Diastasis rectus abdominis (DRA) is a condition in which the two sides of the abdominal muscle separate, as the tissue connecting them stretches. This typically happens in women during and following pregnancy due to the stretching of the abdominal wall, as the uterus expands. Physical therapy has been shown to be a highly effective diastasis recti treatment, helping to prevent and address diastasis recti pain.
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DRA is a common condition that affects many women during the childbearing years. As a fetus grows within the uterus, the uterus expands, which places stress across the structures surrounding it, specifically the muscles. The primary abdominal muscle on the front side of the body is called the rectus abdominis. This muscle is divided into a left and right half by a thick band of connective tissue called the linea alba. You may hear people talk about “6-pack abs”; this is referring to the rectus abdominis. As the uterus expands, stretching across the rectus abdominis could occur. In some cases, the weakening and stretching of the linea alba connective tissue creates a separation between the right and left sides of the muscle, or diastasis.
DRA may affect women during and after pregnancy. Typically, DRA develops in the second or third trimester. It is during this time that the fetus is growing most rapidly and can result in the greatest increase in distance between the two sides of the muscle, potentially resulting in diastasis recti pain.
There are several factors that may make a woman more susceptible to developing DRA. These include age, being pregnant with multiple children (multiparity), and having many pregnancies. The abdominal muscles have many important functions within the body, including postural support, movement, breathing, and protection of the internal organs. Therefore, if their structure is affected by DRA, a woman may have difficulty controlling her posture, which may put her at an increased risk for injury. Additionally, for a woman juggling the many stresses of having a new baby, the discomfort, weakness, and changes to postural control that may result from DRA can negatively affect her quality of life.
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Can diastasis recti cause pain? Yes, it can. Although separated abdominal muscles themselves are not always painful, diastasis recti symptoms can cause pain and discomfort. For pregnant women, symptoms of diastasis recti typically develop gradually over the course of the pregnancy and may linger following labor and delivery.
It’s common to experience any number of the following diastasis recti symptoms:
• A visible and palpable (detected by touch) separation of the rectus abdominis muscle.
• Feelings of “flabbiness” in the abdominal muscles.
• Pelvic-floor muscle dysfunction that causes urinary or bowel problems (incontinence, leakage, constipation, etc).
• Low back or pelvic or hip pain.
• Poor posture.
• Feeling weak through the midsection.
• Sexual pain.
Following a cesarean section (C-section), scarring of the incision may accentuate some diastasis recti symptoms.
Diastasis recti symptoms typically recede as the abdominal muscles heal, but as many as 1 in three women report ongoing issues with abdominal separation 12 months after delivery. Although there’s no way to ensure that diastasis recti does go away quickly after the birth of the baby, you can improve the outlook by seeking treatment at the first sign of diastasis recti symptoms. With the help of a physical therapist, you may be able to reduce symptoms and prevent DRA complications.
Your physical therapist will review your medical history and conduct a thorough interview about your condition. This may include specific questions regarding your pregnancy, labor and delivery, type of delivery (C-section or vaginal), presence of pelvic pain, and information related to your physical recovery, including your breastfeeding habits. Your physical therapist will also ask you when your symptoms began, and how they are impacting your daily life.
The primary diagnostic test for DRA is to perform a gentle abdominal examination to note the degree of separation of the abdominal muscle. Your physical therapist will also assess other factors, such as your posture, back, and hip movement (range of motion), and muscle strength. After this evaluation, your physical therapist will come up with a diastasis recti treatment plan.
Physical therapy is a very effective diastasis recti treatment, helping to manage symptoms and improve functional capacity when DRA is diagnosed. Your physical therapist may help you with:
If you are struggling with diastasis recti pain, request an appointment with IMPACT Physical Therapy. Our expert physical therapists can help assess your symptoms and develop a diastasis recti treatment plan designed to regain strength and comfort.