Fiona McMahon, DPT
Diastasis recti (DR) can be the bane of many who are trying to decrease the size of their stomach following pregnancy. DR occurs when the two six pack muscles (rectus abdominus) separate from one another, leaving the appearance of visible gapping and bulging of the stomach, creating the look of a belly or paunch. We most commonly see DR following pregnancy; however, it can be seen in men and women with abdominal obesity, children with bowel issues, and people who have undergone abdominal surgery. Aside from its cosmetic effects, DR can also cause problems with the low back, bowel, and bladder. Most physical therapists are trained to recognize and treat the musculoskeletal components of DR. We know to release the tight structures that are preventing the full closure of the abs, we correct alignment to reduce pull, we use sports tape to encourage the abs to activate, and we strengthen our patients’ core. It usually works wonderfully, but what if it could work better? If DR is a dysfunction of the musculoskeletal system, why treat the viscera? In pregnancy the uterus grows and as it enlarges and becomes an abdominal organ. The intestines don’t have much say when this happens and get pushed behind the uterus in order to accommodate their new neighbor. After pregnancy the uterus returns to its old home, however the intestines may remain “sticky†from the trauma of being squashed by the uterus, leading to pull on the abdominals from the inside, which prevents the full closure of the abdomen. By treating the organs (AKA the viscera) we can help reduce one more factor impeding the full closure of the abdominal muscles. How do I know if my organs are playing a role in the failure of my diastasis to close? Some of the signs of visceral involvement with DR include low back pain, left sided sciatica, lower extremity joint pain, distention or bulging of the lower abdomen, difficulty digesting raw vegetables, and weakness in the lower extremity following workouts, secondary to reduced bloodflow. What type of results can I expect from visceral mobilization? According to Brandi Kirk, pioneer of this approach for DR, resolution of DR using visceral techniques can take from 12 visits to 1 visit depending on the severity of the separation. She was able to demonstrate in her visceral mobilization class the following closures: Class 1
Patient | Diastasis Width Before | Diastasis Width After |
A | 2 finger widths | 0.5 finger widths |
B | 3 finger widths | 0.5 finger widths |
C | 1 finger widths | 0 finger widths |
Class 2
Patient | Diastasis Width Before | Diastasis Width After |
A | 2 finger widths | 1 finger widths |
B | 3 finger widths | 1.5 finger widths |
C | 2 finger widths | 0.5 finger widths |
If you have struggled in closing your diastasis independently or are experiencing some of the symptoms mentioned above, it is time for a little extra help. Come see the physical therapists at Beyond Basics, who are trained to give you the most complete treatment for your DR. You deserve it!