Diastasis Recti and Your Pelvic Floor
By Keri Gerlach
Pelvic Health Kinesiologist
Did you know that your gap and/or “doming” could be related to your pelvic floor?
IRD (Inter-Recti Distance) a.k.a gap and “doming” or bulging along the LA (Linea Alba) has less to do with strong abs than it has to do with with how you manage pressure or IAP (Intra-Abdominal Pressure). For some, it could be under-recruitment of your pelvic floor and deep core muscles.
The Core and Intra-Abdominal Pressure
To summarize, your core is your body’s internal pressure and load transfer system. Picture a cannister, with your diaphragm on top, your pelvic floor on the bottom, and your deep abdominal muscle layer (transversus abdominis or TVA), and multifidus muscles making up the circular wall of the cannister.
When you breathe in, your diaphragm moves down to make room for your lungs to fill up with air, which in turn creates a downward pressure on the pelvic floor, causing it to move down. When you breathe out, the opposite happens; the diaphragm and the pelvic floor move back up. The two work in synergy. Your multifidus and your transversus abdominis work to support the spine and sustain pressure for movement and load transfer like carrying your baby’s car seat or a laundry basket.
This is all happening without you thinking about it! It’s how your core functions and it kicks in in anticipation of any movement you do. Sometimes, during or after pregnancy, years of postural misalignment, chronic pain, chronic cough, chronic constipation, amongst other habits or health conditions; your body can adopt non-optimal strategies for managing pressure and load transfer.
It’s not your fault! Our bodies are extremely good at compensating for these things and we often develop these non-optimal strategies without even noticing.
What Does This Have to Do With Diastasis Rectus Abdominis (DRA)?
If there is a weak part in the system such as a laxity in the linea alba from diastasis recti; that area is unable to manage pressure optimally so you see doming or bulging; your body’s way of compensating for the internal pressure.
In order to resolve this, we must build strength back into the tissues to retrain the linea alba to carry tension again. To do this we must ensure the core is functioning optimally and that all parts are involved, including the pelvic floor and our deep core muscles.
- Postural correction
- Pressure management
- Pelvic floor muscle training done with movements that involve the abdominal layers
- Ensuring the correct timing of your pelvic floor activation with the rest of the core system
The Gap Is Not the Issue
An interesting study done by Diane Lee and Paul Hodges in 2016 found that closing the Inter-Recti Distance (IRD) was not an essential part of returning the core to optimal function. It was the ability to generate tension and minimize distortion in the linea alba that appeared to be more significant for function.
Here is an interesting picture to show these findings:
Since DRA is a pressure management issue, what about the gap? Well, IRD itself does not seem to cause a functional deficit. For a lot of people, it’s a cosmetic issue and they just don’t like the way it looks; which is completely valid. If it is your goal to improve the look of your abdomen, learning about the above and ensuring your core is functioning optimally can help to “close the gap” for most people.
Not sure where to start? Visit me here to learn how I can help.
Keri Gerlach is a Registered Kinesiologist with a Master of Science Degree in Kinesiology. She has received special education in pelvic health and has been working with pre and postpartum women for 14 years.
Lee D, Hodges PW. Behavior of the linea alba during a curl-up task in diastasis rectus abdominis: an observational study. Journal of Orthopaedic & Sports Physical Therapy. 2016 Jul;46(7):580-9
Michalska A, Rokita W, Wolder D, Pogorzelska J, Kaczmarczyk K. Diastasis recti abdominis — a review of treatment methods. Ginekologia Polska. 2018;89(2):97–101