Discussing Diastasis Recti with Dr. Jennifer Frankoski
By: Jennifer Frankoski
I have 3 finger diastasis width, what am I supposed to do?
Is there treatment for Diastasis Recti??
First off, the width of your diastasis recti is not the ONLY component that should be addressed. Don’t freak out if someone tells you that you have a 3 finger separation. There is HOPE! It is normal to have some diastasis recti during the 3rd trimester of pregnancy and for 6 -12 weeks after pregnancy because your rectus abdominus muscle must separate in order for the belly to expand to make room for a growing baby. The problem occurs when women do nothing to protect the healing process, they stress it more by doing particular movements too soon, they never retrain their core, pelvic floor, and posterior chain correctly, or there were imbalances present prior to pregnancy that could have contributed to the current issues. It is also important to recognize that during pregnancy we need to be smart with our training to not overload the rectus abdominus and pelvic floor and modify movements appropriately.
Trained health professionals, especially pelvic floor physical therapists, can be trained to assess width, depth, breathing, core control, the posterior chain, pelvic floor coordination AND load transfer testing. We should check basics but BUILD on them. A health care professional that knows how to treat diastasis recti SHOULD be looking at all of these components.
So what matters most?
All matter because they all are linked together. How you stand and sit aka posture all affect how your diastasis recti can heal or not heal. Your shoulder, ribs, hips and back positioning all affect your core and your pelvic floor. If you have a muscular imbalance in any of these places, it can create abnormal stress on the trying to heal diastasis recti. For example, a rib flare can create more tension on the abdominal muscles, low back and shoulder. Or a hip that is “tighter” than another can causing more pulling through the core muscles and back if the person is a runner and they do not have equal hip extension motion. Even walking can place more stress on a DR if a patient has poor coordination and body awareness.
So what are some ways to protect the diastasis recti or help with healing?
– Retrain OR learn how to engage your whole core including lower core including transverse abdominus, obliques and understand when you are using a rectus dominant pattern
– Strengthening all the muscles of the core starting with gentle movements showing you can control basics and build on it
– Typically no sit ups right away (you can eventually get back to these) or planks but it depends on the patient. I have some patients I allow to do these earlier because they actually can engage everything correctly and they are not bearing down or out
– Strengthening everything around the core
– Make sure you are breathing correctly
– Correct poor posture
– Not jumping back into front loaded exercises like push ups, planks, ski erg, pulls ups, toes to bar, muscle ups, or front squats too quickly or without being assessed first
– Correcting baby holding mechanics
– Understanding how to contract and relax core through various movements including rotational movements, dumbbell and barbell movements
– Having a pelvic floor physical therapist that understands and treats diastasis recti help evaluate you, find the source or cause of non healing diastasis recti and guide you along the way to recovery.
– Work with a trained professional during your pregnancy to prevent overloading the rectus and worsening diastasis postpartum.
Just understand it is not the end of the world if you have some “separation” and lots of other assessments should be performed before you freak out OR go back to particular movements too quickly if you are unsure. Don’t be scared to move or fear all these movements.
Seek correct and proper guidance to get you back to doing what you love.
Got more questions? We love helping our pregnant and postpartum athletes train smart before, during and after pregnancy. Call or text to schedule an appointment. 980-221-9687
Dr. Jennifer Iskat Frankoski is a Board Certified Physical Therapist with clinical experience in an Orthopedic Residency Program and advanced pelvic floor training. Jennifer is a certified Postpartum Corrective Exercise Specialist (PCES). She is also Certified in Dry Needling L1. She is currently in the process of studying for her Women’s Health Specialty Certification to expand her expertise on orthopedics, women’s health and pelvic floor health. Jennifer earned her Bachelor of Science in Kinesiology and specialized in Exercise Science at Liberty University before going on to Lynchburg College to earn her Doctorate in Physical Therapy. For the past 6 +years she has been treating athletes and active individuals from various fitness and sport facilities with rehab and prevention of injuries.
Dr. Frankoski started the PT practice, Be the Change Physiotherapy in April 2018 to be able to create the change she wishes to see in the therapy and medical world by empowering patients with knowledge, individualized and one-on-one care without insurance limitations. She believes in conservative treatment including manual therapy, exercise prescription, tool assisted soft tissue work, dry needling, motor control training and educating the patient the most effect approach to treat various musculoskeletal, neuromuscular, pelvic floor and other painful conditions.
Jennifer has a history of 8 years of gymnastics experience with 7 years of gymnastics coaching experience, 4 years of track and field as a hurdler and pole vaulter, as well as has run 2 ultra-marathons and currently is active in fitness including Crossfit, HIIT training, running, and is active in the fitness and the Crossfit communities in Charlotte for the past 6 years.