Diastasis recti is a very common post-pregnancy condition seen in between 30-40% of postpartum women. It refers to the splitting of the abdominal muscles and disproportionately affects those who have had more than one child.
Between the abdominal muscles lies a band of connective tissue known as the line Alba; this is the attachment point for the abdominals. When this is stretched, it can reduce the strength of the abdominal wall, leading to symptoms such as instability, increased abdominal pressure, or a bulge in the midline of the anterior abdominal wall. When not addressed, Diastasis recti can contribute to stress incontinence and back pain.
The stretching and thinning of the Linea Alba occurs due to the growing uterus during pregnancy, which places significant pressure on the abdominal wall. The single greatest risk factor for diastasis recti is multiple pregnancies. Other factors, such as carrying large babies, advanced maternal age, and excessive weight gain, can be contributing factors.
Signs and Symptoms of Diastasis Recti:
People with diastasis recti usually have a visible bulge or ridge down the center of their abdomen; this is even more noticeable during movements like sitting up or crunches. Other common symptoms include:
- Lower back pain
- Poor posture
- Difficulty engaging core muscles
- Digestive issues, such as bloating or constipation
It’s important to address diastasis recti to prevent injury and back pain from the weakness in the core muscles and also to prevent stress incontinence, and to prevent future hernias.
Diagnosis
Usually, diagnosis is just by assessment. Treatment for Diastasis recti usually involves strengthening the abdominal muscles, which is recommended postpartum anyway.
Tools such as Ultrasound, MRI, and CT scans can be used, but this is usually only done for research purposes and is unlikely necessary for a regular patient.
How Can Physical Therapy Help?
Physical therapy is the recommended first-line treatment for Diastasis Recti. Treatment involves strengthening the abdominals and educating the patient. Here is a summary of a typical protocol:
1. Initial Assessment: An initial assessment is executed to evaluate the severity of the diastasis recti by measuring the separation and assessing muscle strength. After this, a personalized treatment plan will be developed
2. Education: Physical therapy includes educating patients on the causes of diastasis recti and the importance of specific exercises in recovery. Proper body mechanics, posture, and daily movement habits are key elements of this education.
3. Core Strengthening: Exercises are given that include abdominal activation, pelvic tilts, transverse abdominal contractions, and pelvic floor exercises in the early stages
4. Progressive Exercises: As the patient’s strength improves, the therapist will gradually introduce more advanced exercises. This will include Modified crunches leading to full crunches, planks, side planks, ball tucks, and lots, lots more
5. Breath Control: Proper breathing techniques play an essential role in core activation. Diaphragmatic breathing, for example, helps engage the core muscles effectively during exercises.
6. Postural training: Posture is determined by the resting tension between each pair of muscles. This can be assessed and corrected by your physical therapist. Good posture leads to less strain on the linea alba.
7. Long-Term Monitoring: A good therapist will continually adjust the treatment to cater to the patient as they develop over time
Final Thoughts
Diastasis Recti is a common condition experienced by many postpartum women, but with proper diagnosis and a tailored physical therapy plan, it can be effectively managed. Strengthening the core and improving posture can significantly reduce symptoms and improve overall quality of life. If you suspect you may have Diastasis Recti, consulting with a healthcare professional or physical therapist can help guide you toward the appropriate treatment path.
For a deeper dive into how physical therapy can help, you can read more about it here: https://www.miraclerehabclinic.com/blog/physical-therapy-for-diastasis-recti .
