Diastasis Recti and Pelvic Floor Connection
Diastasis Recti is when there is a separation of the rectus abdominis or the "6 pack muscles" of the abdomen. It is also a thinning of the linea alba (the connective tissue between the muscles).
When someone has diastasis recti, it can be difficult to coordinate or engage the core muscles, it may feel as though they don’t have much core strength and can cause other muscles to become fatigued easily.
So what is the diastasis recti and pelvic floor connection? Well, the pelvic floor is also a part of our core system. Many don’t think of the pelvic floor muscles as part of the core but they also work to stabilize our pelvis. Oftentimes, if there is a dysfunction in one, it carries over to a dysfunction in the other.
What Is Diastasis Recti?
As I mentioned above, diastasis recti is when there is a separation of the rectus abdominis or the "6 pack muscles" of the abdomen. It can be above the belly button, below the belly button or both.
This is something that happens naturally during pregnancy as the uterus grows and expands for the growing baby. Postpartum, these muscles should go back together but some will notice that their separation lingers. This may indicate that they need assistance from a pelvic floor therapist!
Postpartum symptoms of diastasis recti:
Feeling like you have core weakness
Bulging of the abdomen, especially when doing certain exercises
Back pain or muscle fatigue when holding an upright posture (i.e. sitting or standing for long periods)
Pelvic floor symptoms such as urinary incontinence, pelvic heaviness or prolapse
Difficulty with daily tasks such as lifting or carrying (children, laundry baskets, groceries, etc) without compensation
Difficulty returning to exercise without pain, leaking or pelvic heaviness
Bloating or difficulty holding your stomach in (feeling like you can't engage your core)
Frustration with your recovery – feeling like you’re not sure if you’re doing core exercises correctly or efficiently
Understanding The Pelvic Floor
The pelvic floor is made up of a group of muscles, ligaments and connective tissue that are in the pelvis. The pelvic floor is responsible for:
Support: The pelvic floor provides support to the pelvic organs which includes the bladder, uterus (in females) and rectum. The pelvic floor helps to hold these organs in place and provide stability.
Bladder and Bowel Control: The pelvic floor muscles work to keep you dry. The muscles coordinate through contract so you don't pee your pants, stain your undies or let out that sneaky toot! (But also relax once you make it to the toilet too!)
Sexual Function: The muscles contract and relax for sexual function as well. Muscles that are not only strong but also able to fully contract and relax help to enhance sensations and achieve the big O! (You can also let your partner know that this can enhance penis pleasure during sex as a strong pelvic floor can contract and increase pleasure for them!)
Core Stability: Yep, I’ll say it again! The pelvic floor muscles are part of the core! The core also includes the abdomen, back and glutes. These muscles work together to provide stability to the spine and pelvis. They also help with posture, balance and movement.
The Connection Between Diastasis Recti and the Pelvic Floor
As you can see, there is a connection between diastasis recti and pelvic floor as both are part of the core system. The core system helps to manage pressure in our body when we're moving and breathing.
Think of the core as a canister:
Top of the canister = the diaphragm - muscles that helps with breathing
Bottom of the canister = pelvic floor muscles - support the pelvic organs
Front of the canister = deep abs - transverse abdominal muscles, help to stabilize the hips
Back of the canister = spinal stabilizer muscles (multifidus and supporting back muscles), help to stabilize the spine
When you breathe and move:
Inhale = diaphragm lowers, pelvic floor lengthens slightly, abs and back expand → pressure is evenly managed.
Exhale = diaphragm rises, pelvic floor lifts, abdominals and back engage → pressure is released and stability is maintained.
Each part plays a role in stabilizing the spine and pelvis while also working together to function as a whole.
If one part of the canister isn’t functioning well (like the pelvic floor is weak or the abs are separated with diastasis recti), pressure isn’t controlled. This can show up as:
Doming or bulging in the abdomen
Leaking urine or pelvic heaviness
Low back pain
Difficulty building core strength
Why Addressing Both is Important
Healing diastasis and pelvic floor are equally important. You need the whole canister to be functioning efficiently for strength, stability and pressure management.
Pelvic floor therapy works to address both the pelvic floor and diastasis recti while also looking at how the core system functions within the body as a whole. This holistic approach ensures that you aren’t just putting a bandaid on one area while still having an issue in another area.
Practical Strategies for Healing Both
Addressing breathing strategies and core engagement is typically where treatment starts. This helps you to build a strong foundation to then be able to move on from stability to movement without symptoms. Sometimes modifying exercises is necessary to ensure you are engaging with good stability and coordination and not compensating with other muscles.
This may look like downgrading exercises to make them easier, slowing the movement down so you can focus on engagement or finding more appropriate exercises with the intention of getting back to higher level ones.
Working with a pelvic floor therapist to address the diastasis recti and pelvic floor connection can help to ensure that you are:
Engaging the deep core muscles efficiently
Using an efficient breathing pattern
Not bearing down on the pelvic floor muscles when doing core exercises
Not putting pressure out on the abdomen
Able to manage pressure with higher level exercises and when using weights
A one size fits all approach doesn’t always work. Working with a pelvic floor therapist is important so they can evaluate your diastasis recti and pelvic floor concerns, develop an individualized plan to address stability, help you to progress to strength and mobility, and get you back to higher level exercises like running, jumping or lifting!
If you’ve been wondering whether your core is healing the way it should, you don’t have to figure it out on your own! As someone who went through diastasis recti healing, I know how frustrating it can be! I’d love to help you feel strong, supported, and confident again.
If you are in Lancaster, OH or surrounding areas, you can
Click here to book a discovery call to answer any questions you may have in a one on one free phone consultation
Click here to book a 90 minute evaluation so we can develop a plan that works best for you!
Next On Reading List:
What Does The Pelvic Floor Do?
Pelvic Floor Therapy In Lancaster, Ohio
Pelvic Floor Therapy: What To Expect
