Physical therapy Rant on Diastasis Recti - Legacy Physical Therapy

Physical therapy Rant on Diastasis Recti

These days, Diastasis recti, is a topic we see all over the place from different moms groups discussions, to advertisements targeting women for different programs that promise you the “one magical thing” that is going to get everything right for your abdomen. 

Diastasis recti is a fancy word describing a separation of your abdominal muscles. There is a line of connective tissue between your abdominal walls called the linea alba that gets stretched out as the baby grows.This is extremely common in the late 3rd trimester of pregnancy. After giving birth, the separation for some women, it goes away right away and then some women need some help with closure of the separation.   

We have two main pet peeves, and when we talk about Diastasis that seems to be going around in the industry right now. 

1) Absolute Recommendations 

What we mean by that is when people are given recommendations like “everyone should use a brace binder” or “you should never do a crunch or never do a plank” “surgery is the only fix for you”. These absolute statements are absolutely FALSE.  

The real answer, which can be frustrating, is “it depends”. It depends on the person, and what they need to do based on what is going on with their abdominal muscles and surrounding tissue. The treatment needs to adjust based on the person. There are some people that a brace would be appropriate or some people that should be avoiding a plank but others could be just fine to do this. A thorough individual assessment is vital to make sure you are doing the right things based on your body, to assist with closing your diastasis. 

2) Programs where every person gets the exact same instructions and exercises

Now, we’ll put a caveat out there, there are some wonderful online program that we’ve recommended to clients who are unable to join us in person at legacy and for the sake of trying to help as many people as possible, there is some standardization to the exercises that must be done, but everything can’t be tailored to what works best for you.

 This is where we find most people go wrong, they follow the one size fits all program, and it’s not working for them but they continue anyway and could possibly be doing more harm for themselves than good. This is where partnering with a women’s health physical therapy could be helpful, to supplement and tailor the program to you and your needs and get the most bang for your buck with your workouts. 

Those are our 2 pet peeves, but we also want to take a moment to set the record straight on diastasis recti in general. 

Diastasis recti is actually a very normal part of pregnancy. Research shows, there will be some level of separation of the abdominal muscles for pretty much 100% of women by the late 3rd trimester. Diastasis is not something that’s wrong, it’s a normal part of how our body makes room for the baby. 

In the post-partum period, what’s important to take note of is if there are any ongoing issues such as pressure regulation, or how the abdominal muscles are working or other concerns that are individual to each client. It’s not just about the gap, it’s never just about the gap, but the gap is what people tend to make the most big deal about. 

We frequently see women that are scared into thinking that they have an abdominal separation and because of that they shouldn’t be doing any type of exercise or movements because it could make it worse. When they come in for an evaluation, they actually have a very small or no separation but they are still dealing with a “mummy tummy”. This can be a result of many different things. It can be loose, saggy skin or muscles, extra fatty tissue, abdominal muscles that aren’t contracting and working well together,  And/or it might be partly as a result of a Diastasis or a separation there too. Since there are many things that play into it, people falsely assume they have a diastasis, but ignore that other things that play a role.

One of the most common questions we get is ““Is it necessary, or should I be wearing an abdominal binder or a wrap?” Some people will definitely benefit from some short term use of an abdominal binder or wrap, we especially recommend it in the first couple weeks postpartum as everything’s shrinking back up into place & it gives some nice comfortable support. You want the level of support where it feels like a gentle hug, and not like your insides are getting squished out and after the first couple weeks, we are aiming for women to wean out of it. Most women shouldn’t need a brace past the early postpartum time. There are some women where bracing is necessary for them, these would be women that have a very large separation or women that are candidates for surgical repair that need the abominable brace to create support. We just don’t believe in the catch all mentality, where everyone needs to wear a brace. There are some programs out there that require the use of brace or binder to rehab diastasis and we do not agree with this. If you are currently doing a program that does use a brace, and you’re having great outcomes that is good to hear, but if you are not, that may be a clue that you could benefit from a more individualized assessment for what could best help you by partnering with a pelvic floor physical therapist. 

The best thing you can do, when you realize there is a little separation going on, is to not get scared, be active, get strong, move your body and play with your kiddos. If you are worried the diastasis is limiting your function and what you want to do on a day to day basis, then it would be a good time to partner with a PT to set your mind at ease. That’s what we do here at legacy, we want to give people the reassurance that they can move on and exercise and be active. They may need a few modifications or things to watch for but we want to empower women to be active, strong and do what they want to do. 

There are a lot of paths to feel strong and healed, some people may require a surgery and we’ve seen cases where it heals all on its own, we see women who do awesome with conservative management working with a PT, doing exercise or modifying their diet. The biggest thing we want to highlight is don’t be scared, and don’t let those who want to fear or shame you about your body stop you. 

If you have questions about diastasis recti or want a free consultation, schedule a discovery visit with a therapist, we will screen your diastasis for free!

AUTHOR

Brooke Kalisiak

Legacy Physical Therapy

"We help women who are tired of leaking, dealing with pelvic pain, and wanting to get their body back in shape after baby (even if it’s been 30 years) all without relying on medications or surgery."
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