Diastasis Recti Rehabilitation in Faridabad
Diastasis recti (also called diastasis rectus abdominis or DRA) is the separation of the two rectus abdominis muscle bellies along the midline of the abdomen (linea alba). It is extremely common during and after pregnancy -- affecting up to 100% of women in the third trimester and approximately 39% of women at 6 months postpartum. Despite being so common, most women in Faridabad do not receive proper diagnosis or treatment, leading to ongoing symptoms that significantly affect quality of life.
At Realign Rehab Clinic in Faridabad, Dr. Vaishali Suri and our women's health physiotherapy team provide specialised assessment and rehabilitation that effectively closes the gap, restores core function, and eliminates associated symptoms.
What Causes Diastasis Recti?
During pregnancy, the growing uterus pushes outward against the abdominal wall. Combined with hormonal softening of the connective tissue (linea alba) and the mechanical stretching force of the expanding abdomen, the two rectus muscle bellies separate. This separation normally occurs to accommodate the baby, but in many women it fails to fully close postpartum.
Risk Factors
- Multiple pregnancies or closely-spaced pregnancies
- Large baby or multiple babies (twins, triplets)
- Excess abdominal pressure during delivery (prolonged pushing)
- Returning to high-impact exercise too early postpartum
- Performing traditional sit-ups and crunches postpartum (worsens the gap)
- Chronic constipation and straining
Symptoms of Diastasis Recti
- A visible 'dome' or 'coning' of the abdomen when sitting up or straining
- A soft bulge or gap felt along the midline of the abdomen
- Persistent 'mummy tummy' or 'mummy pouch' that doesn't flatten despite weight loss and exercise
- Lower back pain and pelvic instability
- Pelvic floor dysfunction and urinary incontinence
- A feeling of core weakness -- difficulty with lifting, carrying, or everyday activities
- Poor abdominal appearance that does not improve with diet or traditional exercise
Why Traditional Sit-Ups and Crunches Are Harmful
This is critically important: traditional abdominal exercises including sit-ups, crunches, double leg raises, and many yoga poses significantly worsen diastasis recti by dramatically increasing intra-abdominal pressure and pulling the gap wider. Many women make their condition worse by following general 'postpartum fitness' advice that is not appropriate for diastasis recti. Always seek physiotherapy assessment before starting postpartum exercise.
Our Diastasis Recti Physiotherapy Programme
1. Clinical Assessment
We perform a detailed assessment of the inter-recti distance (IRD) -- the width of the gap -- and linea alba tension. We assess pelvic floor function, breathing patterns, and identify dysfunctional movement patterns that are loading the gap incorrectly. This assessment guides the entire rehabilitation programme.
2. Breathing and Pressure Management
The foundation of diastasis recti rehabilitation is learning to manage intra-abdominal pressure. We teach diaphragmatic breathing coordinated with pelvic floor activation -- the basis of all subsequent exercises. Improper breathing and bracing patterns are the primary reason diastasis recti fails to close.
3. Deep Core Activation
Transversus abdominis (TA) activation -- the deep corset muscle -- is the primary treatment exercise for diastasis recti. We use specific techniques including 'drawing-in', heel slides, and dead bugs performed in the correct manner to activate TA without increasing abdominal pressure on the linea alba.
4. Progressive Core Rehabilitation
As the linea alba tension improves, we progressively add functional loading exercises. The programme advances through specific stages, each ensuring the linea alba can handle the load before progressing. Activities are cleared based on gap width and tissue tension, not arbitrary timeframes.
5. Pelvic Floor Rehabilitation
Diastasis recti and pelvic floor dysfunction frequently coexist. Our programme addresses both simultaneously, as they form part of the same core pressure management system.
6. Return to Exercise Guidance
We provide clear guidance on when and how to safely return to general exercise, including which activities to avoid and when higher-impact activities become safe. This prevents the common mistake of returning to inappropriate exercises too early.
What Results Can You Expect?
Most women notice significant improvement in gap width and core function within 8-16 weeks of consistent physiotherapy. The goal is not always complete closure of the gap (anatomically this is not always achievable) but restoration of linea alba tension, core function, and elimination of symptoms including back pain and incontinence.
Frequently Asked Questions
Q: How long after delivery can I start diastasis recti treatment?
We recommend an assessment at 6-8 weeks postpartum, after your obstetric clearance. Earlier assessment is possible to check for severe separation that needs immediate guidance on avoiding harmful activities.
Q: Can diastasis recti close completely?
In many cases, yes. The success depends on the severity of the gap, the quality of the linea alba tissue, and how early treatment begins. Even when complete closure isn't achieved, symptom elimination and functional restoration are almost always possible.
Q: Is surgery ever needed for diastasis recti?
Abdominoplasty (tummy tuck) surgically repairs diastasis recti but carries significant risks and recovery time. Physiotherapy should always be fully optimised before considering surgery. Most women achieve excellent results with physiotherapy alone.
Q: Does diastasis recti cause the mummy pouch?
Yes. The gap in the linea alba allows abdominal contents to push forward, creating the characteristic mummy pouch or tummy bulge that persists despite weight loss and exercise. Closing the gap through physiotherapy reduces this significantly.