Diastasis Recti: From Rehab to Recovery
Once thought of as a “normal” consequence of pregnancy with no path to recovery,
diastasis recti is now rightly seen as an injury that affects all populations. It is a common misconception that the "cause" of diastasis recti is the stretching of the linea alba during pregnancy. However, my research indicates that the injury is influenced by factors beyond pregnancy. I see diastasis recti as the end result of long-term, full-body dysfunction. For recovery to be effective, it has to integrate multiple body systems—those that fall within our scope of practice as movement professionals.
What is diastasis recti?
A common definition of diastasis recti is “an increased distance between the rectus abdominis muscles at the midline caused by weakness in the anterior abdominal wall. Most experts agree that there is a weakness, thinning, and widening of the linea alba and weakness of the associated abdominal musculature. “Patients may notice an overall feeling of instability and/or a bulge in the midline of the anterior abdominal wall, which worsens with increased abdominal pressure, such as with the movement of an abdominal crunch.” (Hall H, Sanjaghsaz H , 2024.)
To rehabilitate diastasis recti, we need to work backwards from the gap itself. This means looking beyond the abdominal wall and examining the central nervous system, respiratory system, musculoskeletal system, and fascial system. These interconnected systems often hold the imbalances that set the stage for diastasis recti to occur. It's important to recognize that the body reaches a tipping point—where injury happens regardless of the specific activity. Limiting recovery to just the muscular system is like placing a bandage over a deep incision. It might cover the surface, but it doesn't address the root cause.
How to build an effective program for your clients
Consistency is the key to obtaining optimal results. Your client is more likely to keep up with their program if it is simple and effective. With this in mind I developed the following four protocols that have been proven to be successful not just for diastasis recti recovery, but as a tool for whole body integration for all of your clients.
The protocols I teach work best in the following sequence:
Regulate
Regulating the central nervous system before attempting a movement increases the potential for a successful client outcome by reducing tension. Most of us, whether injured or not, remain unconscious to the over stimulation our senses are subjected to daily. This stimulates our Sympathetic Nervous System. Our Central Nervous System adapts to this daily onslaught by normalizing this arousal. A traumatic injury like diastasis recti can trigger a hypervigilant state, increasing myofascial tension and reducing functional muscle movement. This affects the outcomes for a rehabilitation program. Addressing the autonomic nervous system first may help reduce tension through the neuro-myofascial system, which in turn will allow for better ease of functional movement.
Release
Some of the protocols I teach utilize self myofascial release techniques to decrease tension and build interoception. Mostly, our diastasis recti clients have either become desensitized to outside stimuli or overstimulated by it. Using exteroceptive stimuli such as carefully selected myofascial release balls, we can apply appropriate pressure to sensitize a body area that feels disconnected. We lay the groundwork for this in one of my courses using SensaBall Myofascial Release routines.
Realign
Once the client has reached a more tension-free, relaxed state and has increased body awareness, we can guide the realignment of the muscles. This re-alignment is achieved through fundamental exercises that combine breathing and bony cueing. These exercises also encourage gentle muscular connection through the pelvic floor, abdominal wall (both anterior and posterior), and throughout the thorax. Simple exercises such as bridging with correct breath and cueing can be instrumental in reconnecting the entire abdominal wall. The simpler you can make the exercise, the more likely it is that your client will stick to their program.
Restore
My methods teach movement professionals to progress the techniques as the client increases their awareness and strength on all levels. When these fundamental exercises are mastered and result in a re-patterning of breath and muscular connection, we add more load, intensity and endurance according to the clients’ schedule. Introducing a new exercise may sometimes cause a regression in diastasis recti tissue, but is easily rectified by reverting to the fundamentals.
“Our aim here is to educate the body in a more functional way of moving that maintains the health and integrity of most of the systems in the body.”
In conclusion, treating diastasis recti requires a comprehensive, multi-system approach that addresses not only the abdominal wall but the body as a whole. By integrating protocols that focus on regulating the nervous system, releasing myofascial tension, realigning the muscles, and restoring functional movement, we empower our clients to heal and move with strength and stability. As movement professionals, it’s our role to guide them through this journey with patience, consistency, and a deep understanding of the interconnectedness of the body’s systems.
“When we treat diastasis recti as an injury, not a condition, we open the door to lasting recovery and overall well-being.”
Carolyne is the founder and director of The Carolyne Anthony Method (formerly The Center for Women’s Fitness), a globally recognized pilates and fitness education organization specializing in evidence-based programs for all stages of women’s health. A certified movement educator, author, and sought-after international presenter, she has trained thousands of instructors worldwide—learn more at www.thecenterforwomensfitness.com