Does Pelvic Floor Therapy Help With Diastasis Recti?
Diastasis recti is the separation of the abdominal muscles caused by stretching of the connective tissue between them, most commonly during pregnancy. This blog explains what causes diastasis recti, the symptoms to watch for, and how pressure management and core function affect recovery.
The article also explores how the pelvic floor and abdominal muscles work together during everyday movement and exercise. Understanding this connection can help individuals recognize when pelvic floor dysfunction may be contributing to weakness, coning, or difficulty returning to activity.
Pelvic floor physical therapy can help assess core function, improve pressure management, and guide safe strengthening progressions for recovery. The blog also outlines what to expect during treatment and realistic timelines for improvement.
Learn how pelvic floor therapy can help with diastasis recti, improve core function, and support safe recovery after pregnancy or abdominal strain.
What Is Diastasis Recti?
Diastasis Recti refers to the separation of the rectus abdominus (six-pack) muscle through the stretching of the connective tissue that is in between (the linea alba). While it often happens because of pregnancy, it can also occur for other reasons such as poor abdominal pressure management. For those who are pregnant or postpartum, it is important to realize that diastasis recti is a normal adaptation that occurs because of having a baby. The abdominal muscles are made to stretch as the pregnancy progresses and the baby grows. Furthermore, there is not a universally “good” or “bad” exercise for diastasis, despite what you may read on the internet. Effective exercise is determined by individual capacity and pressure management.
Common Causes of Diastasis Recti
Pregnancy
Chronic weightlifting with improper pressure management (such as professional movers for example)
Rapid weight gain
Aging
Connective tissue disorders
Signs and Symptoms to Watch For
Visible bulge above or below your belly button
“Coning” in your abdomen that happens with lifting, coughing, or engaging your abdominal muscles
Low back pain
Feeling of weakness in the trunk
Pelvic floor dysfunction such as leaking or constipation
Difficulty engaging abdominal muscles during exercise
How the Pelvic Floor and Core Work Together
The pelvic floor is the bottom or floor of the trunk or “core.” Since it is part of the core, the pelvic floor and core work together. Whenever you do core exercises or functionally use your core, such as pushing, lifting, pulling, your pelvic floor should come along for the ride. For some people, this may not happen, and that is where a pelvic floor PT can be helpful. However, for the most part, the pelvic floor will contract sub-maximally whenever we do lifting, pushing or pulling. One other fun thing to point out is that this is not a Kegel. A kegel is an isolated maximal contraction of the pelvic floor. For our day-to-day movement, we are not performing Kegels. The pelvic floor is automatically engaging along with our core when we do certain tasks.
This is why a pelvic floor examination can be helpful when we evaluate diastasis recti. If there is pelvic floor dysfunction, it can affect the progress that we make with treating a diastasis and it can affect core function in general. We want to make sure there is no specific pelvic floor problem when are rehabilitating our core and working to close a diastasis.
Can Pelvic Floor Therapy Help?
Pelvic floor therapy is the gold standard treatment for diastasis recti. Pelvic floor therapists, like Natalie at Take Flight Physical Therapy, specialize in working with individuals with pelvic or abdominal issues. Treatment for diastasis involves evaluating the abdominal wall for separation, depth and pressure management. We make sure to evaluate the pelvic floor as well. We then prescribe core and hip strengthening exercises and go over your strategy for how to exercise your trunk.
What to Expect During Pelvic Floor Therapy
During your first appointment, we will go over your personal history, concerns and goals. We will discuss your symptoms, past medical and surgical history, lifestyle and more. For this portion of the appointment, you will be seated comfortably.
The next part of the appointment will involve an internal or external assessment. Often, the pelvic floor physical therapist will use a pelvic model to explain anatomy. The model is also used to explain what an internal pelvic floor assessment involves and to answer any questions. Then the therapist and patient decide together if an internal assessment is appropriate for the first visit. Remember an internal assessment is never required and the choice is fully yours as the patient!
Otherwise, an external assessment can be performed. may involve watching you walk, squat, lunge, hinge or stand on one leg. It can also include testing specific muscles for strength and endurance. For diastasis, the therapist will ask you to lay down with your knees bent and to perform a crunch up while they evaluate your abdomen. They may ask you to do this a few times. Based on these findings, you will do some movement and different exercises to assess pressure management and your individual capacity.
The last part of the appointment will include a summary of the therapist’s findings and next steps. The therapist will outline future treatment and what will be most beneficial for the patient to reach their goals.
Exercises That May Support Recovery
There are two important things to note when it comes to exercise and diastasis. The first is that there is no universal blanket recommendation for what is “good” and “bad” when it comes to exercises for diastasis. There is only what will work well for you individually based on your individual capacity and endurance.
The second important things to note is that, for treatment for diastasis to be effective, the muscles of the trunk must be challenged. That means we need to quickly progress from exercises on your back to trunk exercises in quadruped, standing, with rotation and with weights. We need to work in different planes to challenge the musculature.
When to Seek Professional Help From A Pelvic Floor Therapist
If you are noticing coning or bulging in your abdomen
If you are experiencing feelings of weakness in your abdomen
If you are experiencing lower back pain
If you are unsure of how to get back into exercise
If you have any pelvic floor symptoms such as leaking, pelvic pain or other concerns
Recovery Timeline and Expectations
A large part of diastasis rehab centers around strengthening the core muscles and challenging them appropriately. For most people, it takes 8-12 weeks of strengthening exercises 3 times a week to improve the strength of a muscle. Therefore we are looking usually for at least three months of consistent exercise to see improvement in your diastasis.
Where to Find Pelvic Floor Physical Therapy in Queens, NYC and Midtown Manhattan
If you are wondering if you have a diastasis or looking for help with your core, help is available! Pelvic floor physical therapy can help guide you towards improving your diastasis and strengthening your core. If you are in the Forest Hills, Queens, NYC area or Midtown Manhattan, and you are looking for help today, reach out to us! Take Flight Physical Therapy specializes in pelvic floor physical therapy in Forest Hills, Queens, NYC. Give us a call or fill out our contact form today!
