Abdominal diastasis, known clinically as diastasis recti abdominis, or DRA, is the separation that occurs along the midline of the rectus abdominis, or RA (the six-pack muscle) during and after pregnancy. As the fetus grows, the linea alba, the connective fascial tissue that binds the right and left halves of the RA, thins and stretches to make room for the growing fetus.
In most cases, DRA resolves itself within several weeks after childbirth. But for some women, the halves of the RA remain separated. In an attempt to resolve DRA and regain a normal, pre-pregnancy waistline, many new mothers turn to exercises, particularly those that target the abdominal muscles. However, in recent years, there has been a growing clinical consensus that traditional core strengthening exercises like planks and crunches are off-limits to women with DRA.
Certain types of abdominal exercises increase pressure within the abdomen, causing the two sides of the RA to grow farther apart, rather than come together. Crunches are a prime example of an exercise that increases intra-abdominal pressure, causing the RA to separate. However, there are techniques to overcome the separation by engaging the transverse abdominis muscle prior to contracting the RA, which can be learned and integrated into a progressive exercise program.
In the case of planks, it has been argued that horizontal planks allows gravity to exert force on the visceral organs, thereby increasing pressure on the RA, encouraging further separation. While this seems to make sense, the truth is that structures and tissues within the abdominal wall hold the viscera in place, regardless of the body’s position in relation to gravity.
The answer is, it’s complicated. There exist varying degrees of DRA, and a diverse body of DRA patients. To paint all cases of DRA with a broad brush is to do a disservice to women seeking to resolve the condition. Before prescribing a one-size-fits-all treatment for DRA, clinicians should take a number of factors into account, including:
Many women with post-pregnancy DRA are able to resolve it with the help of a targeted progressive exercise program. However, treatment should not focus on the abdominal muscles alone, but should take into consideration the overall function of the core and pelvic muscles, and how they connect to the central stability system. Breathing, muscle recruitment patterns and overall alignment during exercise are foundational to resolving DRA.
If you are suffering from DRA and are eager to resolve it, the postpartum specialists at NYDNRehab can help. We use state-of-the-art technology to diagnose and treat your condition. Our expert staff will help your retrain the muscles of your trunk and core to achieve proper function as you progress toward decreasing and resolving your DRA. Contact NYDNRehab today, and see why we are the best rehabilitation clinic in NYC for the treatment of DRA.