Diastasis Recti Abdominis (DRA) is a condition that often flies under the radar, yet it affects a large number of people—especially postpartum individuals. If you’ve ever noticed a bulge or a gap running down the center of your abdomen, you might be dealing with DRA. But did you know that your pelvic floor may be deeply involved in your recovery?
Let’s break it down.
What is Diastasis Recti Abdominis (DRA)?
DRA occurs when the two halves of the rectus abdominis (the “six-pack” muscles) separate due to excessive pressure or stretching of the connective tissue, known as the linea alba. This is most common during and after pregnancy, but it can also occur in men or non-pregnant individuals due to obesity, poor lifting mechanics, or chronic abdominal pressure.
Common symptoms include:
- A visible gap or bulge in the abdomen, especially when straining
- Core weakness or instability
- Lower back pain
- Poor posture
- Pelvic floor dysfunction (like incontinence or prolapse)
The Connection Between DRA and the Pelvic Floor
The pelvic floor and the core muscles (including the transverse abdominis, diaphragm, and multifidus) work as a team. Think of them as a pressure system: when one part isn’t functioning well, the others can get thrown off balance.
When the linea alba is overstretched in DRA, the core loses its ability to manage pressure. This often results in the pelvic floor muscles compensating—working too hard or not activating correctly. The result? Leakage, heaviness, or other forms of pelvic floor dysfunction.
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapists are uniquely trained to assess not just the pelvic floor, but the whole core system. Here’s what therapy might involve:
1. Comprehensive Assessment
Your therapist will assess:
- The degree of abdominal separation
- Core muscle activation (especially the transverse abdominis)
- Posture, breathing patterns, and movement mechanics
- Pelvic floor function
2. Breathwork and Core Engagement
Learning how to breathe diaphragmatically is foundational. Coordinating the breath with gentle core and pelvic floor activation helps rebuild pressure control and deep core stability.
3. Targeted Exercises
Forget crunches. A therapist will guide you through functional, safe exercises designed to gradually close the gap and improve tension across the midline. Think heel slides, leg lifts, and controlled movements that emphasize deep core activation.
4. Manual Therapy (If Needed)
Hands-on techniques can improve tissue mobility, reduce scar restrictions (especially post-cesarean), and enhance muscle recruitment.
5. Education and Lifestyle Modifications
You’ll also learn strategies for safe lifting, posture, and how to avoid pressure-increasing habits like breath-holding during effort.
Is Full Closure Necessary?
Not always. The ultimate goal isn’t a perfectly closed gap—it’s a functional core with good tension across the midline, effective pressure control, and symptom-free movement. Many people live fully active lives with a small gap, as long as their system is well-coordinated.
Final Thoughts
If you suspect DRA or pelvic floor dysfunction, don’t wait for symptoms to worsen. Working with a pelvic floor physical therapist can be a game-changer for healing, strength, and confidence—whether you’re postpartum or simply looking to restore balance in your core.
Your body is designed to heal, and help is available.