From the Guidelines
Treatment for diastasis recti primarily involves targeted exercises to strengthen the deep abdominal muscles, with a focus on core strengthening exercises like modified planks, pelvic tilts, and transverse abdominal contractions performed consistently, typically 10-15 repetitions, 2-3 times daily. The goal of these exercises is to draw the abdominal muscles inward rather than bulging outward, which can worsen the condition. It is essential to avoid traditional crunches, sit-ups, and heavy lifting, as they can exacerbate the issue.
Key Considerations
- Proper technique is crucial when performing exercises to treat diastasis recti.
- Physical therapy with a specialist trained in postpartum rehabilitation is highly recommended, particularly for cases where the separation exceeds 2 finger-widths.
- Supportive garments like abdominal binders can provide temporary relief and support during healing but shouldn't replace exercise therapy.
- Recovery takes time, typically several months of consistent effort, and should be approached gradually to prevent injury or worsening of the condition.
Surgical Intervention
For severe cases that don't respond to conservative treatment after 6-12 months, surgical repair (abdominoplasty) may be considered, though this is typically reserved for functional impairments rather than cosmetic concerns. The decision for surgical intervention should be made on a case-by-case basis, considering the individual's overall health, the severity of the diastasis recti, and the potential benefits and risks of surgery.
The provided evidence 1 does not directly address the treatment of diastasis recti, focusing instead on anorectal emergencies and the surgical treatment of constipation. However, based on general medical knowledge and the principles of treating abdominal wall separations, the recommended approach prioritizes conservative management with exercise and physical therapy, reserving surgical options for severe, non-responsive cases.
From the Research
Treatment Options for Diastasis Recti
- Physiotherapy is considered the first line of treatment for diastasis recti abdominis, with surgery only considered in cases of functional impairment after a standardized 6-month abdominal core training program 2
- Abdominal exercises have been shown to be effective in reducing inter-recti distance (IRD) below the umbilicus, but their effectiveness above the umbilicus is unclear 3
- Abdominal binding may also be used as a treatment option, with some studies showing positive effects on body image and trunk flexion strength 4
Surgical Treatment
- Surgery may be considered in cases of diastasis recti abdominis with a width of at least 5cm, or in cases of pronounced abdominal bulging or concomitant ventral hernia 2
- Plication of the linea alba is considered the first line surgical technique, with other techniques available but not found to be superior 2
Exercise Interventions
- Exercise interventions, including abdominal exercises and core training, have been shown to be effective in reducing the severity of diastasis recti abdominis in postpartum women 3, 5
- Online exercise interventions have also been shown to be effective in reducing diastasis recti abdominis width and improving core function 5
Diagnostic Criteria
- Diastasis recti abdominis can be diagnosed using a caliper or ruler for measurement, with diagnostic imaging by ultrasound or other imaging modality recommended in cases where concurrent umbilical or epigastric hernia or other cause of symptoms cannot be excluded 2