Understanding Diastasis Rectus Abdominis

Diastasis rectus abdominis (DRA) is a condition where the left and right sides of the most superficial abdominal muscle separate due to stretching of the connective tissue called the linea alba.

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How Do I Know If I Have DRA?

A 2014 study found that 100% of women by their 35th week of pregnancy have DRA, with a separation of 16mm wide just below the belly button. This figure reduces to 35-39% by six months postpartum. This means many expecting and new mothers likely have or have had DRA. If you’re in this category, you may experience the following symptoms:

Visible and palpable separation of the outermost abdominal muscle
A sensation of weakness in the midsection
Doming or coning of the middle abdomen during activities like lifting, rolling over, or doing planks and crunches
Poor posture
Low back, pelvic, and/or hip pain
Persistent “pooch” or “mommy tummy” despite core exercises

During pre/postnatal screening at Gold Coast Pilates Therapy (GCPT) in Beverly, MA, our resident physical therapist and postpartum corrective exercise specialist, Dr. Kristen Hardin, PT, NCPT, PCES, can also help to identify DRA by performing a manual assessment and walking you through how to do a self-assessment.

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Should I even bother dealing with DRA when I’m pregnant?

During pregnancy, the rapid growth of the fetus during the second and third trimesters causes the uterus to expand and place more pressure against the abdominal wall. This pressure leads to widening, or a gap, of the connective tissue between the left and right sides of “the six pack.” The goal of fitness training at this point is to maintain the DRA and prevent the gap from growing larger.

In the postpartum phase, research has shown that DRA may resolve without intervention in the fourth trimester. However, this is not always the case and the earlier you see a specialist, the sooner you will close the gap and be able to return to the activities you love and maximize the joys of motherhood! And if life has gotten in the way and you are one, two, or twenty years postpartum - it is NOT too late to take a look and do something about it!

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How Pilates Helps with DRA

DRA involves more than just the rectus abdominis. It is a WHOLE BODY ISSUE and multiple biomechanical factors come into play. Would you believe that your ribs, hips, pelvic floor, and even your feet can affect DRA? The Pilates Method is a WHOLE BODY EXERCISE SYSTEM that can be incredibly therapeutic for DRA when presented correctly, as a skilled teacher will cue your body from head to toe.

To achieve whole-body integration and management of pressure in the abdomen that puts strain on the linea alba, a Pilates lesson should include the following to promote closure of the DRA:

Learning optimal breathing mechanics
Performing mobility exercises to balance asymmetries in muscle length
Correcting postural misalignments
Properly activating the deep core muscles: transverse abdominis, diaphragm, obliques, pelvic floor, and lower back muscles

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Can I fix my DRA with Pilates Reformer classes or are 1:1 sessions necessary?

Pilates + Physical Therapy = Magic

A 1:1 Studio Pilates Therapy session at GCPT can help you address the specific postural, strength, and movement impairments noted in a DRA screening with an individualized program for your body, your goals, and on your own timeline. During these sessions, you will learn strategies to better manage intra-abdominal pressure in your daily life, as well as exercise, and may receive soft tissue mobilization to manually promote closure of the gap. Like any other area of the body, the fascia along the abdominal wall can get "sticky" and create "knots." This soft tissue restriction can make it very hard for the "six-pack muscles" to return back to the midline of the body. This is where GCPT blends Pilates and physical therapy!

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In our private Studio Pilates Therapy sessions, a licensed physical therapist can work to manually mobilize and release this restricted layer of tissue over the abdominal muscles and bring balance back to your body. In some cases of DRA, the belly button is off-center and after the release work, the changes in the body can be seen immediately to the eye - it is quite amazing!

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Small Group Reformer Training on the North Shore

If 1:1 sessions do not work with your schedule, budget, or preferences, then our intimate Pilates Reformer classes here in Beverly teach alignment, breathing, centering, coordination, and control of the whole body, which can definitely help someone looking to address DRA with workout for the general population. DRA is a whole body issue, which is why Pilates Therapy works!

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Embrace the Journey

Having a DRA during pregnancy is a natural part of growing a beautiful baby. The connective tissues in the abdomen stretch to allow for the baby's growth and for your organs to function properly. If you still have DRA postpartum, that’s okay too! There are many things you can do to help, and I’m here to support you every step of the way – it’s kind of our thing!

Ready to start your journey to healing DRA?

Visit our studio in Beverly, Massachusetts, today by scheduling a session with our specialist, Dr. Kristen Hardin, PT, DPT, NCPT, PCES. After resolving her own DRA, she has served postpartum moms at Treetop Yoga, Stork Ready, and Joint Ventures Physical Therapy in Boston before opening Gold Coast Pilates Therapy in 2022.