How to Heal a Diastasis Recti: And Why Avoiding it Can Lead to Long-Term Issues
If I had a nickel for every time I heard someone tell me that their doctor, friend, mom, grandma (insert whoever likes to give postpartum advice) told them that their postpartum issue will just go away with time, or heal on it’s own…man, I would have a lot of nickels! In certain cases and in certain people, some postpartum issues will heal without intervention; however, Diastasis Recti (DR) is typically not one of them. In this blog post, we are going to uncover what Diastasis Recti is, how we can heal it, how it connects to the pelvic floor and further options for healing if you feel like you’ve already tried everything!
The Impact of a Diastasis Recti
Women who are diagnosed with Diastasis Recti are more likely to have a higher degree of postpartum pain - particularly in the abdominal and pelvic region. It is estimated that 4 out of 10 women report persistent low back pelvic pain for 6 months after delivery. And for many postpartum women, DR is not a health issue that will spontaneously resolve on its own, and in fact, may even last for many years postpartum (*). So, that old saying of, “Just give it time.”, is not necessarily a phrase to hold hope in. And all this is in NO WAY meant to scare you, but instead, inspire you to take control of your postpartum healing and TAKE ACTION!
What is a Diastasis Recti?
Diastasis Recti is the separation of the two sides of our rectus abdominis muscle (think 6-pack abs muscle) that often occurs with pregnancy - as baby grows, your body grows and stretches as well. The distance between the two sides (width) is known as the inter-rectus distance (IRD), and is how we measure if you have an actual DR or if you just have normal separation, as some separation is to be expected and a normal part of pregnancy. In order to be considered an actual DR, the distance must be 2 cm or more of IRD. However, more research is continually emerging, and there is thought to increase that distance to needing 3.5 cm or more of separation to be considered a DR (*). Another thought to consider is not just the WIDTH of the separation, but also the DEPTH of the DR. And along with that, a DR can occur below the belly button, at the belly button, above the belly button and/or the entire length of the rectus abdominis (known as an “open diastasis”). Check out my YouTube video below on how to perform a DR check on yourself! Aside from aesthetics, the location of the DR doesn’t necessarily matter or impact the treatment…and that is not to down play the aesthetics of it at all, as how you feel about the way that you look postpartum MATTERS and is 100% a reason in itself to seek treatment!
How do we Heal a Diastasis Recti?
There are definitely things that a pelvic floor physical therapist can help you with in order to start the healing process! To start with, the first thing that needs to happen is EDUCATION. The more you understand your body, what’s happening, how it’s working and how it can heal, the better your overall DR healing will be - which is EXACTLY why I created this FREE resource for anyone struggling with healing their DR. Click the button below to download my FREE Diastasis Healing Guide and gain further education on healing and exercises you can begin with.
Along with education and understanding, here are some other important aspects of healing a DR:
Targeted connection to the deep core & pelvic floor
A targeted connection starts with breathing! Learning breathing techniques, managing your pressure system, accessing your pelvic floor’s full range of motion and coordinating your breathing with your pelvic floor range is ALL apart of the foundation for healing your DR.
Full body mobility
Once the foundational aspects are achieved, next it’s time to move to the full body approach! This is how you can learn to utilize your deep core and pelvic floor in coordination with the way that your body moves throughout the day while performing various tasks and being functional! Because what is the point of learning proper breathing techniques, gaining full range of motion of your pelvic floor and coordinating the two, unless you ALSO learn to utilize that while you are doing your normal, daily activities and performing full body mobility??
Fascial restriction release
Sometimes, when injury or dysfunction occur, the body naturally develops a “stiffness” to it. It does this as a way to protect us, but also reduces the ability of our tissues to move freely. That’s where fascial restriction release comes in. In order to regain full, functional mobility and allow for functional strengthening as well, the tissue has to be able to get to those end-ranges! Fascial restriction release techniques can assist with that and help reduce those adhesions that can occur after pregnancy, birth and postpartum healing events.
How Does Healing Your Diastasis Recti Connect to the Pelvic Floor??
The rectus abdominis is a part of the core. For a quick refresher on the anatomy and layering of the deep core, refer back to my “Deep Core” blog post! It is one of the most external parts of the core, but still very much plays a role in our stability and ability to manage our intra-abdominal pressure. And the pelvic floor is the base of the deep core. So, the core and pelvic floor work hand-in-hand to create the optimal intra-abdominal pressure that helps to protect our bodies and allow it to work correctly. This also means that if one of them fails (like when a DR occurs), that will impact the other. If pressure is escaping or pushing through our rectus abdominis, then what does that mean for the other parts of the core that rely on the rectus abdominis to do its job?? It means that everything else has to try to make up for that lack of stability, and in turn, can end up creating problems in those other areas. This is how a DR can lead to increased back pain, increased pelvic floor stiffness or pain, and overall increased weakness and stability. Our body is like a chain, everything is connected in one way or another, so when one area struggles, the other areas try to compensate for it, which is fine for the short-term, but if we don’t work to fix the original problem, then those other areas that are compensating for that problem are ALSO going to start to suffer! With all that said, this is why I do not recommend having the game plan of “time” to treat your DR!
Need More Guidance for Healing Your Diastasis Recti?
If you have a suspicion that you may have a DR and have tried figuring it out on your own but to no avail, do NOT give up hope, there is still help! You are the EXACT reason I created my Mind Body Core program. I do not want you having to deal with trying to heal your DR on your own. I don’t want you to feel like there is no other option and play the “just wait and see” game. My program will walk you through step-by-step on what you need to do for your postpartum issue, and not just for DR, but for so many other postpartum experiences as well…
Diastasis Recti
C-section Rehab
Prolapse
Incontinence
Pain with sex
Tailbone pain
Hemorrhoids
Perineal tears
Tight Pelvic floor/Weak Pelvic Floor
Interstitial cystitis and overactive bladder
Pubic symphysis dysfunction
Mommy wrist
Low back pain (SI Joint)
Rib flare
Mom pooch
Umbilical hernia
C-section shelving
If any of those symptoms or experiences pop out to you, you may be wondering HOW my program is going to help you and what all is included. Let me lay it out for you - this is what you will get with Mind Body Core:
Step by step guidance on healing the core, pelvic floor and common postpartum dysfunctions
12 week rehab protocol that targets the deep core and pelvic floor as well as encompasses a full body holistic approach
Guidance on how to return to running safely as well as guidance on how to return to the exercise YOU want to get back to
Runners checklist with guided testing videos
6 week check up checklist and tools
Education on proper functional movement to protect your body with baby
Full anatomy overview of the pelvic floor and core
Tips for “finding your pelvic floor and core”
Know when it is too much and signs to look out for when you need further care
C-section education
Education on what a c-section is
Weekly scar massage work
Scar healing guidance
How to use binders/bloomers for support
Functional movement with a c-section
A 2 week pre-phase for c-section mom’s for best possible healing outcomes
I understand that some have difficulty accessing a pelvic floor physical therapist for in-person sessions and may not even have that option even if they did have access to one. For this reason (and more…), I created my program to improve ease of access to material and education that can help postpartum women. I created this program to give women an option who may currently feel like they don’t have an option for healing their body. I created this program for every single one of you who has ever been told that there is nothing that can be done for your postpartum issue or that your postpartum issue is just a normal part of having kids and is now your burden to bear. No. I do not accept that, and neither should YOU! There is help, there are answers and I am here to help you figure it out!
Doc Lizzie
*(Thabet & Alshehri, 2019) & (Cavalli 2021)