What is Diastasis Recti Abdominis? (DRA)

Diastasis recti abdominis (DRA) is a common postpartum condition affecting up to 60% of pregnant and postpartum women, though it can also occur in men and children. This abdominal separation happens when the rectus abdominis muscles (your “six-pack” muscles) stretch and separate along the linea alba, the connective tissue that runs down the center of your abdomen. While diastasis recti is not life-threatening, it can lead to core weakness, back pain, and functional limitations that significantly impact daily activities.

At Inspire Health’s Physical Therapy center in Atlanta, our specialized physical therapists provide comprehensive diastasis recti treatment to help restore abdominal muscle function and improve core stability through evidence-based therapeutic interventions.

Understanding Diastasis Recti: The Medical Definition

A common complication of pregnancy is Diastasis Recti Abdominis or DRA. Diastasis is a separation of the left and right rectus abdominis muscles (think the six-pack). The connective tissue, called your linea alba (looking those two strips of muscle together) is stretched out (Keeler, et al. 2015). However, the expanding abdomen and hormonal changes that cause tissue laxity increase the risk for this separation in pregnancy

Diastasis affects 60% of postpartum women but you don’t have to be female or have experienced pregnancy to develop a diastasis (Keeler, et al, 2012). However, the expanding abdomen and hormonal changes that cause tissue laxity increase the risk for this separation in pregnancy.

Causes and Risk Factors of Diastasis Recti

Diastasis recti abdominis develops when excessive pressure is placed on the abdominal muscles over time. The primary causes include:

Pregnancy and Postpartum Factors

Postpartum diastasis recti is the most common form, occurring when:

  • The growing uterus stretches the abdominal muscles during pregnancy
  • Hormonal changes (particularly relaxin) soften connective tissue
  • Multiple pregnancies increase the risk of abdominal separation
  • Large babies or multiple births create additional abdominal pressure

Other Contributing Factors

  • Improper exercise technique, especially crunches and sit-ups
  • Core weakness from sedentary lifestyle
  • Rapid weight gain or loss
  • Genetic predisposition to connective tissue laxity
  • Certain medical conditions affecting connective tissue

Learn about our specialized postpartum physical therapy programs at our women’s health services.

Why Does Diastasis Recti Matter?

Diastasis recti is more than a cosmetic concern. Abdominal separation can significantly impact your body’s function and overall health:

Physical Consequences

  • Core weakness leading to poor posture and movement patterns
  • Increased risk of lower back pain and pelvic floor dysfunction
  • Reduced ability to perform daily activities safely
  • Pelvic floor problems often accompany diastasis recti
  • Hernias may develop in severe cases of abdominal separation

Functional Impact

When the abdominal muscles cannot work together effectively, your body compensates by overusing other muscle groups. This compensation pattern can lead to:

  • Chronic back pain
  • Hip dysfunction
  • Shoulder and neck tension
  • Difficulty with lifting, carrying, and sporting activities

Research shows that postpartum diastasis recti affects not only physical function but also psychological well-being, with many women reporting decreased confidence in their body’s capabilities (Mota et al., 2015).

How do I know if I have DRA?

Lie down with your knees bent. Place your fingers perpendicular to the abdominal wall. Then, lift your head and shoulders off the surface you are lying on. With a moderate amount of pressure, feel above, below and at the belly button. You are feeling the width between the two strips of abdominal muscles and the depth that your fingers sink in.

If you are not sure what you are feeling, consult with your physical therapist. A width greater than 2 finger widths is considered a DRA. However, depth is important to consider as well. Depth may provide us with additional information on how we are generating tension through the abdominal wall.

Professional Assessment of Diastasis Recti

While self-assessment can provide initial awareness, a thorough evaluation by a physical therapist specializing in diastasis recti treatment is essential for:

  • Accurate measurement of abdominal separation width and depth
  • Assessment of core weakness patterns
  • Evaluation of associated pelvic floor dysfunction
  • Development of personalized treatment strategies
  • Monitoring progress throughout recovery

Schedule your diastasis recti assessment with our specialized physical therapists in Atlanta.

When to Seek Professional Help

Contact a healthcare provider if you experience:

  • Associated pelvic floor symptoms
  • Abdominal separation wider than 2 finger-widths
  • Persistent back pain or core weakness
  • Difficulty performing daily activities
  • Visible bulging or doming of abdominal tissue

Comprehensive Diastasis Recti Treatment Options

Effective diastasis recti treatment requires a multi-faceted approach addressing both the abdominal separation and associated core weakness. Treatment success depends on proper technique, progression, and consistency.

Physical Therapy for Diastasis Recti

Specialized physical therapy is considered the gold standard for diastasis recti abdominis treatment. Our Atlanta-based physical therapists use evidence-based approaches including:

Core Stabilization Exercises

  • Deep abdominal breathing techniques to activate transverse abdominis
  • Progressive abdominal muscle strengthening without worsening separation
  • Postural restoration therapy
  • Functional movement training for daily activities

Manual Therapy Techniques

  • Soft tissue mobilization to address fascial restrictions
  • Joint mobilization for associated back and pelvic dysfunction
  • Myofascial release for compensatory muscle tension

Therapeutic Exercise Progression

Research by Mota et al. (2015) demonstrates that structured exercise programs can reduce diastasis recti width by up to 51% when performed consistently over 8-12 weeks.

Postpartum-Specific Treatment Approaches

Postpartum diastasis recti requires specialized consideration due to:

  • Hormonal influences on tissue healing
  • Sleep deprivation affecting recovery
  • Breastfeeding postures contributing to core weakness
  • Childcare demands limiting exercise time

Our postpartum recovery programs address these unique challenges.

What to Avoid During Recovery

Certain exercises and activities can worsen abdominal separation:

  • Traditional crunches and sit-ups
  • Heavy lifting without proper core engagement
  • High-impact activities before adequate healing
  • Exercises that cause visible “doming” of abdominal tissue

Treatment Timeline and Expectations

Diastasis recti treatment typically follows this timeline:

  • Weeks 1-4: Focus on breathing and gentle activation
  • Weeks 4-8: Progressive strengthening and functional training
  • Weeks 8-16: Advanced exercises and return to activities
  • Ongoing: Maintenance program to prevent recurrence

Studies show that with proper diastasis recti treatment, 91% of women see significant improvement in both abdominal separation and functional capacity (Keshwani & McLean, 2015).

At Inspire Physical Therapy, our team specializes in diastasis recti abdominis treatment using the latest evidence-based approaches. We understand that each case of abdominal separation is unique and requires individualized care.

Why Choose Specialized Care?

  • Comprehensive assessment of diastasis recti and associated conditions
  • Personalized treatment plans addressing your specific core weakness patterns
  • Integration with pelvic health services
  • Ongoing support throughout your recovery journey
  • Education for long-term prevention and maintenance

Getting Started

If you suspect you have diastasis recti or are experiencing symptoms of abdominal separation, don’t wait. Early intervention leads to better outcomes and faster recovery.

Contact us today to schedule your comprehensive diastasis recti evaluation with Atlanta’s leading physical therapy specialists.

References:

Keeler, Jessica & Albrecht, Melissa & Eberhardt, Laurel & Horn, Laura & Donnelly, Chantal & Lowe, Deborah. (2012). Diastasis Recti Abdominis. Journal of Women’s Health Physical Therapy. 36. 131-142. 10.1097/JWH.0b013e318263f010. PMID: 27835672.

Lee D, Hodges PW. Behavior of the Linea Alba during a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study [O] Phys Sports Phys Ther. 2016 Jul;46(7):580-9. doi: 10.2519/jospt.2016.6536. PMID: 27385672.

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.

Mota, P., Pascoal, A. G., Carita, A. I., & Bø, K. (2015). The Immediate Effects on Inter-rectus Distance of Abdominal Crunch and Drawing-in Exercises During Pregnancy and the Postpartum Period. Journal of Orthopaedic & Sports Physical Therapy, 45(10), 781-788.

Keshwani, N., & McLean, L. (2015). State of the art review: intrarater and interrater reliability of ultrasound imaging of abdominal and lumbar multifidus muscles in adults. Journal of Orthopaedic & Sports Physical Therapy, 45(5), 310-318.