Diastasis recti is a very common condition referring to the separation of the rectus abdominis muscles (also known as the “six pack”).

These abdominal muscles run vertically along the front of your stomach, and are divided into left and right sides by the linea alba.

The linea alba is a fibrous connective tissue that is flexible and elastic, which allows it to support changes in the abdominal muscles and your everyday movements.

This condition is mostly seen in pregnant or postpartum individuals, but can actually happen to anybody due to excessive pressure on the abdomen.

We’ll talk more about how diastasis recti is caused soon, but first, let’s talk about the symptoms that the condition can create.

Symptoms of diastasis recti can vary from person to person, and can range in intensity depending on the severity of the abdominal separation. Diastasis recti can be felt and seen, as it may create a bulge near the belly button that is soft to the touch.

Individuals with diastasis recti can experience a variety of symptoms, including the following:

• Difficulty lifting objects
• Painful sex
• Pelvic, back, or hip pain
• Urinary incontinence
• Constipation
• Poor posture
• In rare cases, a hernia
• And more

This disruption in core strength and muscle coordination can make it difficult for individuals to perform daily tasks. You may struggle to lift objects, even light ones, or experience a change in the shape of your stomach when you sit up or roll over.

While diastasis recti itself is not painful, it can affect your posture, breathing, flexibility, and other muscle groups in the long run if left untreated.

Many of the symptoms listed earlier are directly tied to the pelvic floor, too. The pelvic floor is a group of muscles located in the pelvis that help support your pelvic organs, provide stability and balance to the body, and allow for many important functions like urination, defecation, and sexual appreciation.

The pelvic floor and core muscles are closely interconnected, and must coordinate to allow for proper posture and movements like walking, lifting, jumping, and so on.

When one of these muscle groups experiences dysfunction, it affects the other. Pelvic floor dysfunction can harm the abdominals, and problems with the abdominals—like diastasis recti—affects the pelvic floor.

This is why diastasis recti often creates symptoms like urinary incontinence or constipation.

As mentioned before, leaving diastasis recti untreated can affect other parts of your body. Not just your pelvic floor, but also your hips and back, as you may begin to compensate for the lack of core strength and develop harmful habits in your movements or posture.

Start Healing with Hive

Diastasis recti is caused by increased pressure and tension on the abdominal walls. Most commonly, diastasis recti occurs as a result of pregnancy, which causes the abdominals and linea alba to stretch, especially during later trimesters.

It usually occurs during the third trimester, but often goes unnoticed until postpartum.

Many individuals will have diastasis recti for a number of weeks postpartum as the linea alba and abdominals slowly return to their normal, healthy state.

However, in some instances the linea alba becomes thinned or overstretched and does not return to its usual state, creating abdominal separation and a variety of uncomfortable symptoms.

There are also some factors that increase the likelihood of diastasis recti. For example, individuals who have pregnancies back-to-back are more likely to experience diastasis recti.

Additionally, having a vaginal delivery, a difficult delivery, a heavy baby, or a multiple pregnancy (twins, triplets) may make you more likely to have diastasis recti, as these factors put extra pressure on the abdominals and pelvic floor.

One other important aspect that can influence the likelihood of diastasis recti is pre-pregnancy preparation, or the health of your abdominals and pelvic floor before pregnancy and childbirth.

Having low core strength, poor muscle coordination, postural imbalances, or pelvic floor dysfunction before and during pregnancy can unfortunately affect your overall experience during pregnancy, childbirth, and postpartum healing.

While you may not be able to predict the outcomes of pregnancy, or necessarily prevent diastasis recti entirely, you can improve your outcomes and lower your risk of such complications by engaging in pelvic floor therapy for childbirth preparation.

Pregnancy is not the only cause of diastasis recti. Any individual, regardless of whether or not they were born with a uterus, can experience diastasis recti.

The linea alba can become overstretched from other causes that create excessive straining or pressure, such as heavy lifting (especially with poor technique) or chronic coughing.

Even in the case of non-pregnant individuals, having core weakness, poor muscle coordination, misalignment, poor posture, or pelvic floor dysfunction can impact your risk of diastasis recti.

These dysfunctions put excessive strain and pressure on the abdominals, and when these problems are combined with poor technique during exercise, this can weaken the linea alba and create a gap.

Lastly, other factors such as genetics can increase your risk of diastasis recti. Individuals with connective tissue disorders such as Ehlers-Danlos syndrome may be predisposed to diastasis recti.

Physical therapy serves as the primary treatment method for diastasis recti, and looks to correct any weakness or imbalances in the body that contribute to the condition.

Treatment for diastasis recti often requires both an orthopedic and pelvic floor physical therapy approach in order to properly resolve all possible contributors to the condition.

This is so that the health of the abdominals, core, and pelvic floor can be addressed in order to provide a comprehensive treatment.

With that being said, some treatments used to treat diastasis recti at Hive Therapy and Wellness include the following:

Core Strengthening

As you would imagine, regaining core strength, mobility, flexibility, and coordination is essential for addressing diastasis recti. Restoring your abdominal health will allow you to properly engage in daily activities without discomfort!

Therefore, your physical therapist will curate an exercise routine for you that focuses on gradually restoring strength and practicing good form.

This routine will need to start out with moderate exercises and progressively become more challenging as your condition improves.

Starting out with high-intensity exercises can worsen diastasis recti, so it is very beneficial to work with a professional who can guide you through the process.

In addition to improving your posture and abdominal strength, your physical therapist will also work on the flexibility and mobility of your core. This can involve stretching and therapeutic exercises that will address tightness and resolve harmful movement patterns that may cause tension in your abdominals.

Pelvic Floor Training

As mentioned before, the pelvic floor is very interconnected with the abdominals. Pelvic floor dysfunction can affect the coordination and mobility of your core muscles, and therefore should be addressed as a part of your treatment for diastasis recti.

Your pelvic floor therapist will identify any weakness, tightness, inflexibility, or lack of coordination in your pelvic floor and utilize a variety of treatments to address it.

This can include neuromuscular re-education and biofeedback to help you regain control of your pelvic floor muscles. These treatments allow you to better understand the role of your pelvic floor, and help you feel your pelvic floor muscles as they contract and relax.

Regaining control of these muscles is essential for restoring coordination between your abdominals and pelvic floor.

Additionally, once you have better control of your pelvic floor, you’ll be able to engage in strengthening exercises and relaxation practice—which will address weakness or tightness in those muscles.

Restoring good health to both your abdominals and pelvic floor will allow them to coordinate and function as needed, supporting your daily movements and reducing the effects of diastasis recti!

Correcting Breathing Patterns

As a part of your diastasis recti treatment, your physical therapist will address your breathing habits and patterns. Improper breathing patterns disrupt your intra-abdominal pressure, which can contribute to or worsen diastasis recti.

Intra-abdominal pressure refers to the pressure in your abdominal cavity, which fluctuates as you breathe and is affected by abdominal tension.

To prevent worsening of your condition and support good intra-abdominal pressure, your physical therapist will teach proper diaphragmatic breathing techniques and other breathing strategies.

Improving Posture and Coordination

Diastasis recti can significantly affect your posture, movements, and muscle coordination—vice versa, having poor posture, coordination, or movement mechanics can also contribute to diastasis recti.

Your physical therapist will be sure to address these aspects through postural corrections and educating you on proper form during activities such as lifting or transitioning between positions.

You can also expect to learn how to activate and coordinate your muscles during these activities in order to reduce strain on your abdominals and pelvis, and maintain good intra-abdominal pressure.

Tension Relief and Scar Tissue Management

In order to further relieve tension in your abdominals, pelvic floor muscles, and diaphragm, your physical therapist can use manual therapies to reduce tension, address trigger points, and relieve muscle tightness.

Manual therapies are physical techniques that manipulate tissues such as muscles, nerves, ligaments, and tendons.

Manual therapies can also be used to address scars and adhesions from past surgeries or injuries, which may impact core mobility and comfort.

At-Home Care

To support long-term prevention of diastasis recti and maintain good abdominal health, your physical therapist can educate you on at-home care techniques.

This may be core or pelvic floor exercises, breathing exercises, practicing good posture, and strategies to avoid excessive straining.

Whether you are currently experiencing diastasis recti, planning to become pregnant, or are just concerned about your abdominal health, physical therapy can be very beneficial for your health journey.

The providers at Hive Therapy and Wellness work hard to provide a holistic and comprehensive treatment plan for each and every patient in order to best support their health goals.

When addressing diastasis recti, Hive’s physical therapists may include any of the following treatments in your care plan:

• Neuromuscular re-education 
• Manual therapy
• Exercise prescription 
• Dry needling 
• Cupping 
• Tissue scraping 
• Behavioral modifications 
• Therapeutic activities 
• Electrical muscle stimulation
• Spinal manipulation 
• Therapeutic modalities 
• Biofeedback