Diastasis Recti, a condition in which the abdominal muscles separate, is a common concern for many, particularly after pregnancy. This separation occurs when the connective tissue between the two sides of the rectus abdominis (the “six-pack” muscles) weakens, creating a gap. While the condition is often associated with pregnancy, it can also affect individuals who have experienced significant weight fluctuations, heavy lifting, or even advanced age.
What is Diastasis Recti?
Diastasis Recti, or abdominal muscle separation, occurs when the connective tissue (the linea alba) that holds the left and right sides of the rectus abdominis muscle together becomes stretched or weakened. As a result, a visible bulge or gap can appear down the midline of the abdomen. This condition can lead to a variety of issues, including core instability, lower back pain, pelvic floor dysfunction, and poor posture.
While Diastasis Recti can occur in both men and women, it is most commonly seen in women following pregnancy due to the pressure placed on the abdominal muscles during gestation. However, it can also occur in people who have experienced significant weight gain, those who have engaged in heavy lifting, or as a result of the natural ageing process.
How Physiotherapy Can Help Treat Diastasis Recti
The good news for those suffering from Diastasis Recti is that physiotherapy can often help reduce or even eliminate the condition without the need for invasive surgery. In fact, many physiotherapists specialise in treating this condition through various non-surgical methods aimed at restoring the integrity and function of the abdominal muscles and core.
1. Core Strengthening Exercises
A key component of physiotherapy treatment for Diastasis Recti is strengthening the core muscles. The rectus abdominis muscles are part of the core, and the gap created by Diastasis Recti can lead to weakness and poor function of the entire core. Physiotherapists typically recommend specific strengthening exercises that target the deep core muscles, such as the transverse abdominis and pelvic floor muscles, to help close the gap and improve core stability.
Exercises that engage these deeper muscles while avoiding excessive pressure on the abdominal wall can significantly reduce the separation over time. Physiotherapists may also recommend techniques like abdominal bracing, where patients are taught to activate their core muscles controlled and effectively.
2. Breathing Techniques
Breathing plays a crucial role in the function of the core muscles. Physiotherapists often teach diaphragmatic breathing techniques as part of the rehabilitation process. These techniques help activate the deep abdominal muscles while encouraging proper alignment and posture. Breathing exercises also help reduce the risk of excessive intra-abdominal pressure, which can worsen Diastasis Recti.
By focusing on controlled, deep breathing, patients can effectively engage the correct muscles, helping to heal the separation in the abdominal wall.
3. Postural Alignment
One key factor contributing to Diastasis Recti is poor posture, particularly the habit of slouching or bearing down incorrectly while performing everyday activities. Physiotherapists work with patients to correct postural imbalances that can exacerbate the condition. By teaching proper alignment and body mechanics, physiotherapists can help reduce strain on the abdominal muscles, preventing further separation and promoting healing.
Maintaining correct posture during activities such as sitting, standing, and lifting is essential for improving Diastasis Recti and preventing the condition from worsening.
4. Manual Therapy
In some cases, manual therapy may be used to help reduce the gap between the separated muscles. This can involve soft tissue mobilisation or gentle abdominal massage to promote connective tissue healing. While manual therapy alone is not typically enough to heal Diastasis Recti, it can be an effective complementary treatment alongside exercises and postural adjustments.
A physiotherapist may also use techniques like myofascial release to address any tension or tightness in the muscles and connective tissue, aiding in the healing process.
5. Education and Lifestyle Modifications
A vital part of physiotherapy is patient education. Physiotherapists help patients understand the condition, its causes, and the importance of making lifestyle modifications to support healing. This might include recommendations for avoiding certain activities that could put undue pressure on the abdomen, such as heavy lifting or high-impact exercise, as well as guidance on incorporating functional movements into daily life to support recovery.
Can Surgery Be Avoided?
In many cases, physiotherapy can significantly reduce or even resolve Diastasis Recti without the need for surgery. However, the extent of recovery depends on factors such as the severity of the condition, the patient’s commitment to the prescribed exercises, and how long the separation has been present.
Surgery, specifically a procedure known as abdominoplasty or rectus abdominis plication, may be considered in cases where physiotherapy has not yielded results or if the separation is particularly severe. This is typically a last resort, as physiotherapy can often provide significant improvements.
