Treating Diastasis Recti With Physical Therapy (2022)

Diastasis recti—or diastasis rectus abdominis, as it is known in medical terms—is a common condition that develops when the two portions of the outermost abdominal (stomach) muscle separate.

This issue typically happens during pregnancy, when the muscle stretches to accommodate a growing baby, but it can also occur in infants or in older men and women as well. Learn how to treat and prevent diastasis recti with physical therapy in the sections below.

An Overview of Diastasis Recti

Diastasis recti occurs when the midline of the most superficial abdominal muscle—called the rectus abdominis—starts to separate. Widening in this area of connective tissue, which is known as the linea alba, can occur for a variety of reasons, including:

  • Pregnancy: This happens as the result of the increased pressure that an enlarging fetus places on the wall of the stomach. In fact, it is estimated that 66% to 100% of women experience diastasis recti in their third trimester. People carrying multiple babies or those who are smaller in stature may also be more prone to it.
  • Stomach obesity: Those who undergo frequent or rapid changes in body weight, or with a genetic predisposition for this condition, may also be at risk.
  • Newborn babies: This form of the condition typically self-resolves.

One of the hallmark signs of diastasis recti is a visible deformity or bulge in the center of the stomach. This bulge can move in and out and is typically made worse by activities that activate the abdominal muscles. Common aggravating actions include:

  • Sneezing
  • Coughing
  • Rolling over in bed
  • Lifting

While this condition is frequently painless, it may lead to:

  • Abdominal-area discomfort
  • Low back pain
  • Hip pain in some cases

It can also cause the stomach to feel flabby and your core muscles to seem weak or ineffective.

Diagnosing the Condition

Diagnosing diastasis recti is a relatively straightforward process. Your physician or physical therapist will usually begin by palpating (examining by touch) the midline of your stomach to assess for any bulging or protrusion and to determine the location and severity of the separation. They may also ask you to activate your abdominal muscles to evaluate for any changes that occur when you attempt to activate the rectus abdominis.

In addition, a thorough subjective history is usually taken. During this portion, your healthcare provider will ask you about your pregnancy and labor history, when the symptoms began, and what activities make it better or worse.

In rarer cases, your healthcare provider may also order a computed tomography (CT) scan or an ultrasound to confirm the diastasis recti diagnosis.

How Diastasis Recti Can Be Treated With Physical Therapy

Treating Diastasis Recti With Physical Therapy (1)

(Video) Diastasis Recti Exercises - From a doctor of physical therapy

In many cases, diastasis recti self-resolves after your baby is born or when significant weight loss occurs. That said, in many cases, physical therapy (PT) may be necessary to treat this condition. PT uses several different strategies to address the symptoms of this issue. They include:

  • Core strengthening: As your abdominal muscles are stretched further and further, they become less effective in providing core stability. Physical therapy can help reduce the separation that occurs in the rectus abdominis by strengthening your stomach muscles. Your PT can also help you target the low back, hip, and diaphragm muscles, which can lend support to the affected area of your stomach.
  • Education: In an effort to reduce the strain placed on your abdominal muscles, it is important to avoid certain activities that put more stress on the area where muscular separation has occurred. Your PT will teach you the most common movements to avoid and will help you find compensatory strategies that work for you.
  • Bracing: In addition to exercises that target the core muscles, certain braces can help support your abdomen and decrease the amount of separation that has occurred. Your PT can help you find a garment that allows you to carry out your daily activities while providing stability in the area where diastasis recti has occurred.
  • Neuromuscular electrical stimulation (NMES): NMES is a device that uses an electrical current to stimulate your abdominal muscles to activate. This treatment is frequently utilized by physical therapists to treat diastasis recti in combination with core strengthening exercises. Research has shown that the use of NMES along with exercise leads to smaller abdominal separation width and increased stomach strength when compared with treating the condition with exercise alone.

Ways to Prevent Diastasis Recti

Most, if not all, women will experience some degree of diastasis recti as they progress through their pregnancy. In these cases, it may be impossible to completely prevent the condition from occurring. That said, starting a regular core strengthening program early in your pregnancy may help facilitate the resolution of the condition and alleviate some of the symptoms after labor.

In other situations, certain steps can be taken to reduce the chances that diastasis recti occurs, like:

  • Maintaining a healthy body weight
  • Avoiding the strain that obesity can place on the wall of the stomach
  • Regularly focusing on exercises that keep your stomach, hip, pelvic, and low back muscles strong

Frequently Asked Questions

How long will it take to heal diastasis recti with physical therapy?

While individual situations will vary, a review of the evidence supporting the use of PT to treat diastasis recti showed some improvement was noted in as little as six weeks. Other studies, however, reported it took three to six months before significant progress occurred.

What should you wear for physical therapy with diastasis recti?

As part of their evaluation, your physical therapist will typically examine your bare abdominal area to assess the diastasis recti. As a result, your stomach should be easily accessible when going to PT. In addition, it is important to wear loose-fitting, comfortable clothes that make it easy to exercise during your sessions.

Will your stomach get softer when going to physical therapy for diastasis recti?

After the birth of a baby or significant weight loss, it can take a long time for the skin in your stomach to regain its elasticity and firmness. In fact, in many people, this area will always appear softer or less firm after it is stretched by pregnancy or excess weight. While physical therapy can help strengthen the core muscles in your stomach, it is typically not effective in resolving this completely normal side effect of pregnancy or obesity.

A Word From Verywell

Diastasis recti can be an uncomfortable and unpleasant condition to deal with. Not only does it cause a visible deformity in your stomach, but it can also lead to pain during your daily activities. The important thing to remember is that this issue is both extremely common and very treatable! If you are experiencing separation in your stomach muscles, be sure to speak to your doctor or physical therapist about which treatments are right for you.

3 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Benjamin DR, Van de Water ATM, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review.Physiotherapy. 2014;100(1):1-8. doi:10.1016/j.physio.2013.08.005

  2. American Physical Therapy Association. Physical therapy guide to diastasis rectus abdominis.

  3. Kamel DM, Yousif AM. Neuromuscular electrical stimulation and strength recovery of postnatal diastasis recti abdominis muscles.Ann Rehabil Med. 2017;41(3):465-474. doi:10.5535/arm.2017.41.3.465

    (Video) Exercises to Fix Your Diastasis Recti | Physical Therapy

(Video) How We Treat Diastasis Recti | Physical Therapy

Treating Diastasis Recti With Physical Therapy (2)

By Tim Petrie, DPT, OCS
Tim Petrie, DPT, OCS, is a board-certified orthopedic specialist who has practiced as a physical therapist for more than a decade.

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FAQs

Can diastasis recti heal with physical therapy? ›

Physical therapy offers not only effective and personalized treatment for diastasis recti and associated postpartum issues, but also helps to improve the strength and function of a woman's core muscles (which include abdominal and pelvic floor muscles) for long-term health.

How long does it take to fix diastasis recti with physical therapy? ›

How Long Does It Take To Heal Diastasis Recti? Depending on the severity of your diastasis recti, it can take anywhere from 6-12 months of consistent work. It is recommended to work with a PT or Pilates instructor three times a week.

Can pelvic floor physical therapy help diastasis recti? ›

Pelvic floor physical therapy can help individuals improve core strength to reduce the length and depth of their abdominal separation. A study published in the Journal of Women's Health Physical Therapy found that 90% of non-exercising pregnant women exhibited DRA, compared to 12.5% of exercising women.

What is the fastest way to heal diastasis recti? ›

The key to healing diastasis recti is rebuilding your core from the inside out. You need to strengthen the transverse abdominis (TVA) muscle, which is the deepest abdominal muscle and can provide support for those muscles that have been stretched.

How do you fix diastasis recti years later? ›

In Short, YES. The vast majority of these symptoms can be improved and often fully resolved through correct training of the deep core muscles, coupled with healthy posture, breathing, and alignment in daily life.

How do I know if my diastasis recti is healed? ›

How To Know if Diastasis Recti is HEALED - YouTube

Can you fully heal diastasis recti? ›

Yes, it's possible to fix diastasis recti without surgery. Surgery is rarely performed to fix diastasis recti. Healthcare providers will recommend physical therapy or at-home exercises to help heal diastasis before surgical methods.

How long does it take to reverse diastasis recti? ›

In most cases, recti diastasis usually heals on its own over a postpartum period of 6 weeks to 3 months.

What makes diastasis recti worse? ›

Make sure to avoid certain activities and exercises that may make diastasis recti worse. These include crunches, ab twists, planks, backward bends that stretch the abdominal area, certain yoga poses, or any type of heavy lifting activities that bulge out the stomach.

What type of physical therapist treats diastasis recti? ›

As a pelvic floor physical therapist, almost every new mom I treat has concerns over diastasis rectus abdominis (DRA) or “diastasis recti.” This condition happens during and after pregnancy because of the stress placed on the rectus abdominus (the famous “six pack” muscle) as a fetus grows within the uterus.

Can Massage Help diastasis recti? ›

Massage therapy for Diastasis Recti can be very helpful to rebuild proper abdominal tone as long as you're also working with a physical therapist who specializes in this issue. An experienced massage therapist can open stuck tissues that are pulling the abdominal muscles outward.

Can diastasis recti cause organ prolapse? ›

With diastasis recti, there's less abdominal support to hold your organs in place. Your bladder or uterus can slip down (prolapse). Straining your abdominals increases your odds of prolapse.

How do I get rid of belly fat with diastasis recti? ›

A tummy tuck can also help both men and women repair diastasis recti (abdominal separation), which can flatten the belly while also preventing & reducing lower back pain. Liposuction. As you know, it's impossible to lose weight only in one area of the body, which is why liposuction is such a useful option.

Will losing weight help diastasis recti? ›

Weight loss may improve the appearance of the diastasis in patients who are overweight, and exercise may help strengthen the supporting abdominal muscles.

Is surgery the only way to repair diastasis recti? ›

One non-surgical way to treat diastasis recti is through physiotherapy. Special focused exercises with a certified physiotherapist can reduce tummy muscle separation and improve your bulging belly, however, this is not usually very effective. The best and most effective way to treat diastasis recti is surgery.

What happens if diastasis recti goes untreated? ›

If left untreated, diastasis recti can potentially lead to poor core stabilization, pelvic floor dysfunction, and back or pelvic pain.

Can a waist trainer fix diastasis recti? ›

There will be some natural shrinking of a diastasis recti in the months post pregnancy, but a waist trainer is unlikely to assist in this process. If you sustain a bad cut, it makes sense to have the two sides stitched together to allow proper healing.

When is diastasis recti severe? ›

Diastasis is considered severe when the connective tissue is stretched and the muscles of your core can no longer support your pelvic and abdominal region. Specifically, when your deep core cannot generate tension and hold you stable and strong.

Does diastasis recti cause big belly? ›

The most common symptom of diastasis recti is a belly bulge. But there may be other symptoms, such as poor posture and belly pain due to the weakened core muscles. In some cases, diastasis recti will resolve on its own. Treatment, if needed, can include exercise, surgery, or nonsurgical options.

Is cycling good for diastasis recti? ›

Is indoor cycling an approved workout for diastasis recti postpartum? This can be a safe and motivating option for low-impact cardio while gradually increasing intensity. While you're cycling, be mindful of your posture (spine lengthened, pelvis neutral, ribs anchored) and breathing.

Does diastasis recti affect bowel movements? ›

Diastasis recti can lead to side effects like lower back pain, constipation and urine leaking. It can also cause difficulty with both breathing and movement.

Does belly binding help diastasis recti? ›

For many women, while their organs return to their original positions, their abdominal muscles may not close naturally within the standard 2-month time frame after delivering. This is known as diastasis recti. Belly binding can help to hold the muscles together and speed up that closure.

Can you fix diastasis recti without tummy tuck? ›

A rectus diastasis does NOT require a tummy tuck to be repaired. I frequently repair the rectus diastasis through old C-section scars as well as through belly button incisions.

Can I do squats with diastasis recti? ›

Q: Can you do squats with diastasis recti? A: Yes, if you do them correctly and you have a solid connection to your core. Keep in mind, as mentioned above, that diastasis is caused (and continues) when we have continuous or repetitive forward, forceful pressure out on the abdominal wall.

Is diastasis recti a hernia? ›

Is Diastasis Recti a Hernia? While diastasis recti and abdominal hernias may look similar, they are not the same. Diastasis recti is not a protrusion of intestines or abdominal tissues like a hernia; it is a bulge of muscle due to the stretched connective tissue.

Does diastasis recti get worse over time? ›

Over time, Diastasis Recti can worsen as the separation increases. This results in the internal abdominal organs, such as the uterus and intestines, having less protection in the front to hold them in place. Other complications of Diastasis Recti include: lower back pain.

Where do you feel pain with diastasis recti? ›

Diastasis recti happens when pregnancy stretches the abdominal muscles, causing them to split apart. It can also happen in people with obesity. The symptoms may include lower back pain, abdominal discomfort, and a loss of bladder control. Additionally, diastasis recti can cause a bulge in the middle of the abdomen.

What should you not do if you have diastasis? ›

Skip any movement or exercise that places strain on the midline or causes the belly to bulge outward, like sit-ups and planks.

Does coughing worsen diastasis recti? ›

Mistake 1: Bulging Abs Forward When You Sneeze & Cough

Any action that exerts forceful pressure on your abdominal muscles, causing them to bulge forward, can induce or re-open diastasis recti.

What happens if you do sit-ups with diastasis recti? ›

In fact, sit-ups can actually make the bulge worse, and incorrect form while doing sit-ups can even cause diastasis recti. If your client has diastasis recti you want her to avoid doing anything that puts strain on the middle of the abdominals, where the muscles have separated.

Can Massage Help diastasis recti? ›

Massage therapy for Diastasis Recti can be very helpful to rebuild proper abdominal tone as long as you're also working with a physical therapist who specializes in this issue. An experienced massage therapist can open stuck tissues that are pulling the abdominal muscles outward.

What exercises to not do with diastasis recti? ›

Make sure to avoid certain activities and exercises that may make diastasis recti worse. These include crunches, ab twists, planks, backward bends that stretch the abdominal area, certain yoga poses, or any type of heavy lifting activities that bulge out the stomach.

Does insurance cover diastasis recti treatment? ›

The diastasis repair is normally not covered by insurance and is generall considered cosmetic in nature by insurance carriers.

When is diastasis recti severe? ›

Diastasis is considered severe when the connective tissue is stretched and the muscles of your core can no longer support your pelvic and abdominal region. Specifically, when your deep core cannot generate tension and hold you stable and strong.

Does Kinesio tape work for diastasis recti? ›

What about taping Diastasis Recti? According to a 2017 study by Awad et al, Kinesio taping effectively reduced diastasis rectus abdominis in the postpartum phase. In that study, the tape was applied for 3 days on, 1 day off, over and over for 1 month.

Can cupping help diastasis recti? ›

Cupping can speed up the approximation process and sometimes can close the gap to two fingers width within one session (for reference diastasis recti is separation greater than 2 fingers).

Does cycling help diastasis recti? ›

Is indoor cycling an approved workout for diastasis recti postpartum? This can be a safe and motivating option for low-impact cardio while gradually increasing intensity. While you're cycling, be mindful of your posture (spine lengthened, pelvis neutral, ribs anchored) and breathing.

What happens if diastasis recti goes untreated? ›

If left untreated, diastasis recti can potentially lead to poor core stabilization, pelvic floor dysfunction, and back or pelvic pain.

Why is my diastasis recti getting worse? ›

Can Diastasis Recti Get Worse Over Time? Over time, Diastasis Recti can worsen as the separation increases. This results in the internal abdominal organs, such as the uterus and intestines, having less protection in the front to hold them in place.

Are squats OK with diastasis recti? ›

Q: Can you do squats with diastasis recti? A: Yes, if you do them correctly and you have a solid connection to your core. Keep in mind, as mentioned above, that diastasis is caused (and continues) when we have continuous or repetitive forward, forceful pressure out on the abdominal wall.

What kind of doctor fixes diastasis recti? ›

They must be sewn back together, which is why diastasis recti repair is best performed by a board certified plastic surgeon. “When it comes to diastasis, it should be a plastic surgeon repairing it, and it is a traditional tummy tuck situation,” Dr.

Can I get disability for diastasis recti? ›

A 10 percent disability rating for diastasis recti of the abdominal muscles is allowed, subject to the regulations governing the award of monetary benefits.

Will insurance pay for a tummy tuck if you have diastasis recti? ›

Diastastis recti is not typically covered by insurance. Repair of the rectus muscles is typically done during a tummy tuck. The best course of action for you would be to make an effort to lose some of the weight you have gained in order to allow for a better repair of your abdominal muscles.

Where do you feel pain with diastasis recti? ›

Diastasis recti happens when pregnancy stretches the abdominal muscles, causing them to split apart. It can also happen in people with obesity. The symptoms may include lower back pain, abdominal discomfort, and a loss of bladder control. Additionally, diastasis recti can cause a bulge in the middle of the abdomen.

Can you live with diastasis recti? ›

If your abdominal separation is not too big, you may decide to live with it. But you should bring those muscles back together before you have another pregnancy. Your doctor can measure how far apart your muscles are using finger widths, a measuring tape or instrument, or ultrasound.

Does coning always mean diastasis recti? ›

Coning is when the center connective tissue of the abdomen, the linea alba, protrudes outwards beyond the rest of the abdominal wall. This tends to occur due to diastasis recti, or the normal occurring separation of the six pack abs during pregnancy.

Videos

1. Heal Diastasis Recti FAST – Physiotherapy Guide to FIX & FLATTEN your BELLY
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5. How to START Diastasis Recti Exercises that FIX YOUR GAP | PHYSIO GUIDED Abdo Separation Repair
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