The director of Physiotherapy of the Spanish Abdominal Diastasis Association (AEDA), Rafael Vicetto, has stressed that, in this pathology, "in many cases, the best results are achieved when a good assessment, specialized Physiotherapy, and surgery when indicated are combined".
The entity recalls that abdominal diastasis "is a more frequent condition than it seems - it affects more than 45 percent of women after pregnancy - and consists of the separation of the rectus abdominis muscles as a consequence of a stretching of the linea alba", and specifies that, "although it is usually associated with pregnancy, it can also appear due to other factors, such as overweight, constipation, chronic cough, or repeated performance of abdominal exercises".
"Beyond aesthetics, specialists insist that it is a problem that can affect the pelvic floor, stability, posture, trunk control, and overall abdominal functionality," AEDA has remarked, emphasizing that "not all diastases require surgery and, in many cases, specialized Physiotherapy is sufficient to achieve relevant improvements."
In the same vein, the organization points out that "in mild or moderate diastases, conservative treatment through Physiotherapy can be the main option." "The approach is not solely based on reducing muscle separation, but on improving how the abdomen functions as a whole: activation of the transverse abdominis, pelvic floor integration, intra-abdominal pressure control, and movement re-education," it has detailed.
When surgery becomes the most appropriate option
According to AEDA, "when this work is carried out individually, it can translate into a clear improvement in core stability, posture, and the sensation of abdominal strength, even without the need for surgical intervention," although it acknowledges that "however, there are cases in which the structural damage to the abdominal wall makes surgery the most appropriate option."
In the opinion of specialists, "this occurs when the separation is severe, there are associated hernias, there is persistent pain or significant functional limitation, or when the quality of the tissues is significantly deteriorated." "In these cases, surgery allows the abdominal wall structure to be repaired, but it does not act on muscle function, which must subsequently be recovered with Physiotherapy," stated the director of Surgery at AEDA Almería, Dr. Manuel Felices.
Likewise, the group emphasizes the importance of "differentiating between surgical techniques, as not all are indicated for the same patient profiles." "Abdominoplasty is usually indicated when there is excess skin or significant sagging, while the 'REPA' technique focuses on the internal repair of the abdominal wall in patients with good tissue quality," he specified.
"The choice of technique must be based on the patient's actual situation, not just on criteria such as invasiveness or scar aesthetics," he stressed, adding that "surgery should not be understood as an isolated solution, but as a phase within a broader recovery process."
In this process, the entity emphasizes that "previous physiotherapy work helps prepare the abdomen, improve muscle activation, and optimize body control before the intervention." "After surgery, Physiotherapy is essential to recover functionality, retrain movement, and consolidate long-term results," he concluded.