by Jennifer Mohns, DPT
I have been receiving a lot of questions about my previous blog called “The Mummy Tummy.” Diastis rectus abdominis (DRA) or diastasis recti affects women during and after pregnancy. Sixty-six percent of women have DRA in the third trimester of pregnancy.
A lot of the questions have been repeats so I feel it would be best to take this time and space to answer the questions to the public.
Q: “Does it matter how long ago the separation happened? Can it still be fixed?”
A: The answer is always yes to this question. There is not an amount of time that makes the separation irreversible. However, as the body becomes accustomed to the separation and the muscles learn to align in this misfigured position. The longer the separation has been present the longer the rehabilitation may take. If the muscles are used to a certain alignment it will take longer to train them to approximate the separation.
Q: “How do I know if I am a candidate for physical therapy vs surgery?”
A: The idea of surgery is tossed around regularly when it comes to DRA. However, surgery is rarely the appropriate answer. Most cases of DRA can be treated conservatively through physical therapy treatment or with a belly binder. In most cases, a DRA 4 fingers and smaller can be approximated completely without surgery. I have even treated a couple of women with a full five finger separation that have benefitted from physical therapy alone. I strongly suggest consulting with a physical therapy who specializes in women’s health or DRA before consulting with a surgeon. Most medical doctors do not know that physical therapists treat this dysfunction with such high success rates.
Q: “Do I have to participate in physical therapy treatments 3 times per week to fix my DRA?”
A: This is one of the most common questions I am asked by women who have just had a child and have other little ones at home. I understand that it is hard to find a PT in your area that can help with DRA specifically and it is hard to travel consistently when you need to be working or with your children. It is very possible to participate in PT 1-2 times per month and actually do most of the work on your own at home. Once you have been evaluated and educated about the treatment process it can be down as an independent home program with follow up appointments. It is best to begin physical therapy as soon as possible in order to approximate the separation in the most efficient way, so even 1-2 appointments in the beginning can make a big difference.
Dr. Mohns is a Physical Therapist at Boston Sports Medicine