Physical Therapy for Diastasis Recti

During pregnancy, the elasticity of your abdominal muscles enables them to stretch to accommodate your growing baby. However, the linea alba is made up mostly of collagen, which is less elastic than muscle. For many women, the linea alba thins during pregnancy and gradually tightens up again over several weeks postpartum. But in some instances, the linea alba is stretched to the point of separation, leaving an undesirable gap between the right and left sides of the RA.

Not only is diastasis recti cosmetically undesirable, giving you a postpartum tummy that will not go away, but it can interfere with the overall function of your abdominal canister, leading to a plethora of related issues.

Symptoms of diastasis recti include:

  • Pelvic pain
  • Core instability
  • Low back pain
  • Urinary incontinence
  • Constipation
  • Sexual dysfunction
  • Organ prolapse
  • Poor posture

Reduced abdominal function from diastasis recti can restrict physical activity, which can be devastating for athletic women who want to remain active.

Contributing Factors to Diastasis Recti

Pregnancy is the primary cause of diastasis recti, but certain other factors can contribute to its likelihood:

  • Multiple birth pregnancy
  • Short timespan between pregnancies
  • Carrying a large birthweight baby
  • Pregnancy at an older age
  • Poor collagen quality
  • Sedentary lifestyle
  • Obesity

Getting in shape before pregnancy, maintaining a healthy weight and practicing lifestyle behaviors that promote healthy collagen production can reduce your risk of diastasis recti.

Diagnosis of Diastasis Recti


The best and the most precise way to assess diastasis recti is by using diagnostic ultrasonography. The benefits are:

  • The best and the most precise way to assess diastasis recti is by using diagnostic ultrasonography. The benefits are:
  • precise measurement of the diastasis gap
  • dynamic assessment of the functional components of the abdominal canister (diaphragm, pelvic floor and multifidi muscles)
  • Sonoelastography to estimate the stiffness of the intact linea alba. We also use diagnostic ultrasound as a feedback tool for abdominal muscle retraining in the initial stage

Please explore more advanced diagnostic option unavailable anywhere else:


Diastasis Recti Treatment

In an effort to flatten a postpartum belly, many women begin an exercise program of challenging abdominal exercises like crunches and leg lifts, but those exercises can sometimes make the condition worse.

Other women try wrapping the abdomen to draw the RA together, hoping the collagen will repair itself, which is ineffective. In severe cases, some women even have cosmetic surgery to close the gap. However, cosmetic solutions do not restore full function to the abdominal canister, which is the real problem posed by diastasis recti. Diastasis recti physical therapy offers a conservative, non-invasive treatment solution.

Diastasis Recti Rehab at NYDNR

The pelvic pain specialists at NYDNR use a targeted conservative approach to treating diastasis recti. Our therapy is individualized, taking into account the specific needs of each patient.

Physical therapy for diastasis recti

You do not have to live with a diastasis recti that keeps you from living a healthy active lifestyle. At NYDNR, we combine innovative therapies with state-of-the-art technology to restore your abdominal function and integrity, so you can enjoy the very best quality of life.


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Diastasis Recti

Diastasis recti is a separation of the rectus abdominis muscle that creates your “six-pack.” The separation occurs along the linea alba, the band of connective tissue that runs down your abdominal midline. The condition is most commonly seen in the post-partum phase of pregnancy, although it may also be caused by abdominal obesity in both males and females. Pregnancy-related separation results from the uterus pushing against the abdominal wall, coupled with an influx of pregnancy hormones that soften connective tissue. While often painless, many women consider the condition to be cosmetically disfiguring.

Risk Factors for Diastasis Recti include:

  • multiple birth pregnancy
  • multiple pregnancies close together
  • large birthweight baby
  • pregnancy over age 35
  • abdominal surgery
  • abdominal obesity

Because the muscles of the abdominal canister protect the spine and stabilize the pelvis during physical activity, diastasis recti can inhibit and impede physical performance. When left untreated, diastasis recti can lead to low back and pelvic pain, constipation, movement dysfunction, and hernia.


Diastasis Recti Diagnosis

Diagnosis of diastasis recti entails a manual physical exam and diagnostic ultrasonography to assess the severity of the condition.

Diastasis Recti Treatment

While surgery may be a viable treatment option in severe cases, it will not restore function of the rectus abdominis. Conservative therapy that is non-invasive can promote healing of the linea alba and optimize function of the abdominal muscles. Conventional abdominal strengthening exercises like crunches and leg lifts should be avoided, as they can aggravate the condition.

The post-partum specialists at NYDNRehab use conservative targeted methods and specific interventions that are clinically proven to effectively treat diastasis recti. We begin with Vojta reflex therapy to activate the deep abdominal muscles. We then follow up with more direct training of the abdominal wall, using a combination of DNS (dynamic neuromuscular stabilization) and ISM (integrated system model) approaches.

You do not have to live with an unsightly abdominal separation that keeps you from being active. The team at NYDNRehab combines professional expertise with cutting edge therapies to restore your abdominal muscles to full integrity and function. Schedule a consultation today, and see why the sports medicine professionals at NYDNRehab are considered the very best in NYC.

Research at NYDNRehab


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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