Diastasis recti and breathing disorders: diastasis can be improved and resolved without surgery in many cases. There are several non-surgical strategies and methods that have demonstrated their value in improving and closing diastasic

By Chiara De Benedetti & Yusung Kim

If we think about diastasis as a myofascial issue we can immediately understand that the healing process of the separation of the abdominal muscle cannot happen overnight, it requires time and consistency, like all the other changes we demand to our bodies through exercise.

A specific training program for the resolution of diastasis must be tailored to the individual, to the type of diastasis (which can be assessed), to their lifestyle and goals. It is also important to be aware of the consequences of diastasis which I rank, based on my professional and personal experience, in two main groups: in response to muscular imbalance and in response to discomfort.

consequences of diastasic resti by chiara di benedetti

As a matter of fact, breathing dysfunction are both consequences of muscular imbalance and discomfort and, as has already been mentioned, in order to repair diastasis, the first step is fixing breathing patterns. Moreover, to maintain the results, breathing training has to be maintained consistently.

This is one of the reason why the assessment of breathing patterns disorders (BPD) is so crucial in the healing process of diastasis recti.

Assessment of BPD Australian osteopath and breathing therapist Dr. Rosalba Courtney argues that BPD should be assess by a comprehensive assessment because it is affected by a variety of factors. A comprehensive assessment should include measurements of breathing symptoms and breathing patterns and also measurements of breathing holding time.

Comprehensive BPD assessments – Breathing Disorders

Symptom questionnaires used to evaluate BPD

The Nigmegen Questionnaire (NQ) is the most commonly used questionnaire to identify BPD. Of the16 questions, 4 are related to breathing symptoms and 12 are related to peripheral and central neuromuscular, or general tension related to symptoms.(Dixhoorn and Duivenvoorden, 1985a,b)

According to van Dixhoorn, the mean score of healthy people is about 11. A score higher than 23 indicates that is an obvious BPD.(Dixhoorn and Duivenvoorden, 1985a)

Breath holding time tests

Breathing holding ability is one of the methods of identifying the breathing ability of individuals with hyperventilation syndrome or BPD A commonly used protocol for breathing holding time is the Control Pause of the Buteyko Method technique. The Control Pause is a method of holding breathing at the end of exhalation and measuring time. At this time, the first point at which the need for breathing occurs indicates the subject’s breathing holding ability. The standard for healthy population is more than 25 seconds. Less than 20 seconds suggest the presence of BPD.

The Hi Lo breathing assessment

The Hi-Lo breathing assessment have been developed to identify dominant patterns of respiration. During the Hi Lo test, the patient puts one hand on the chest and the other the abdomen. During patient breathing, the examiner identifies the dominant pattern of the patient’s breathing motion. It is suggested that the patient’s hand is a typical thoracic dominant pattern if it moves vertically. If the patient’s hand moves inward toward the spine and outward in the exhalation, it suggests a “paradoxical breathing pattern”.

Yusung test

Solution – breathing technique

The breathing techniques considering these matters: reduce breathing rate and breathing volumes; increases use of abdomonal/lower thoracic chest (diaphragm) movement; uses nasal route of breathing; encourage relaxation.

The breathing techniques provided above reduce the sensitivity of the central chemoreceptor, which senses carbon dioxide and controls breathing, softens the the rhythm of breathing and stimulates parasympathetic system, which also works on psychological factors such as anxierty.

The use of the nose and abdomen/diaphragm expands the airways, improves pressure control of the breathing pump, reduces breathlessness, improves the body’s efficient oxygen supply, and increases chest wall and spinal stability.

This techniques seem simple, but it is not easy for pateints with BPD to perform alone. For successful BPD treatment, treatment should be received under the guidance of a skilled therapist, and it is important to treat in cooperation with patients and therapists.

In addition, it will be important for the patient to practice repeatedly with patience in order for the trained breathing technique to adapt to the body, so that the normal breathing pattern becomes a habits. Training program for the treatment of diastasis recti There are many training programs and some physiotherapeutic based approaches for the treatment of diastasis recti.

The Tupler Technique® for Diastasis Recti

One of the most popular and effective program is the Tupler Technique®, created by Julie Tupler in the 1990s in New York (United States). The Tupler Technique® is a research and evidenced based exercise program to bring separated muscles back together by strengthening the connective tissue between the separated muscles. Over the years and thanks to its effectiveness, the program has been translated into many languages (German, Italian, French, Czech, Spanish, Portuguese, Indian) and has spread to many parts of the world.


Diastasis Recti and Breathing Disorders are strongly correlated and are dependent on each other. Both can impair the quality of life, both can be recognized, assessed and improved through specific exercises and constancy. Fixing both can give us great physical and mental benefits for a better quality of life.