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Can Physical Therapy Heal Diastasis Recti?

Updated: Jul 18



The "mommy pouch" or Diastasis Recti (DRA), is a possible outcome of pregnancy that the diet and fitness industry greatly profit off of.


But believe it or not, doing crunches, sit ups, v-ups and everything else you're doing in an Ab Lab class might actually be making it all worse!


Medical solutions for DRA include physical therapy and surgery. Physical therapy should be used before and after surgery if surgery is required, in order to improve healing times and decrease risk of reoccurrence post op.


Physical Therapy is the best intervention for Diastasis Recti and should always be implemented before considering an Abdominoplasty.

To understand why this is, let's first get into what Diastasis Recti actually is. The word Diastasis means separation. Recti refers to the Rectus Abdominis, which are the two superficial strap-like muscles that comprise our "six-pack" abs.


We define DRA as a separation of two fingers, or two centimeters.


Who gets DRA


When DRA occurs, the two muscles are separated. This is a common occurrence during the later stages of pregnancy, but can also appear in infants, abdominal obesity, and IBS/constipation, abdominal surgeries, and heavy lifting with poor mechanics.


DRA in Pregnancy


DRA is very common during pregnancy, normal DRA will occur around the third trimester and spontaneously heal by 6-8 weeks postpartum.


27% of women in the second trimester have DRA

66% of women in the third trimester have DRA

53% persist immediately postpartum

36% remain at 7 weeks postpartum


(Boissonault and Bleschak)


Spontaneous healing of DRA only occurs up to 8 weeks postpartum. No further improvements will be made without intervention (Coldron Y et al). This is one reason why early postpartum physical therapy is so critical for moms. Moms can and should begin healing their DRA immediately postpartum.


DRA is also associated with other issues including prolapse, pee leaks, pelvic and back pain, and increased risk of abdominal injury.


Can pelvic floor PT fix it?


Pelvic floor physical therapy will help retrain the core system to support the body and in doing so heal the DRA. Some clients do find that their separation decreases, others regain strength and support but have no decrease in separation.


Pelvic floor physical therapy will always help restore the system to healthy function and strength, but only surgery is a guaranteed fix for the gap.


As abdominoplasty surgery is extremely invasive with a difficult recovery time and 40% failure rate, it should absolutely be considered a last resort for extreme cases of DRA.


Conclusion


Pelvic floor physical therapy is an extremely important part of prenatal physical therapy and can help moms decrease severity and risk of developing DRA, as well as act to initiate early postpartum rehabilitation of the abdominal wall.


Although physical therapy cannot guarantee a decrease in "the gap," it will improve function, strength, and decrease other risk factors associated with DRA. Women can function well, even with a gap, if they are able to restore stiffness and strength to the core system.


If an Abdominoplasty is chosen for addressing DRA, physical therapy should be integrated before and after surgery to improve surgical outcomes and decrease reoccurrence of DRA post op.





  1. Boissonnault JS, Blaschak MJ. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther. 1988 Jul;68(7):1082-6. doi: 10.1093/ptj/68.7.1082. PMID: 2968609.

  2. Coldron Y, Stokes MJ, Newham DJ, Cook K. Postpartum characteristics of rectus abdominis on ultrasound imaging. Man Ther. 2008 May;13(2):112-21. doi: 10.1016/j.math.2006.10.001. Epub 2007 Jan 5. PMID: 17208034.

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