Diastasis recti abdominus, DRA, or sometimes called just plain old diastasis can affect anyone. Most commonly we see this condition in the prenatal, postpartum, or post (abdominal) surgical populations.
What is a diastasis
Contrary to popular belief, you aren’t split down the middle. Rather the connective tissue that connects the rectus abdominus AKA your six pack abs loses tension. This loss of tension results in cosmetic changes to the abdominals.
For example, many people complain of “mommy tummy” after giving birth. Rather than a couple extra pounds on the belly, the abdomen takes on a protruding appearance. It could be DRA.
See below for an illustration of diastasis.
How to improve diastasis
So just build up your core… it’s that simple, right? You can try all the crunches or waist trainers that you saw on tik tok, but still not see the results you want.
It’s all about how your diastasis behaves. If you find the middle of your belly is pushing out and rigid when you crunch or lift up your child, then your abdominals may be a bit over taxed (Lo 2023). You may need some help to modify that strategy.
Doing breathing exercises on repeat and not seeing results, you probably need to challenge your abdominals much more.
There is no one size fits all treatment for diastasis. That’s where pelvic floor physical therapists come in.
Your core is more than six pack abs
Your core is a pressure management system like a canister. Your diaphragm creates the lid, your pelvic floor forms the bottom, and your deeper abdominal muscles, along with the obliques, and rectus abdominus wraps around 360 degrees. See below.
Every-time you inhale the diaphragm lowers down with the pelvic floor. When you exhale, the diaphragm lifts along with your pelvic floor. With an intact core, these movements keep pressure well managed.
Diastasis causes a disruption in this canister.
A pelvic floor physical therapist has the tools to address all parts of the canister.
For example, an under-active or overactive pelvic floor will cause some pesky problems. Pressure has to go somewhere, this can result in leaking when you sneeze, some really tight hip flexors when you try to work out, or heaviness and bulging in your pelvic floor when you lift.
A pelvic floor PT, will help you gain the mobility and strength in your pelvic floor that you need to create a strong foundation.
In addition, your pelvic physical therapist uses hands-on techniques to optimize tension across the abdominal wall which helps your muscles fire better. If you had abdominal surgery or a cesarean birth, your scar can be limiting your progress. A tight and stiff scar can prevent your muscles from engaging correctly. Your therapist can help mobilize your scar and teach you techniques for home mobilizations.
Your PT will also teach you the correct way to engage the whole core canister system so you can build better strength and improve tension across your diastasis.
Do you think you have a diastasis? More exercise does not always equal improvement. The core canister is a complex system. A pelvic floor physical therapist can guide you in your diastasis recovery.
Lo, A. (2023) Diving into Diastasis. The Physio Detective.