The physiotherapists at Donna Sarna Physiotherapy & Rehabilitation can help in determining the extent of your diastasis recti and advise you on exercises and techniques that can lessen the separation in a safe and effective manner. Not all abdominal exercises are safe to perform after pregnancy if you have diastasis recti, and some exercises can make the separation worse. Strengthening of specific muscles that stabilize the core is the first step and is necessary to reduce the separation. Muscles that comprise the inner core include the diaphragm, as well as a specific stomach muscle known as the transverse abdominus, specific back muscles known as the multifidi, and muscles of the pelvic floor. A pelvic floor evaluation is performed as a component of the assessment to ensure that you are activating the core muscles correctly and in the right order. It is an important component of the assessment as often women experience other postpartum pelvic floor issues such as prolapse, pain, and incontinence.
The assessment is a two-part process with a global approach incorporating not just the abdomen and pelvic floor, but also assessment of posture, breathing, range of motion, strength and stability of the torso, back, hips, pelvis and extremities. The associated musculature and fascia as well as the nerves and joints are also evaluated. The pelvic floor component will include an external evaluation of the skin and connective tissue in the perineal and genital area as well as an internal examination of the vagina and possibly the anal canal if indicated. The pelvic floor muscles and sphincters are tested for muscle tone and tightness, strength, endurance, trigger points, and tissue integrity. Position of the pelvic organs and integrity of their supporting ligaments and fasciae are also evaluated. You are always welcome to have a trusted individual present during assessment or treatment.
An individual treatment plan is developed based on the assessment findings. Manual therapy techniques including myofascial release and visceral manipulation is performed to decrease the tension in the abdomen that contributes to the pull on the fascia and subsequent separation of the abdomen. Your physiotherapist will also guide you through a safe and effective exercise program to restore your core and regain your function.