There is really no shortage of information floating around about diastasis recti (DR).
A recent study found that 100% of women experience diastasis recti (DR) by 35 weeks of pregnancy. Some women spontaneously heal by several weeks of postpartum and many do not, requiring a more focused approach to address the DR. Research has also not been able to find a direct link between postpartum DR and any of the following factors: maternal weight gain, baby’s birth weight, pre-pregnancy body mass index (BMI) or BMI at 6 months postpartum (Lee, 2017).
A google search of the term diastasis recti (or more formerly called diastasis rectus abdominis (DRA)) will result in an abundant amount of resources that do anything from explain the condition to offer exercises and advice on how to “close the gap.” Though awareness of DR has seemed to increase, talk to any woman who has been pregnant in the last 10 years and you will still find many who do not know what DR is and have never had anyone discuss it with them.
The current challenge seems to be working through the various resources, some of which seem contradicting, and knowing what information to apply and what resources to trust. That is the most frustrating thing. Like much information available to us on the internet, information found when googling DR can be very informative and factual or it can be confusing or lack correct detail and scope of what influences healing. So, what are a few things you MUST know about diastasis recti?
1. DR is NOT just about a gap or separation.
Diastasis recti is a significant separation of the space between the two columns of the rectus abdominis muscle. The area of separation occurs at the linea alba, which lies between the columns of the rectus. The rectus abdominis muscle also has a sheath covering it that endures stress and stretch during pregnancy, resulting in separation as well. DR that does not heal spontaneously after birth likely does not due to abdominal wall dysfunction. So, the continued DR is merely a symptom of what is going on at a deeper level. To place exclusive focus on the separation itself is missing out on what needs to be addressed to heal it. And, that leads me to #2.
2. DR healing and treatment is multi-faceted
Diastasis recti, as mentioned, is a symptom of a deeper problem. For many, DR that is assessed and treated thoroughly leads to great healing and functional gains. To heal DR thoroughly, a program must include assessing all abdominal muscles and addressing any weaknesses that are found. This is by far one of the most heavily emphasized pieces of any online or in-clinic program. However, if a program relies on this solely, it is lacking other very significant influencers of DR. Our bodies function as a large unit comprised of many systems and parts that influence the whole. A treatment plan to heal DR must include consideration of this and include assessment of the breath (breathing mechanisms), abdominal strength, alignment, body mechanics (how do you move?) and consideration of individualized healing. Another important part of healing, especially postpartum, is the influence of hormones and our diet (what are you fueling your body with?). Don’t forget that everyone may heal differently, so your connective tissue may not “bounce back” the same as someone else’s tissue. That reminder brings me to #3.
3. There are NO quick fixes; healing takes time.
That is just the honest truth based on science and my professional experience, but it doesn’t and shouldn’t take away the fact that healing is possible. If you come across an article or program that promises amazing results of fixing DR with one exercise or an “easy-to-do plan” you should be very cautious. And notice that I mentioned “fixing.” What I focus on with patients is healing, and healing is more about just the gap, is multi-faceted in treatment and takes time. With all of that in mind, rest assured that with the right help, you can work to heal DR.
Reference: Lee, Diane. Diastasis Rectus Abdominis. A Clinical Guide For Those who are Split Down the Middle. 2017.
Dr. Robyn Wilhelm, PT, DPT, Private Practice Owner in Mesa, Arizona specializes in pelvic floor and women's health physical therapy. Connect with Dr. Wilhelm on her practice website http://www.wilhelmpt.com.
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Dr. Robyn Wilhelm, PT, DPT specializes in women's health and pelvic PT. An Ohio native, she enjoys Buckeye football and misses the Fall season. Dr. Robyn enjoys her life in Arizona and spending time with her husband, two kids and Chocolate Lab George.