Julie Wiebe

Dr. Julie Wiebe, PT, DPT

Everything You Need to Know About Diastasis Recti

EPISODE: 3   |    DATE: August 20, 2020

Julie hopes that all women continue to keep advocating for yourselves. Keep at it. You know your body best and if it’s not working the way you want it to, there are people like Julie who can work with you to help.

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Key Takeaways

  • Professionals actually don’t have a great operating definition of what exactly is a diastasis recti that they might be concerned about. Why? Because the technical term of a diastasis is a separation of the abdominal muscles, which we all have. That line of separation is an expected phenomenon. That’s a normal way that the abdomen functions. It has this bit of a separation and it’s there so we can breath, eat, get constipated or bloated, etc. It allows some give in the abdominal wall which is necessary for some of the functions and particularly for pregnancy.
  • The issue is we have the same word for what’s normal and naturally occurring and what has become pathology and used as a diagnosis. 
  • The real work with diastasis recti is to understand what is a diastasis that is returning to its functional baseline and what is a diastasis that’s been retained after pregnancy that is interrupting a woman’s ability to access and use her abdominal wall in a functional way and in fitness.
  • If possible, it’s really important for women to know what their baseline diastasis (aka natural separation is) before they get pregnant so they can understand how it’s healing and coming back together after pregnancy.
  • A diastasis if often measured in fingers or centimeters (fingers are approximately 1 centimeter wide). It’s measured both across and deep.
  • Most women naturally have a 2 centimeter wide naturally occurring diastasis.
  • There is much learning still happening in the field about diastasis recti, and one of the things they are still learning is that pros are no longer considering the distance between the sides of the abdominal wall as an indication that you’re healed. What seems to be most important is getting tension back over that fascia again.
  • Healing your diastasis is unique to you and your own movements patterns, genetics (with regards to fascia), etc. Because of that, unfortunately, treatment isn’t one size fits all. Exercises that work for one person may not work at all for another. For this reason, it’s important to seek professional help from a pelvic health therapist who can help you with an individualized plan.
  • Julie is very passionate about returning women to fitness, and works with her patients to make that happen in the most functional, effective and safe way.
  • What the research seems to be showing with regards to the linea alba, which is the fascia that connects the abdominal muscles, is that it’s a genetic thing. Some women are just genetically predisposed to a thinner connective tissue. Some women aren’t. Women with a stiffer connective tissue have a higher quality or different kind of collagen density. 
  • For this reason, for your first pregnancy, there is no way to predict how your fascia will respond to pregnancy. But once you’ve had your first, you’ll be able to tell, and it will inform your following pregnancies and how your connective tissue will fare.
  • It’s a great idea to see a pelvic health therapist during your pregnancy as well as after you give birth. They can give you exercises to do to potentially minimize the diastasis, teach you how to push effectively, etc.
  • It’s all about creating tension over the fascia, and the way to do that is with properly distributed pressure (think holding your breath versus moving with breath) and loads. If you lift a weight and can maintain good tension over the fascia, it’s probably ok. But if lifting a certain weight causes loss of tension over the fascia, it’s a better idea to back off and lighten the weight to a point where tension is maintained.
  • Julie talks about a method she uses for breathing and moving on the exhale called Blow Before Your Go. Essentially, before performing any movement, like picking up your baby or child, unloading the dishwasher, etc., you want to breathe in and then blow your breath out. Blow out most of your breath, then do your movement (bend down to pick up a toy or child, etc.). This helps with the pressure system and your diastasis.
  • One of the biggest concerns with some general diastasis programs is that the focus is on just one muscle, not the entire system. What’s more effective is to train women how to activate a system, not simply an individual muscle. 
  • We discuss when one might want to consider surgery, which is a very real possibility for some women. But no matter what, Julie recommends having a year of conservative care with a pelvic health therapist before making a decision about surgery.

About Julie Wiebe, PT, DPT

Julie Wiebe, PT, DPT is a physical therapist with over 20 years of experience in both Sports Medicine and Pelvic Health. Her passion is to return women to fitness and sport after injury and pregnancy and equip pros to do the same. This passion led her to pioneer an integrative approach to promote women’s health in and through fitness. A published author, Julie is a sought after speaker to share her evidence-based, integrative approach internationally at clinics, academic institutions, conferences and professional organizations and remotely through lectures and online coursework. Julie maintains a clinical practice in Los Angeles, which is where I had the pleasure of working with her. She promotes innovative solutions and educated hope for women through her blog, videos, social media, live and online courses. When not trying to change the world one pelvic floor at a time, Julie is happy to focus on her first passions: being mom to the Z’s (Zoe and Zack), and wife to David.


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