Diastasis Recti (DR) is a widening of the space between the “6-pack” abs (rectus abdominis). DR can contribute to poor posture, low back pain, pelvic pain, abdominal pain, incontinence (leakage), pelvic organ prolapse, and difficulty pushing during labor.
Pelvic floor physical therapy provides individualized guidance to ensure proper core muscle engagement, helping to strengthen and coordinate the abdominal wall through progressive abdominal loading. We can perform abdominal myofascial release, prescribe individualized exercises, and educate on pressure management.
Tips to Minimize DR Width & Depth:
Properly manage increases in intra-abdominal pressure – exhale and pelvic brace on exertion. Work with a pelvic PT to ensure you know how to perform a pelvic brace correctly.
Perform abdominal myofascial release Work with a pelvic PT to show you how.
When transitioning from lying down to sitting up, try to avoid jackknifing or sitting straight up. Instead, log roll onto your side before sitting up.
Approach heavy lifting, sit-ups, crunches, and twisting activities with caution. A pelvic PT can provide individualized guidance to progressively load the abdominal muscles and help you return to these activities symptom-free.
Strengthen the core musculature prenatally, during pregnancy, and postpartum to help prevent and improve diastasis
Ensure you’re not letting your belly bulge out during exercise, especially core targeted exercises. You should be able to keep your transverse abdominis engaged and drawn up and in towards the spine during the exercise. If you’re unable to do this or you experience any of the 3 “P’s” (Pain, Pressure, or Pee your pants) modify the exercise.
Maintain good posture – Check your posture in the mirror, aiming for a neutral pelvis (not tucked in but not sticking out), with the rib cage stacked over the pelvis (not tipped back). You can do mini squats or core activations here to retrain the posture, or stand against a wall with your heels, pelvis, ribs, and head pressed back against the wall.
Wear an elastic binder/abdominal support during pregnancy (Baby Belly Band is great).
A postpartum belly band can be a great tool immediately postpartum (up to 2-6 weeks) while working on building a strong core or longer if experiencing severe diastasis with back pain (Belly Bandit is great).
Wear the band low so that the bottom is at the pubic bone, and ensure it is slightly looser at top to avoid compressing organs downward. You can gently pull your belly up from under the band and in towards the midline to avoid downward pressure and to approximate the muscles. Take the band off if you experience increased pelvic pressure/heaviness, pain, or urinary leaking. Remember to not rely solely on the band to do work for you.
In pregnancy, a large DR can cause the uterus to shift forward. Wearing a belly band during labor can be beneficial in providing support and stability.
~These tips and tricks are not medical advice and do not replace pelvic floor physical therapy~
DR risk factors include:
Excessive low back arch/Poor abdominal muscle tone
Tightness along the sides of the trunk and back
Inactivity during pregnancy
Aggressive abdominal exercises after the 1st trimester
Being petite
Being over 35 years old
Expecting more than one baby/Increased number of childbirths
Obesity/Large baby/More weight gain during pregnancy
DR in a previous pregnancy
Previous Cesarean section