Resolving Abdominal Diastasis: Alignment is Key to Closing the Gap


If your six-pack is split down the middle after pregnancy or due to overtraining, you are no doubt willing to try anything to pull it back together. The Internet offers scores of solutions for resolving diastasis rectus abdominis, or DRA, ranging from tips on bracing and binding, to exercises designed to bridge the gap. However, doing a few exercises a day and forcing your abs together by binding them may be insufficient to resolve DRA.

Whether you realize it or not, you use your abs all day long, to produce movement, stabilize your pelvis and support your spine. Yet most of us pay little attention to alignment during everyday movements, or when sitting or standing still. And therein lies the key to resolving DRA — being aware of and correcting your alignment, all day long.

The following guidelines can help you improve your alignment during exercise and everyday activities, which in turn will help you close the DRA gap.

  1. Your muscles work together. When you focus on exercising only your abdominal muscles to the neglect of other muscles in your lumbro-pelvic region, you are creating imbalances that promote poor alignment. Your muscles work together in a coordinated sequence of contractions to produce specific movements, like lifting your toddler or loading groceries in the car. A balanced exercise program is key to maintaining optimal alignment throughout the day, because multiple muscles help to support and stabilize your abdomen as you move.
  2. Alignment during exercise is critical. You can watch exercise videos all day long and try to duplicate the movements. But if you have never been taught the basics of good alignment, you may be doing your abs more harm than good. Good alignment means you are not just recruiting specific muscles, but you are also paying attention to the position of your entire body during any given exercise. A therapist can teach you the basics of good alignment and train you to recruit your muscles in a deliberate way.
  3. Breathing is an important part of physical activity. Whether you are working out or doing the laundry, your breathing habits play a role in alignment, because your diaphragm muscle affects your abs. Breathing is an involuntary activity, meaning you don’t have to think about it to make it happen, and most people pay little attention to their breathing patterns throughout the day. Yet many people unconsciously hold their breath during physical exertion, which increases intra-abdominal pressure and widens the DRA gap. Exhaling upon exertion will reduce pressure and help close the gap.
  4. Lead movement with an exhale. Before you engage your ab muscles or exert yourself physically, inhale deeply, then exhale as you begin and carry out your movement, paying attention to engaging your ab muscles. Not only will you encourage the DRA gap to close, but you will protect your low back in the process.
  5. Check your gap during and after exercise, and throughout the course of your day. The more you practice awareness of your DRA, the easier it will become to keep it in check, and the more quickly it will resolve itself.

Help for DRA in NYC

Unless you have a degree in exercise science or are a trained athlete or fitness professional, you may need help understanding how to align your body correctly during exercise and daily activities. The sports medicine professionals at NYDNRehab can teach you correct body alignment and design a balanced exercise program to help resolve your DRA. We use state-of-the art technology and advanced retraining methods to identify movement deficiencies and help you correct them. Contact NYDNRehab today, and say goodbye to DRA.



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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