Outpatient Physiotherapy
Diastasis Recti (Abdominal separation) This leaflet provides information, answers and self-help strategies regarding the management of diastasis recti.
FREQUENTLY ASKED QUESTIONS What is diastasis recti? Diastasis recti, also known as abdominal separation, is a condition where the abdominal (six pack) muscles become overstretched and then separate along the midline of the abdominals, called the linea alba.
How can I tell if I have diastasis recti? A sign of diastasis recti is an observable doming down the middle of your stomach. It is different to a hernia. You can check this by lying on your back with your top rolled up so you can feel your stomach. Gently tuck your chin towards your chest and lift your head and shoulders up from the floor, if you notice a doming shape in the midline of your stomach it could be a sign of diastasis recti.
What are the causes? Diastasis recti is most common in females, particularly following pregnancy. However it can also be present in the male population.
Other causes include: Many years of poor abdominal loading/lifting with poor technique. Chronic straining. Hypermobility. Obesity. Multiple pregnancies. Twins and IVF pregnancies carry a higher risk of diastasis recti due to the increased bump size and tissue elasticity.
How is it treated? Diastasis recti is best treated by progressively strengthening the abdominal muscles with a specific exercise programme. Making adaptations to activities during the day, such as avoiding strenuous exercises/activities that cause the abdominal wall to bulge out, for instance straining on the toilet, heavy lifting and rising up from lying down which can be adjusted by rolling to the side to get out of bed. Tubigrip or stomach supports can also be helpful initially to support your posture, however this is most effective when combined with the strengthening exercises provided overleaf.
WHAT CAN I DO? Deep stomach muscle strengthening programme
EXERCISE
A strengthening programme which focuses on increasing abdominal muscle strength can help reduce the diastasis. These exercises can be effective and will need to be done regularly during a long term period to have any benefit. During the exercises you will need to ensure you avoid any doming of your tummy and if this occurs, regress to the previous exercise.
I have tried these treatments before. What else can I do? In some cases, a diastasis may not significantly change following Physiotherapy. Your GP will be best positioned to discuss this and any other options if there is no improvement following an exercise programme for at least three to six months.
1
Fully exhaling to engage the abdominals Lie on your back with your knees bent up and feet flat on the floor whilst placing your fingers on the abdominal wall, just inside your pelvic bones. Take a silent breath in through your nose, and fully exhale through your mouth, like you’re trying to mist up a mirror. Hold the fully exhaled position for three seconds. Repeat up to 10 times in one set.
EXERCISE
2
Single knee lifts Starting position as in exercise 1. Perform the same breathing technique, but lift your knee as you exhale. Hold it as you inhale, and exhale fully as you lower it back down. Repeat this 10 times on each leg.
EXERCISE
3
Single knee lifts with leg straightening Starting position as in exercise 1 Lift one knee up and then straighten your leg all the way to the floor, then bend your knee back upwards to the starting position. Exhale when the leg is moving, inhale when it is at the start or end position. Repeat this exercise 10 times on each leg, slowly and with control.
EXERCISE
4
Alternate tabletops Lie on your back with knees bent up and feet flat. Raise both your hips and knees so they are at a 90 degree angle. In this position, slowly lower one leg to the ground so it is fully straight whilst keeping the other leg at a 90 degree position. Inhale whilst your leg is still, exhale as it moves. Repeat this exercise 10 times on each leg, slowly and with control.
EXERCISE
5
Deadbugs Starting position as in exercise 4. Raise both your hips and knees so they are at a 90 degree angle and your arms are elevated straight up to the ceiling. In this position, slowly lower one leg to the ground so it is fully straight, whilst keeping the other leg in a 90 degree position. At the same time, move the opposite arm backwards. Inhale at the start, exhale as you move, inhale at the other end of the movement, and exhale as you come back to the start. Repeat this exercise 10 times on each leg, slowly and with control.
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