing that optimal recovery requires attention to how your body works as a whole.

Your recovery journey begins with a thorough evaluation of your abdominal separation, breathing patterns, and overall core function. This detailed assessment allows us to create a personalized treatment plan that evolves through three key phases:

Phase 1: Foundation Building
In your initial sessions, we focus on establishing proper core function through:

• Teaching optimal breathing mechanics to manage intra-abdominal pressure
• Training proper engagement of deep core muscles
• Addressing postural patterns that may be contributing to your symptoms
• Beginning gentle exercises that support tissue healing
• Learning modifications for daily activities to prevent further strain

Phase 2: Progressive Strengthening
As your core control improves, we advance your treatment to include:

• Graduated exercise progression focusing on functional movement patterns
• Integration of core strengthening with daily activities
• Manual therapy techniques to improve tissue mobility and muscle function
• Advanced breathing strategies for more challenging activities
• Education about optimal movement patterns for your specific needs

Phase 3: Functional Integration
The final phase of treatment prepares you for long-term success through:

• Advanced core strengthening exercises tailored to your goals
• Activity-specific training for work, sports, or hobbies
• Strategies for maintaining core stability during challenging movements
• Development of a sustainable home exercise program
• Tools for monitoring and maintaining your progress

Our Treatment Approach

‍At Mendwell, we employ various evidence-based techniques to support your recovery:

• Manual Therapy: Hands-on treatments to improve tissue mobility and muscle function
• Real-time Movement Analysis: Assessment of your movement patterns to identify and correct compensations
• Neuromuscular Re-education: Training to improve coordination between your core and pelvic floor muscles
• Progressive Exercise Programming: Carefully sequenced exercises that build strength while protecting healing tissues

‍Our treatment philosophy emphasizes:

• Individual attention and personalized care plans
• Integration of the latest research in core rehabilitation
• Focus on functional outcomes that matter to your daily life
• Comprehensive education to empower your long-term success
• Regular assessment and program modification based on your progress

We're committed to working with you until you achieve your goals, whether that's returning to exercise, caring for young children without pain, or simply feeling confident in your core strength again. Our evidence-based approach, combined with personalized attention to your specific needs, provides the support needed for successful recovery from diastasis recti.

Frequently Asked Questions

Can diastasis recti occur in people who haven't been pregnant?
Yes, while diastasis recti is common during and after pregnancy, it can affect anyone who experiences increased intra-abdominal pressure, including men and children.

How can I tell if I have diastasis recti?
‍While a qualified healthcare provider should make an official diagnosis, you might notice a visible bulge or "doming" along your abdomen's midline during activities that engage your core. Our physical therapists can perform a proper assessment to determine the extent of separation and develop an appropriate treatment plan.

Will I need surgery to fix my diastasis recti?
‍Most cases of diastasis recti respond well to conservative treatment through physical therapy. Surgery is typically only considered when significant functional impairment persists after completing a comprehensive physical therapy program. Our team can help determine the most appropriate treatment path for your specific situation.

How long does recovery take?
‍Recovery timelines vary depending on factors such as the severity of separation, consistency with exercises, and individual healing rates. Many patients begin noticing improvements in core function within 6-8 weeks of starting treatment, though complete recovery may take several months of consistent work.

Can I exercise while receiving treatment for diastasis recti?
‍Yes, but it's crucial to work with a qualified professional to ensure exercises are appropriate and performed correctly. Our physical therapists will guide you through safe, effective exercises that support your recovery rather than potentially worsening the condition. We'll help modify your existing exercise routine and gradually progress activities as your core function improves.

Is it ever too late to treat diastasis recti?
‍No, it's never too late to begin treatment. Whether your diastasis recti developed recently or years ago, physical therapy can help improve core function and reduce symptoms. The key is working with qualified professionals who understand how to properly assess and treat this condition.