Beyond the Gap: A New Way to Think About Diastasis Recti
I came home from PelviCon last weekend feeling incredibly inspired. So many speakers challenged long-held beliefs about women’s health and encouraged us to think differently about how we care for women.
As a pelvic health occupational therapist, one presentation that really stayed with me was pelvic health physiotherapist and researcher Gráinne Donnelly’s discussion of diastasis recti (DRA) and her ongoing work challenging how we assess and talk about DRA.
For a long time, the conversation around diastasis has focused on one thing:
The gap.
How wide is it? Has it closed? Which exercises should you avoid? Are you making it worse?
And somewhere along the way, a normal adaptation of pregnancy became something women were taught to fear.
Diastasis is an adaptation, not a failure
During pregnancy, the abdominal wall has to stretch and adapt to make room for a growing baby.
This also echoes Antony Lo’s work encouraging clinicians to view women’s bodies as resilient and adaptable, rather than fragile, and to consider diastasis as an expected adaptation to pregnancy rather than something women should fear.
That means shifting the question from:
“How do we close the gap?”
to:
“How is this person functioning?”
Looking beyond the gap
The size of a diastasis doesn't tell us the whole story.
Can you exercise? Lift your baby? Return to running or strength training? Do you feel strong and confident in your body—or are you worried that movement might make things worse?
This is why I’m excited about the Diastasis Rectus Abdominis Questionnaire (DRAQ), a patient-reported outcome measure designed to look beyond anatomy and better understand the physical, functional and psychosocial impact of DRA.
Instead of defining success only by centimeters or finger widths, we can look at function, symptoms, confidence and quality of life.
A different approach to DRA
Good rehab shouldn't leave women with a long list of movements they're afraid to do.
As an occupational therapist, I’m interested in what DRA means for your actual life. Can you comfortably care for your baby, get up from the floor, carry the car seat, exercise, work, and return to the activities that make you feel like yourself?
We can assess the abdominal wall while also looking at breathing, pressure management, strength, the pelvic floor and whole-body movement—and then progressively build capacity for the activities that matter to you.
That might include lifting. Planks. Running. Abdominal exercises. Or movements you've previously been told were “bad” for diastasis.
The goal isn't necessarily a perfectly closed gap.
The goal is a body you trust and feel confident using.
Maybe it's time we stop asking women:
“How big is your gap?”
and start asking:
“What do you want your body to be able to do?”
Learn More
The Diastasis Rectus Abdominis Questionnaire (DRAQ)
A patient-reported outcome measure developed to evaluate the biopsychosocial impact of DRA in women who have given birth. Message me to learn more
Gráinne Donnelly – DRA & Pelvic Health Research
Explore Gráinne Donnelly’s research, including her work examining how we understand, assess and communicate about diastasis recti.
Antony Lo – Diastasis Done Differently
Learn more about Antony Lo’s biopsychosocial, person-centered approach to diastasis and his work challenging fear-based messaging around DRA.
