By Paige Pebesma, Physiotherapy Resident

What is a diastasis rectus abdominus (DRA)?

A diastasis rectus abdominus (DRA) is a separation/stretch between the left and right sides of the rectus abdominis muscle, which is the muscle in the front of our abdomen (often referred to as your 6 pack muscles). It is important to know that a DRA is an increase in space between these muscles, it is NOT a physical break between those muscles. 

What are the Types of DRA?

There are two types. Acquired DRA and Congenital DRA.  

Acquired DRA is when the DRA appears at some point throughout an individual’s life but is not present at birth. This type of DRA is common in women during pregnancy and after childbirth due to the constant increased tension in the abdomen. It also sometimes occurs in individuals who have a weak core and work a strenuous job with lots of lifting and use of abdominal muscles. 

Congenital DRA is when it is present at birth. It usually presents as a bulge shape down the middle of the abdomen between the sternum (breast bone) and the belly button. It is often easily seen when a child strains and uses those abdominal muscles (ex: a sit up or head lift).

When does diastasis recti go away in children?

Congenital DRA may close together on its own, often by the age of 3, as the abdominal muscles grow and strengthen. However, in some children this DRA may remain without intervention.

What Happens if you Ignore Diastasis Recti or if it Goes Untreated? When should I  Worry About Diastasis Recti?

If the DRA does not resolve on its own, it can result in overall core weakness which can affect things like posture, development, balance, walking and other gross motor skills. It can also impact a child’s ability to self-regulate (emotional impact), decrease their confidence with movement, cause pain, or contribute to chronic constipation, among other issues. 

What are the signs and symptoms of DRA? 

Signs of DRA in babies:

• Not lifting legs/not playing with feet
• Difficulty lifting head against gravity
• Holding breath during activity
• Constipation
• Bulging belly at midline

Signs of DRA in young children:

• Difficulty lifting head from lying on back to sitting
• Using arms to assist from lying on back to sitting
• Holding breath during activity
• Constipation, incontinence, belly aches
• Poor balance or clumsiness
• Visible big belly and/or bulging at midline of belly
• Anxiety or poor emotional regulation
• Poor fine and/or gross motor skills
• Poor focus and ability to sit still
• Postural insecurity 

Diastasis Recti Treatment

Getting help from a knowledgeable physiotherapist is a great first step to helping close the DRA and improve overall core strength in babies and children. Strengthening the core early on is very important to provide your child with a strong central foundation to help with many other aspects of development including balance, coordination, future gross motor skills, and so much more! If you notice any of these above signs in your child or you recognize some other signs of a weak core after reading “How to Spot & Help Fix Your Child’s Weak Core” or “What do Reading, Writing & Balance Have in Common?” then it is possible your child has a DRA or overall weak core. You can book an appointment with Paige or one of our other Physiotherapists/ Physiotherapy Residents for an assessment and individualized treatment if needed.