Ashley Tisdale brought this post-pregnancy condition to light

When actress Ashley Tisdale (High School Musical, etc.) posted she “had diastasis recti from being pregnant that really affected my confidence,” 55,091 Instagram followers in five days did more than “like” her post. They Googled diastasis recti.

Talking with a doctor provides the expert guidance and assurance that Google entries cannot. The first thing Tara Chute, MD, Cape Cod Hospital obstetrician/gynecologist, does for her patients who have this condition is to provide reassurance. Diastasis recti is normal, fairly common, and not life-threatening, she said.

Diastasis recti is a weakening of the connection between the muscles of the abdomen, Dr. Chute explained. There can be laxity (loosening) of the area for a variety of factors. Pregnancy is the most common cause because it increases pressure in the abdomen, which weakens connective tissue between the muscles. You can also see it in patients that are obese, or some with other issues, she said.

“Studies say that as high as 50 or 60 percent of pregnant women have this,” Dr. Chute said. “It’s almost always asymptomatic, so the vast majority of times there is no clinical significance at all. Most people who have diastasis recti don’t know they have it, and the condition resolves itself.”

What about future pregnancies?

Will the condition impact future pregnancies? Dr. Chute said if you have a weakness in that connective tissue, it is more likely to happen again, but diastasis recti isn’t something that should discourage a patient from becoming pregnant again. Diastasis is not something she considers a risk when counseling women who want to talk about having another pregnancy.

Treating Diastasis Recti

Although most women aren’t even aware they have diastasis recti and it is not problematic, Dr. Chute outlined what can be done for those who do need help.

“Sometimes the diastasis becomes large and there is a wide separation of the muscles,” she said. “Then it becomes uncomfortable, or patients see a protrusion in their abdomen, almost like a hernia. We try to minimize intervention during pregnancy because the abdomen is going to get larger, and we don’t want to treat something that’s going to reoccur. But after pregnancy we do a variety of things.”

First, over time and with weight loss and strengthening of those muscles, the space can close, she said. But if it stays the same or gets worse over time, Dr. Chute refers women to physical therapy.

Physical therapy – it’s never too late

Lynne DiPirro, doctor of physical therapy (DPT), is one of the pelvic health therapists Dr. Chute relies on for her patients. Dr. DiPirro works at Barnstable Physical Therapy and is a pelvic floor therapist, among other specialties.

“If problems with diastasis recti continue six weeks after giving birth, then it would be considered abnormal. Some people get bloating, lower abdominal pouching, and feel like they can never lose the baby weight no matter how hard they try. These people are aware something is wrong. Too little is written about diastasis recti, so we have a big educational effort to teach women so they know there are resources to help them,” Dr. DiPirro said.

When women are referred to Dr. DiPirro, she first assesses how wide and deep the diastasis is and then shows them appropriate abdominal strengthening exercises, pelvic floor strengthening exercises and proper breathing and lifting mechanics. “Even your posture is important,” she said, “and we talk a lot about lifestyle and behavior modification before getting into the strengthening exercises.”

Interestingly, Dr. DiPirro said she treats women from their 40s to their 80s who deal with urinary incontinence, pelvic organ prolapse and pelvic pain because of conditions like diastasis recti—many who were unaware they had diastasis after their pregnancies.

“It’s never too late to heal your diastasis or get therapy for prolapse to heal your incontinence,” she emphasized. “I treat people in their 80s all the time. Some people find out long after their pregnancies that they have a diastasis, and with the right exercises you can see improvements.”

Dr. DiPirro said primary care physicians, obstetricians/gynecologists, urologists, gastroenterologists and urogynecologists are the right people to talk with about whether pelvic floor therapy is right for you. They can refer you to a therapist.

Is surgery an option?

Surgery to repair diastasis recti is very rare, Dr. Chute said. Most women have only mild cases and should not be worried about having surgery. However, it is good to know that a plastic surgeon or general surgeon can provide care if necessary.