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Diastasis Recti Women's Health Physiotherapy

Diastasis recti, also known as Diastasis recti abdominis (DRA) is a separation of the rectus abdominal muscles at the linea alba. It can occur as a result of prolonged transverse stresses on the linea alba in women during pregnancy, Post-menopausal women and men.

Effect of pregnancy on Diastasis Recti

During pregnancy, the linea alba has to accommodate a growing fetus, consequently the line alba softens causing an increase in the width of the linea alba (inter-rectus distance or IRD). This tends to be experienced by women in their third trimester.

What is the linea alba?

There are two rectus abdominis muscle heads which run parallel to each other and are separated by connective tissue in the middle of the body which is the linea alba.

How do I know if I have Diastasis recti? (DRA)

Confirmation of a DRA comes from assessing the inter-rectus distance.

If the therapist can place two or more finger widths (approx. 2cm) in the sulcus between the medial borders of the rectus abdominus muscles, then the patient may be presenting with a DRA. This palpation can be sufficient in detecting the presence of or absence of diastasis recti.

How is Diastasis recti abdominis (DRA) managed?

1. Patient education: It is important to understand how generating tension in the connective tissue (linea alba) by working the tranversus abdominis and pelvic floor alongside retraining of the diaphragm function helps to strengthen the core.
   
   
2. Pelvic Floor exercises (Kegel exercises): can help strengthen the deep abdominal muscles because all the core muscles contract as a cohesive group. We encourage pelvic floor exercises to be performed throughout pregnancy and post-partum too!
   
   
3. Breathing exercises: help to retrain the diaphragm by training it to descend after giving birth. During pregnancy, as the uterus grows, the diaphragm is pushed upwards. Since the diaphragm forms the top of the core muscles, the breathing exercises help to retrain the diaphragm to full function.
   
   
4. Core strengthening exercises: help to improve pelvic alignment, tone the abdominals, develop dynamic stability and train the synergistic functioning between the external and internal layers of the abdominal wall
   
   
5. Avoiding sit-ups and crunches: these types of exercises can put a strain on the pelvic floor and can increase intra-abdominal pressure. It is best to avoid these during pregnancy and in the post-partum period.
   
   
6. Completing activities of daily living without increasing abdominal pressure.
   
   
7. Postural awareness: helps women to become aware of certain stresses on their body in certain positions and how to minimize rigidity in the upper spine and over-using the wrong muscles.
   
   
8. Using abdominal binders: these can be helpful in the post-partum period, however the wrong use of them can also cause problems, so it is best to seek the advice of a qualified Physiotherapist specializing in Diastasis recti.