How Can You Repair Diastasis Recti Without Surgery

diastasis recti repair without surgery

Pregnancy can put a great deal of stress on the mother’s body, and sometimes there is long-term damage after the baby is born. One of the more frustrating and challenging after-effects of childbirth is diastasis rectus abdominis (DRA), the separation of the left and right halves of the long rectus abdominis (RA) muscle that forms the six-pack.

While separation of the RA during pregnancy is normal and indeed necessary to accommodate the growing fetus, in some cases the two halves do not come back together after childbirth. This happens when the linea alba, the strip of fascial tissue that dissects the right and left RA, is overstretched and thinned. In some cases, the linea alba actually splits.

The prevailing consensus among the medical community is that if DRA has not been resolved within a year after childbirth, surgery is the only option. Yet the female body is highly adaptive, and the same principles that apply to gaining muscle and improving bone density also apply to increasing the density of connective tissue. When subjected to the right sort of overload (the challenge posed by exercise), and using proper mechanics in exercise execution and breathing, the density of the linea alba can be increased and the gap narrowed in most women.

Getting the Big Picture

The vast volume of information about DRA zeros in on the distance between the halves of the RA, however, the problem is often more complex than just closing the gap. Many other factors may play a role in DRA, and understanding the complexities of the lumbro-pelvic area is key to resolving DRA.

Some factors involved with DRA include:

  • Breathing mechanics and the actions of the diaphragm
  • Bladder continence
  • Uterine prolapse
  • Alignment of the spine and pelvis
  • Core stability
  • Movement control
  • Overall fitness

Low fitness, deficient movement and breathing mechanics and postural issues can actually place additional stress on the linea alba, preventing it from becoming denser and healing. In order to resolve DRA, the entire lumbro-pelvic region must be addressed, to realign the spine and pelvis, and strengthen the structures that stabilize and reduce pressure in the pelvic area.

Factors Influencing Healing Diastasis Tecti without surgery

While not all cases of DRA can be resolved with conservative treatment, many can, even years after childbirth. The determining factors are largely dependent on the individual patient.

  • Genetics and hormones affect the quality of fascial tissue, and its elasticity. While the fascial tissue of some women may not respond to conservative treatment, fascia that has retained its elasticity and responds to directed overload stands a good chance of regenerating to resolve DRA.
  • Consistently applying the principles of good mechanics in movement and breathing, correct abdominal recruitment patterns, and good postural alignment during the execution of daily tasks is key to repairing DRA. In other words, the patient must be compliant, and willing to take responsibility for resolving her DRA on a daily basis.
  • Patient education is key to resolving DRA. As the saying goes, if you don’t believe you can do a thing, you are right. Education, along with support and encouragement, can help the patient to buy into her own treatment and persevere with the treatment protocol.

Many new mothers want a quick fix to resolve their DRA, and lack the patience and dedication needed for successful conservative treatment. For some, surgery may seem like the most practical solution to what they see as a cosmetic issue. However, while surgery may close the gap, it will not resolve the underlying postural and mechanical issues that contribute to DRA.

Diagnosing Diastasis Recti


Many misconceptions exist about DRA. To get a realistic idea of the extent of your diastasis, diagnostic ultrasound provides dynamic images of your core and abdominal muscles in real time.

Dr.Kalika is an internationally recognized expert in diagnostic musculoskeletal ultrasonography and rehabilitative ultrasound imaging. (RUSI)

Please explore more advanced diagnostic option unavailable anywhere else:


Treatment for DRA in NYC

If you are suffering from Diastasis Rectus Abdominis or other post-partem pelvic issues like incontinence, prolapse or pelvic pain, the sports medicine team at NYDNRehab can help. We use the latest technologies, therapies and treatments to accurately diagnose and treat your condition. Contact NYDNRehab today and shedule diastasis recti repair without surgery, so you can get back to your active life.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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