Diastasis Rectus Abdominis (DRA)

What is diastasis rectus abdominis? 

Your rectus abdominis, commonly referred to as your “6-pack muscles,” is attached to either side of your linea alba, a band of connective tissue that runs from the bottom of your sternum to your pubic bone. These muscles play a key role in protecting your internal organs, maintaining posture, and supporting your pelvis and back. In pregnancy, the added pressure of a growing baby and hormones that cause laxity in your connective tissue, causes the linea alba to stretch and separate.    

After giving birth, DRA may naturally resolve when your hormone levels return to normal. However, some studies have shown that even at 6 months postpartum, up to 40% of women continue to have DRA.  

Who is at risk? 

DRA can occur in both genders and across all age groups. Risk factors include pregnancy, having a caesarean section or any other abdominal surgery, or losing a significant amount of body mass over a relatively short amount of time. There are, however, no increased instances of DRA among people who perform heavy lifting, pregnant women with large babies, and people who experience significant weight gain.   

How do I know if I have DRA? 

At MOTI, we screen every postpartum woman for diastasis rectus abdominis, even if they are being treated for something unrelated. This screening can also be performed at home or at your doctor’s office.  

To check if you have DRA, start by lying on your back with your knees bent and feet on the floor. You or a partner can place their hand palm down on your belly with their fingers gently pressing into your navel area. Then, perform a small crunch by lifting your head off the ground and bringing your chin towards your chest. You will notice your rectus abdominis contracting under your fingers as you lift your head. If you feel the muscles separate and  form a gap of at least two finger widths, then you have DRA.   

What do I do if I have DRA? 

If you have DRA, it is best to have the condition treated because it can lead to other issues such as lower back pain, hip pain, and pelvic floor dysfunction. Physical therapy and exercise are the only conservative measures that have been shown to decrease the separation of the rectus abdominis. Returning to traditional core exercises may make the condition worse because as your muscles contract, they tug on the linea alba causing further separation. It is recommended to find a physical therapist trained in postpartum conditions to provide guidance to safely treat your DRA.    

– Dr. Fei Zang, PT, DPT

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