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Dips and Splits. We are not Talking Gymnastics, We are Talking Diastasis Recti

By Michal Porath PT, MPT, McKenzie A-D, Advance Schroth Certified SSOL And Jessica Lowy PT, DPT, CMTPT, DN, McKenzie A-D,  Advanced Schroth Certified SSOL

What is Diastasis Recti?

Diastasis recti, a condition characterized by the separation of the abdominal muscles, is a common condition, especially among postpartum women. This condition can lead to a weakened core, lower back pain, and a protruding belly.  Physical therapy can play a crucial role in managing and improving diastasis recti, offering hope and recovery for those affected. Diastasis recti occurs when the left and right sides of the Rectus Abdominus muscle separate along the midline of the abdomen. The rectus abdominis runs vertically along the front of your stomach, and is frequently referred to as your “six-pack.”  This separation is caused by the stretching of the linea alba, the connective tissue that runs down the center of the Rectus Abdominus muscle. Diastasis recti most commonly occurs in women during and after pregnancy from the growth of the uterus. As your uterus expands during pregnancy, the abdominal muscles are stretched and the linea alba thins and pulls apart. It is important to note that while it is most commonly associated with pregnancy, diastasis recti can also affect men, infants, and individuals who have experienced significant weight fluctuations.

Causes and Risk Factor

The primary cause of diastasis recti in women is the stretching of the abdominal muscles during pregnancy to accommodate the growing uterus. Factors that can increase the risk include:

  • Multiple pregnancies
  • Carrying multiples (twins, triplets, etc.)
  • High birth weight of the baby
  • Advanced maternal age
  • Excessive abdominal exercises during pregnancy

In men and non-pregnant women, diastasis recti can result from improper weight lifting techniques, rapid weight changes, or excessive abdominal strain.

Symptoms

The symptoms of diastasis recti can vary in severity and may include:

  • A visible bulge or ridge along the midline of the abdomen
  • A feeling of weakness in the abdominal muscles
  • Lower back pain
  • Poor posture
  • Gastrointestinal discomfort

Diastasis recti in itself is not painful. You may feel pain associated with some of the side effects of the diastasis, but the ab separation itself doesn’t hurt. You may feel weakness in your core when doing once easy tasks, like lifting a laundry basket. Some people feel a jelly-like texture in the space between the left and right abdominals when contracting the ab muscles.

Can I test myself for Diastasis Recti?

Yes you can! Here’s how:

Lie on your back with your knees bent and feet flat on the floor.

Lift your shoulders slightly off the ground, keeping one hand behind your head for support. Almost like you are doing a sit-up. Look down at your belly.

Move your other hand above your belly button area, palms down and fingers towards your toes.

Use your fingers to feel for a gap between the abs. See how many fingers can fit in the gap between your right and left abdominals.

If you feel a gap of two or more finger widths, discuss your concerns with your healthcare provider. They should confirm diastasis recti with a proper diagnosis and recommend appropriate care.

The Role of Physical Therapy

Physical therapy is a highly effective, non-invasive approach to managing diastasis recti. A physical therapist (PT) specializing in this condition can create a personalized treatment plan to help patients regain strength and function in their core muscles.

Assessment and Diagnosis

The physical therapist will begin with a thorough assessment to determine the extent of the separation and evaluate the patient’s overall core strength and function. This involves a physical examination and specific tests to measure the gap between the abdominal muscles. Diastasis recti can occur above the belly button, below the belly button and at the belly button. Your PT will use their hands and fingers to feel the abdominal area for gaps, dips and muscle tone. Some providers may use ultrasound, measuring tape or a tool called a caliper for a more accurate measurement. This exam typically occurs at your postpartum appointment before being cleared for exercise.

An abdominal gap wider than 2 centimeters is considered a diastasis recti. Diastasis recti is also measured in finger widths, for example, two or three fingers’ separation.

Treatment Plan

The treatment plan typically includes a combination of exercises and techniques designed to strengthen the core muscles, improve posture, and reduce the separation of the abdominal muscles. Key components of the plan may include:

  • Deep Core Activation: Exercises that target the transverse abdominis, the deepest abdominal muscle, to provide stability and support to the core.
  • Pelvic Floor Exercises: Strengthening the pelvic floor muscles, which work in conjunction with the deep core muscles, to enhance overall core stability.
  • Breathing Techniques: Learning proper breathing techniques to engage the core muscles effectively during exercises and daily activities.
  • Postural Training: Improving posture to reduce strain on the abdominal muscles and promote healing.
  • Progressive Strengthening: Gradually increasing the intensity of exercises as the patient’s core strength improves, ensuring a safe and effective recovery process.

Education and Lifestyle Modifications

In addition to the exercise regimen, physical therapists educate patients on lifestyle modifications to support their recovery. This may include advice on proper lifting techniques, safe exercise practices, and ergonomic adjustments to daily activities.

Diastasis recti can be a challenging condition, but with the right approach, recovery is possible. Physical therapy offers a safe, effective, and personalized solution to help patients regain their strength and confidence. If you suspect you have diastasis recti, consult with a physical therapist to develop a tailored treatment plan and embark on your journey to recovery.

At Prime Orthopedic Rehabilitation, we have both male and female therapists.  Our therapists all hold advanced certifications to help with your specific needs, including Orthopedic Certified Specialist (OCS) certifications for orthopedic specialties, McKenzie approach for spine, Schroth Certification for Scoliosis, Graston and John Barnes techniques for Myofascial Release, as well as LSVT (BIG) for Parkinson’s treatment, Vestibular rehab for dizziness, balance and vertigo, Strength and Conditioning certifications (CSCS) for Sports Rehab, as well as therapists certified in dry needling, cupping, and instrument assisted soft tissue mobilization (IASTM). We offer general outpatient physical and occupational therapy, both in our offices, in Tenafly and in Northvale, and In-Home.  Prime also has seventy 5-star google reviews and offers more one on one time than most other offices.  Call us today to ask how we can help you (201) 503-7173.

Jessica Lowy, DPT, CMTPT, DN, Mckenzie A-D, Advanced Schroth Therapist and Michal Porath, MPT, Mckenzie A-D, Advanced Schroth Therapist are owners of Prime Orthopedic Rehabilitation in Tenafly and Northvale, NJ. They treat all injuries in their clinic, in addition to general orthopedic and post surgical patients. Call (201) 503-7173 for an appointment.


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