Physical Therapy and Pregnancy: Part 1 Diastasis Recti

Pregnancy affects your entire body in pretty big ways, so it’s not surprising that after the baby is born you might experience pain, weakness or a new condition. Diastasis recti, pelvic floor dysfunction, symphysis pubis dysfunction or sacroiliac joint pain are all common conditions that can come on during or after pregnancy. The focus of physical therapy is on strengthening the muscles around the source of pain, functional exercises to teach you ways to care for yourself and your baby to avoid injury and therapies for pain after pregnancy.

Diastasis Recti is a fairly common condition caused by pregnancy in some women. “Diastasis” refers to a separation and “recti” is in reference to the rectus abdominis muscles. With this, there is a belly “pooch” caused by a separation down the middle of the abdomen between the left and right muscles. There is thin connective tissue holding everything together, but the muscles have pulled away from each other during pregnancy and not come back together to meet in the middle. This condition is more likely to happen if you are pregnant with multiples, have babies close together in age, or are over 35 years old.

Usually this gap will close after delivery, but some women require the help of physical therapy to bring the muscles back together. It is important to be properly diagnosed by your doctor, midwife or physical therapist. It’s really simple for them to diagnose, just by feeling your abdomen as they have you raise your head and shoulders up from the table.

If you have diastasis recti, there are certain exercises that can make it worse, like sit-ups, planks, crunches, pushups and swimming. Core workouts are often the first thing women try to lose their baby weight or “pooch” when they are cleared for exercise around 6 weeks postpartum, but not every woman is checked for diastasis recti.

If you are diagnosed with diastasis recti, the separation of the abdominal muscles needs to be closed before certain exercises in Pilates or Yoga can be tried again. This is often done by using a binder or postpartum support like the Mama Strut Postpartum Support Pelvic Binder and engaging the transverse (deep core) muscles. A physical therapist who is trained in postpartum issues, pelvic floor conditions and diastasis recti can build a program for you that will first help you to close the separation, then help you to strengthen your core and build muscle. If you are working with a trainer, be sure they know what diastasis recti means and how to proceed with your workout plan.

Our local expert is Danielle Xuereb, Doctor of Physical Therapy at Peak Physical Therapy in McKinney, Texas. She specializes in postpartum conditions and healing and individualizes exercise programs for patients with diastasis recti. She works with women before, during and after pregnancy to prevent symptoms from worsening, bring relief for pain, and build strength in the core and pelvic floor. She creates programs that are safe and effective for diastasis recti and has had success in healing women without a need for surgical intervention.