Whether your abs feel weak or you see an odd bulge down the midline of your belly, we’ve got you. Separated abs — PTs call it diastasis rectus abdominis (DRA) — is common postpartum and can also be the result of overworking your abs. It’s never too late to repair DRA, but the sooner you do, the better: If left untreated, side effects can include back pain and bladder/bowel leaks. Does fixing your six-pack from the couch sound too good to be true? With virtual visits, that’s exactly how you’ll start.
GET MEASURABLE RESULTS
WHAT CAUSES SEPARATED ABS
During pregnancy, connective tissue between the rectus abdominis muscles stretches to fit your baby (picture taffy being gently pulled apart), creating a gap. At the gym, DRA can be the result of overworking upper abdominals while undertraining deeper core muscles.
WORK 1:1 WITH A PHYSICAL THERAPIST
Your PT will work with you to create a therapeutic exercise program that can improve DRA without surgery. Your treatment plan may include:
- Strategies for avoiding strain on your abs
- Techniques to re-activate abdominal muscle & tissue
- Exercises that help reduce ab separation
CLOSING THE GAP
Increasing tension in connective tissue takes time. Most patients notice improvement within 6-8 weeks and see a more significant change in 3+ months. Be patient with your body!
LET’S GET STARTED!
COMMON & TREATABLE
At 1 year postpartum, 1 in 3 women have DRA that doesn’t typically resolve on its own. Physical therapy delivers results without the need for surgery.
"I still look 5 months pregnant."
"My abs bulge out after I eat."
"I can’t connect with my ab muscles."
Sources: Mommers EHH, et al. The general surgeon's perspective of rectus diastasis. Surg Endosc. 2017; Sperstad JB, et al. Diastasis recti abdominis during pregnancy and 12 months after childbirth. British Journal of Sports Medicine. 2016.
Separated Abs FAQ
What is diastasis recti?
Diastasis recti is the stretching of the linea alba, the midline connective tissue between the rectus abdominis or “six-pack” muscles. Without adequate tension in the linea alba, your abdominals are not well supported. Long-term effects can include back pain and poor posture, as well as pelvic floor issues, including bladder and bowel leaks.
What does diastasis recti look like?
Diastasis recti isn’t always visible, but many patients with DRA notice a bulge down the midline of their belly, especially when their abdominal muscles are tensed during exercise or when coughing. Other patients report still looking pregnant, months or years after they’ve delivered their baby.
How do I know if I have diastasis recti?
During pregnancy, your growing baby pushes the abdominal organs upward and the ribs flare to create more room. This expansion changes the way the ribs articulate with the spine, which makes the joints more vulnerable.
At the same time, your hormones change, which can affect the laxity of the joints, including the now vulnerable costovertebral joints. These joints are typically injured due to an excess of pressure on the ribs from inside the body. This pressure can come from increased intra abdominal pressure, like a cough or sneeze, which can alter the position of the rib in relation to the vertebrae. Or added pressure can also come from something more physical, like a kick or punch from the growing baby, which can also alter the posture of the rib.
When assessing your rib pain, your Origin PT will begin by looking at your posture and the way you breathe. Our treatment plans often include different manual therapy techniques for your mid back and ribs, exercises to improve your postural strength and mobility, and strategies to optimize breathing patterns and posture. Taping techniques are often used to help rib pain as well.
What causes pregnancy-related hip pain? How does physical therapy help?
During pregnancy, the shape of the pelvis and uterus change. The pelvis expands and widens to prepare for childbirth, and the uterus expands as the baby grows. As the pelvis and belly change, the muscles and ligaments that attach to the pelvic girdle and pelvic cavity can move and stretch, causing pain and discomfort.
Hip pain can start at any point during pregnancy, but we typically see it arise in the middle of the second trimester once the hips widen and the belly pops a little. Pain on the side of your hips may arise even later as the load through your hips increases while sleeping. Round ligament pain is often transient, and will come about during growth spurts.
More often than not, hip pain is caused by a certain movement or position that is putting too much strain or pressure on the muscles of the hip. Your PT will assess your movements and positions and find the driver of your pain. Once identified, your PT will treat your hip pain with a combination of manual therapy techniques to the hips, strengthening and mobility exercises to provide added stability to the hips and optimize range of motion, as well as make corrections to the way you move and position yourself.
Your PT will ask you about your sleeping positions, work set up, preferred exercise, and even how you position your seat in your car. They may make modifications to one of all of those movements to address your symptoms.
Why do my neck and shoulders hurt so much during pregnancy? Can PT help with the pain?
During pregnancy, the breasts grow and get heavier. As a result of this change, the center of mass shifts forward, which can promote slouching and rounding of the neck and shoulders. Because of this change, the muscles of the neck, shoulders, and upper back must work harder to maintain proper posture as well as head and neck alignment. When these postural muscles are weak, the body will compensate and utilize whichever muscles it has available, typically the upper trapezius muscles. When these muscles are overworked, they go into spasm causing neck and shoulder pain. Neck pain during pregnancy can arise at any time, but it typically comes about later in the pregnancy when sitting or finding a comfortable sleeping position becomes challenging.
When we’re treating pain in the neck and shoulders, we look at your posture and positioning in its entirety. How are you sleeping? What is your work set up? What does the curve in your low back look like? We address any movement, position, or body part that could be affecting how your neck and shoulder move.
Your neck pain and poor posture is treated with a combination of manual therapy techniques to your muscles and joints, postural exercises, and strategies to improve the way you sit, sleep, and move. One of the biggest drivers of neck and shoulder pain is the way we move and hold our head. By making meaningful, long term changes to your movement patterns, you can have long term success.
Your PT will show you how to sit, sleep, drive, lift, and carry without overly stressing your neck and shoulders. They may also use certain taping techniques to improve your postural awareness as you get stronger.
Why does pregnancy cause tailbone pain and what can a PT do to fix it?
During pregnancy, the hormones that help your pelvic joints loosen to prepare for childbirth will also affect your tailbone or coccyx. The combination of a less stable tailbone and increased body weight during pregnancy puts more load through the tailbone, particularly with sitting, leading to pain and inflammation in the area. As a result, the muscles that are attached to the coccyx, including the pelvic floor, will tighten, which can make pain worse.
We treat tailbone pain or coccydynia from the inside out. We assess the pelvic floor, the glutes, and the rest of the muscles of your pelvic girdle to find the root cause of pain. We also look at the way you sit, stand up, and walk. Through a combination of manual therapy, specific strengthening and lengthening exercises, and changes to the way you move, we treat coccydynia comprehensively. Your PT may also recommend a pillow to sit on while your tailbone heals.