Diastasis recti, which commonly occurs after pregnancy, is a separation between the rectus abdominis muscles. Physical therapy involving gentle strength exercises can improve or even cure symptoms.

Diastasis recti occurs due to weakness in the abdominal wall. Many conditions can cause it, but the most common cause in adults is pregnancy.

According to a 2021 review, various studies have found that between a quarter to more than half of pregnant people have diastasis recti after giving birth. Rates are higher in people who have had multiple pregnancies.

Because weakness in the abdomen leads to diastasis recti, strengthening exercises can often reverse it. However, it is important to do these exercises under the guidance of a physical therapist, since certain exercises or an incorrect form can worsen symptoms.

Read on to learn more about physical therapy for diastasis recti.

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Physical therapy (PT) offers many benefits for diastasis recti. Some of these include:

  • helping a person learn how to activate their abdominal muscles
  • teaching a person to move in a way that reduces the risk of injury
  • offering personalized exercise recommendations based on a person’s recovery and needs
  • sharing additional techniques, such as bracing or taping, to reduce pain and improve mobility

Some research from 2022 suggests that PT is more beneficial for improving function than appearance, so a person should discuss their treatment goals with a doctor or physical therapist before starting on a treatment plan.

Researchers continue to debate the right standard of care for diastasis recti. No standard list of exercises is right for everyone, especially since recently pregnant people may have additional concerns, such as pelvic floor dysfunction.

It is important to talk with a physical therapist before trying new exercises and to discuss any new symptoms as they appear.

Treatment should begin with identifying areas of weakness and avoiding exercises, lifting, and routines that stress these areas unnecessarily. Some beginner-level exercises include:

  • Cat-Cow: Get on the hands and knees. Engage the core and draw the belly button toward the ceiling, rounding the back. Arch the back and lower the belly button downward. Repeat several times.
  • Opposite arm and leg extension: While still on hands and knees, engage the core. Extend the left leg straight back, and the right arm straight forward, parallel with the head. Hold, then repeat on the other side.
  • Abdominal braces: Lie on the back, with the knees bent and feet flat on the floor. Draw the belly button down, pushing the small of the back into the floor. Repeat several times.
  • Bridge: Lie on the floor, with the knees bent and feet flat on the floor. Lift the hips off the floor, forming a bridge, and hold. Repeat several times.

As a person builds strength and mobility, they can try these more difficult routines:

  • Flutter kicks: Lie flat on the back, with legs extended out. Using the abdominal muscles, lift the torso slightly off of the ground. Lift the legs off of the ground, then move each leg up and down and then apart and back together. Stop if there is pain or strain.
  • Leg lift: While in the same position, keep the torso slightly off of the floor. Push the legs together, then lift them off of the ground and point the feet toward the ceiling. Lift the legs as high as they will comfortably go.
  • Single-leg bridge: Lie on the back, with the knees bent and feet flat on the ground. Lift one leg off the ground, keeping the knee bent and moving the knee toward the head. Then lift the hips off the ground and hold. Repeat on the other side.

PT offers personalized, customized treatment plans. It usually begins with a detailed discussion of goals and symptoms, as well as a physical exam.

After that, each session is different. Some things that may happen during a PT session include:

  • A physical therapist might examine the abs or measure the separation between the abdominal muscles.
  • The physical therapist may show the person how to perform specific exercises, ask them to perform them, then offer feedback.
  • The physical therapist may ask about new or emerging symptoms.
  • The physical therapist may massage or manipulate the abdomen or nearby groups of muscles.

Research on PT for diastasis recti generally suggests that it works, especially in improving mobility. However, there is little agreement among experts about the right exercises to do.

A 2021 analysis found very low quality scientific evidence to support any specific exercise regimen.

Moreover, most research has looked only at people with mild to moderate diastasis rectus, rather than those with more severe cases. This suggests that a person may need to try out different physical therapists and PT methods to get results.

Other treatment options depend on a person’s treatment goals. For example, changing the appearance of diastasis recti may require surgery, even when a person’s physical symptoms improve.

Some treatment options for diastasis recti include:

  • surgery to repair weak or damaged muscles
  • lifestyle modifications, such as not lifting heavy objects or not performing certain motions
  • weight loss to reduce strain on the abdominal muscles
  • remaining physically active to prevent additional muscle pain due to a sedentary lifestyle

Learn more about treatment for diastasis recti.

The following are answers to commonly asked questions about PT for diastasis recti.

How long does healing take?

There is no set time to heal diastasis recti, and sometimes it does not fully heal with PT. People should seek guidance from a healthcare professional if they experience symptoms after several months of treatment.

What else can I do to help it?

There are no specific guidelines for managing diastasis recti, but remaining active and maintaining a healthy weight may help. It is important for a person to do any exercise their physical therapist recommends between sessions.

Will my stomach ever feel the same?

Some people recover fully from diastasis recti, while others regain function but find that their stomach still bulges. If this happens, surgery may help.

Diastasis recti can change the appearance of the stomach, causing a visible bulge. It may also cause pain and mobility difficulties that can make certain exercises difficult.

PT is one method for reducing the pain of diastasis recti and preventing secondary issues like low back pain. People concerned about diastasis recti should see a healthcare professional and seek guidance from an experienced physical therapist.