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Diastasis Rectus Abdominis

Written By: Naomi Dillon PT, DPT

During pregnancy your body moves and changes to accommodate your ever-growing baby. As your baby grows larger and larger, your abdomen has to relax and stretch to allow for the baby to find space. After pregnancy, some people’s bodies struggle to return to the “normal” abdominal position, and some space remains between the rectus abdominis (or the 6 pack muscle). We believe that this is due to stretching of what is known as the linea alba, resulting in what we call Diastasis Rectus Abdominis (or DRA). During your first assessment, your Physical Therapist can determine how significant your diastasis is and can help you determine what areas should be strengthened.

In the research, we find that about 60% of postpartum women have this separation1. This common finding can coincide with low back pain, as well as some other pelvic floor conditions, like urinary incontinence. Many women find their way into physical therapy to address these issues, improve their strength, and to make sure they safely return to their activities. 

Research suggests that to take care of all of these issues, core retraining guided by a PT helps to resolve low back symptoms, incontinence symptoms, and can help to reduce the gapping that many women notice. Initially, your PT will work with you to make sure you are able to isolate your pelvic floor and transversus abdominis. From there, they will help you build up your core strength and ability to transfer load through your abdomen by performing abdominal strengthening exercises while making sure that your core canister (pelvic floor, transversus abdominis, and diaphragm) are all working to give you strength and stability 2,3,4,5. 

  1. Leopold, Madeline BA1; Santiago, Kristen BA1; Cheng, Jennifer PhD1; Keller, Leah CPT2; Abutalib, Zafir MHS3; Bonder, Jaclyn MD4; Sharma, Geeta MD5; Tenforde, Adam MD6,7; Casey, Ellen MD1 Efficacy of a Core Strengthening Program for Diastasis Rectus Abdominis in Postpartum Women: A Prospective Observational Study, Journal of Women’s Health Physical Therapy: October/December 2021 – Volume 45 – Issue 4 – p 147-163 doi: 10.1097/JWH.0000000000000214 
  2. Lee D, Hodges PW. Behavior of the linea alba during a curl-up task in diastasis rectus abdominis: An observational study. Journal of Orthopaedic & Sports Physical Therapy. 2016;46(7):580-589. doi:10.2519/jospt.2016.6536 
  3. Sandra B Gluppe, Marie Ellström Engh, Kari Bø, Immediate Effect of Abdominal and Pelvic Floor Muscle Exercises on Interrecti Distance in Women With Diastasis Recti Abdominis Who Were Parous, Physical Therapy, Volume 100, Issue 8, August 2020, Pages 1372–1383, https://doi.org/10.1093/ptj/pzaa070
  4. Sandra L Gluppe, Gunvor Hilde, Merete K Tennfjord, Marie E Engh, Kari Bø, Effect of a Postpartum Training Program on the Prevalence of Diastasis Recti Abdominis in Postpartum Primiparous Women: A Randomized Controlled Trial, Physical Therapy, Volume 98, Issue 4, April 2018, Pages 260–268, https://doi.org/10.1093/ptj/pzy008
  5. Nicole F Hills, Ryan B Graham, Linda McLean, Comparison of Trunk Muscle Function Between Women With and Without Diastasis Recti Abdominis at 1 Year Postpartum, Physical Therapy, Volume 98, Issue 10, October 2018, Pages 891–901, https://doi.org/10.1093/ptj/pzy083