Relationship Between Interrectus Distance and Symptom Severity in Women With Diastasis Recti Abdominis in the Early Postpartum Period

Phys Ther. 2018 Mar 1;98(3):182-190. doi: 10.1093/ptj/pzx117.


Background: Diastasis recti abdominis (DrA) is associated with negative body image, musculoskeletal pain and dysfunction, and perhaps urogynecological complaints. The severity of DrA has traditionally been determined by measuring the interrectus distance (IRD); however, the relationship between IRD and symptoms in women with DrA is unclear.

Objective: The objective of the study was to investigate the relationship between IRD and symptom severity in women with DrA in the early postpartum period.

Design: This study used a cross-sectional design.

Methods: Thirty-two women with DrA were assessed at 3 weeks postpartum. The IRD was measured using ultrasound imaging. Symptom severity was assessed using the Multidimensional Body-Self Relations Questionnaire subscales (body image), visual analog scales (abdominal, low back, and pelvic pain intensity), the Modified Oswestry Index (disability due to low back pain), and the Pelvic Floor Distress Inventory and Pelvic Floor Impact Questionnaire (urogynecological dysfunction). Spearman correlation coefficients (ρ) between IRD and each outcome were calculated and tested using 1-tailed significance (adjusted α = .009).

Results: The group median IRD was 2.97 cm (interquartile range = 1.65 cm), with the largest IRD in the sample being 7.97 cm. The IRD was significantly correlated with worst abdominal pain in the last 24 hours (ρ = 0.45, P = .005) and with overall body image (ρ = -0.44, P = .006) but not with the other outcomes.

Limitations: Women in the sample were primiparous, were in the early (3 weeks) postpartum period, had relatively low body mass indexes (mean = 25.0 kg/m2) considering that they had recently given birth, were all breast-feeding, and had a narrow age range (27-35 years old). These factors limited the generalizability of our results to all women with DrA.

Conclusions: This preliminary work suggests that, in the early postpartum period, IRD as a measure of DrA severity is meaningful for body image.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude to Health
  • Body Image / psychology*
  • Cross-Sectional Studies
  • Diastasis, Muscle / physiopathology
  • Female
  • Humans
  • Postpartum Period / psychology*
  • Rectus Abdominis*
  • Severity of Illness Index*
  • Young Adult

Grant support