Health, postpartum

Diastasis Recti 101

Diastasis rectus abdominis (DRA) is a separation of the left and right sides of our most superficial abdominal muscle and caused by forces that stretches connective tissue called the linea alba.
How do I know if I have a DRA?
A 2019 study suggests that 100% of women by their 35th week of pregnancy have DRA – measured by 16mm wide, just below the belly button. This same study reported that this figure reduced to 39% by 6 months postpartum. This tells us that there is a good probability that many expecting mothers and moms of littles have or have had a DRA!

If you fall into this category, then you may experience any or all of the following symptoms:

  • A separation of the outermost abdominal muscle that is visible and felt by palpating, or touching, the stomach
  • A sensation of weakness throughout the midsection
  • Doming or coning of the middle of your abdomen while lifting, rolling over, or during exercises such as planks and crunches
  • Poor posture
  • Low back, pelvic, and/or hip pain
  • Feelings of “the pooch” or “mommy tummy,” even if you have been working on your core strength

During a virtual session, a prenatal and postnatal fitness specialist can also help to identify DRA by walking you through a self-assessment.
Can I fix my DRA with virtual training sessions?
Sorry mama, but there is no magical fix. Only YOU can help to manage and close your DRA with consistent, long term effort, BUT it is very do-able! The same specialist that can help you ID the DRA can also assess your posture, strength, and movement patterns, teach you strategies to better manage intra-abdominal pressure, develop an individualized program for your body and your goals and help you progress the exercises in a safe and effective manner.
During pregnancy, the rapid growth of the fetus during the second and third trimesters causes the uterus to expand and place more pressure against the abdominal wall. This pressure leads to widening, or a gap, of the connective tissue between the left and right sides of “the six pack.” The goal of fitness training at this point is to maintain the DRA and prevent the gap from growing larger.
DRA can resolve without intervention in the fourth trimester, however the earlier you see a specialist, the sooner you will close the gap and be able to return to the activities you love and maximize the joys of motherhood!
How does Pilates help?
DRA is not purely an issue with the rectus abdominis. There are many biomechanical factors that come into play. Contrology, commonly known as Pilates matwork, is a whole body exercise system that (when modified correctly) can be an incredibly powerful therapeutic activity for DRA!
“The movement principles are elements that are present in the successful performance of all the Pilates exercises: whole body movement, breathing, balanced muscle development, concentration, control, centering, precision, and rhythm. (PMA Study Guide 2005)”
By learning optimal breathing mechanics, performing mobility exercises to balance asymmetries in muscle length, correcting postural malalignment, discovering how to properly activate the deep core muscles (transverse abdominis, diaphragm, oblique, pelvic floor and lower back muscles) as a unit with Pilates-based exercises, one will integrate with the mind with the body, control intra-abdominal pressure and feel a deep sense of whole body integration as the DRA begins to close.
In essence, a DRA during pregnancy is part of the process of growing a beautiful baby, so do not fret if you have one! The job of the connective tissues in the front of the abdomen are to stretch and allow for the baby to grow and for your organs to keep doing their jobs. If you still have a DRA in the postpartum period, that is OK, too! There are lots of things to do and I am here to help with that – it’s kind of my thing!
About Dr. Hardin
Flourish Care provider, Dr. Kristen Hardin, PT, DPT, NCPT  is the founder of K Pilates Rehab. She is a Physical Therapist and Prenatal + Postpartum Pilates specialist. Her goal is to empower busy moms of littles to pamper themselves with Pilates to balance their bodies for birth and beyond. During her career in orthopedics, sports and dance medicine, home health, and fitness, she became a mom to a spunky little girl and busy baby boy. With a new appreciation for maternal wellness, Kristen has devoted her professional development to prenatal and postpartum fitness coaching.