Diastasis Recti Treatment: Emphasizing an Individualized Approach

Posted on Posted in All Posts, Take Control of Your Health, Women's Health
 

Hello all!  I’m writing today as a person inspired by new information and am compelled to share with you what I’ve learned.  For those of you familiar with my writing, you’ve seen me post previously on diastasis recti (DRA) and it’s management.   In general, it is an area of great interest for me, helping pre and post partum women (no matter how old their children) recover function, return to activities they love, and feel their best.   Many women, and some men, have been coming to Thrive concerned about the look of their DRA.  As a mom myself, I understand this concern…adjusting to our post baby bodies is effortful and knowing what is in our power to change and how to do it is ambiguous.  As a physical therapist, I look at DRA from another perspective as well: how can we clinicians enable our patients to move with ease, support load through the abdominal wall, and ultimately participate in life fully?  I want for my clients to, without pain, return to activities they love while feeling good about how they look.

Elizabeth D'Annunzio Shah, PT, DTP, MTC, OCS,at course: The Abdominal Wall After Pregnancy & Diastasis Rectus Abdominis
Elizabeth D’Annunzio Shah, PT, DPT, MTC, OCS, and classmates at The Abdominal Wall After Pregnancy & Diastasis Rectus Abdominis.

If you are reading this post, it means that you’re doing the internet deep dive into DRA treatment.  As a clinician, I’ve done that too…spent hours on the computer trying to find a consensus on care.  Do we use a brace?  On which muscles do we focus our intervention?  How do we know when to advocate for our patients to have further medical evaluation by a physician or surgeon?  Who in the community can I send my patients to when they’re done with PT and want to begin more rigorous exercise?  Ultimately, I found that I was in need of a more in depth exploration of the topic, so I took it to the source.  I went to Akasha Studios in Vancouver for a course created by Diane Lee & Associates entitled The Abdominal Wall After Pregnancy & Diastasis Rectus Abdominis, taught by physiotherapists Tamarah Nerreter and Leigh Fortuna.1   Diane Lee is a leader in the field of physical therapy and has, through extensive research and experience, developed the definitive text and related professional educational courses on the management of abdominal wall dysfunction.2

I’m not going to get into the weeds with you on specifics of treatment, but there are a few really important points that I wanted to relay to our readers and persons interested in DRA recovery in general:

1. THERE IS NO SUCH THING AS A ONE SIZE FITS ALL APPROACH TO DIASTASIS RECTI MANAGEMENT.  Just as no two persons are the same, no two DRAs are either.  The separation of the linea alba often times reflects dysfunction, but what generates and perpetuates said dysfunction is different in all people.  While this may seem obvious, many people come to me seeking a quick fix, or looking for the internet resource, book, or exercise DVD that will solve all their problems.  While there are some wonderful resources out there, ultimately creating an individualized approach to DRA management based on the patient’s unique physical attributes, activity requirements, and goals is the best way to enable healing.

2. THERE ARE PEOPLE OUT THERE DOING GREAT WORK IN THIS FIELD.  At the course, I was surrounded by physical therapists and fitness professionals seeking to bring to their patients and clients the most current information and nuanced care possible.   Meeting these people in person, networking and drawing regional connections, and combining our shared experience is essential in distributing information and encouraging the best possible practice as we approach our post partum clientele.   Similarly, I am a part of a wonderful network of women practitioners in the New York metro area the includes doulas, PTs, OTs, group fitness professionals, and personal trainers who’s job it is to know the best care providers are in our region for women’s health, rehabilitation, and fitness.   When you are seeking care for your DRA, regardless of where you live, your care provider should be approaching you with a nuanced, whole body perspective and be informed on the resources available in your community, online, and on paper that might serve to round out your care and exercise experience.

Sometimes, the correct answer to a posed question is vague and yields more questions.  Is there a one-size fits all fix to DRA?  No.  Can person improve the overall health, function, control, and aesthetic of the abdominal wall post DRA?  Yes!  Partner with a passionate practitioner that’s eager to problem solve, and get to work!  In other words, seek out professionals with specific expertise in this area of treatment, readers.   You will be better served this way, and you are worth it!

Citations:

1. The Abdominal Wall & Diastasis Rectus Abdominus. (2018). The Abdominal Wall.  Surrey, BC: Akasha Studio.
2. Lee, D. (2017). Diastasis Rectus Abdominis: A Clinical Guide For Those Who Are Split Down the Middle. Surrey, BC: Learn with Diane Lee.


 


Elizabeth D'Annunzio Shah Physical Therapist New York CityElizabeth D’Annunzio Shah, PT, DPT, OCS, MTC works with patients of all ages and abilities including recreational athletes, professional dancers and performing artists. She has a special interest in vestibular and balance disorders, movement theory and creative solutions for both neurologically and musculoskeletally impaired persons. Elizabeth is passionate about exercise as a means to maintain health, manage stress and enjoy life! She practices yoga in the Iyengar tradition, is an avid surfer, and participates in distance running events whenever possible. (more)