Women's pelvic health · Oahu
Diastasis recti physical therapy in Oahu
Diastasis recti is a widening of the gap between the two halves of the rectus abdominis. It happens in most pregnancies, and physical therapy is the recommended first-line treatment.
- TRICARE, HMSA, and HMSA QUEST in-network
- No state referral requirement; some plans need one
- Video visits anywhere in Oahu
About the condition
Diastasis recti: what is going on.
During pregnancy the connective tissue down the middle of the abdomen stretches to make room. For many women it stays wider afterward, and the midline bulges or domes when they sit up or lift. Diastasis is not a tear and not a hernia, but it changes how the abdominal wall manages pressure, and it often travels with low back pain, pelvic floor symptoms, and a core that feels weak no matter how many crunches are done.
The width of the gap matters less than how well the tissue tensions under load. Physical therapy focuses on restoring that tension and on teaching the abdominal wall, diaphragm, and pelvic floor to work together again.
Common experiences
What people with diastasis recti often describe
These are the patterns Dr. Shalem hears most often. Any of them is a reason to book a discovery call.
A visible ridge or dome down the midline when sitting up
A gap that can be felt above or below the navel
Low back pain with lifting or carrying
A core that feels weak or unsupported
Pelvic floor symptoms alongside the separation
Treatment
How physical therapy addresses it.
The program retrains breathing and pressure management first, then builds deep abdominal activation, then progresses to loaded movements, planks, and the patient's own sport. Crunches and sit-ups are reintroduced only once the midline can hold tension. Most of the work is a few minutes a day at home.
What a video visit looks like
Dr. Shalem teaches a self-check of the midline on camera, watches how the abdomen responds to sitting up, lifting, and breathing, and adjusts the program visit by visit.
Coverage in Hawaii
Insurance and pricing
Bring your plan name to the discovery call and we confirm your physical therapy benefit before the first visit.
TRICARE
In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for.
HMSA
In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit.
HMSA QUEST
In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit.
Private pay
Available for any other plan. HSA and FSA cards accepted.
Referrals
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
Military families at Joint Base Pearl Harbor-Hickam, Schofield Barracks, Marine Corps Base Hawaii, and Tripler are seen by video from home. TRICARE Select members need no referral.
How it works
How a virtual visit works
Dr. Shalem teaches a self-check of the midline on camera, watches how the abdomen responds to sitting up, lifting, and breathing, and adjusts the program visit by visit.
Discovery call
15 minutes, free, by phoneA short call to hear what is going on, explain how visits work, and check insurance or pricing. No pressure to book.
Evaluation
60 minutes, by videoDr. Shalem takes a full history, watches how you move and breathe, and guides the self-assessments she needs to build a plan.
Your plan
Same visitYou leave the evaluation with a plain-language explanation and a short home program, usually a few minutes a day.
Follow-ups
45 minutes, every 1 to 2 weeksProgress checks, program updates, and techniques you can do yourself, for as long as they are useful.
For a video visit you will need
- A phone, tablet, or laptop with a camera
- A private room
- A mat or towel
- About an hour
Questions
Diastasis recti questions in Oahu
Can diastasis recti be fixed without surgery?
Physical therapy is the recommended first-line treatment. The goal is a midline that tensions well under load and a core that does its job, which for most women resolves the symptoms. Surgery is considered when a hernia is present or when conservative care has not helped.
I am years postpartum. Is it too late?
No. The abdominal wall responds to training at any point.
Which exercises should be avoided?
That depends on how the midline responds, which is what the evaluation checks. Blanket lists of forbidden exercises are usually too restrictive.
Do I need a referral for physical therapy in Hawaii?
Hawaii allows you to start physical therapy without a physician referral. Your insurance plan may still ask for one (TRICARE Prime and some HMSA plans do), and we check that for you before the first visit.
What insurance do you take in Hawaii?
TRICARE: In-network (TRICARE West). TRICARE Select members can book directly with no referral. TRICARE Prime members need a referral from their primary care manager, and we tell you exactly what to ask for. HMSA: In-network with HMSA PPO and HMO plans. Some HMSA plans require a referral from your primary care provider; we check yours before the first visit. HMSA QUEST: In-network with HMSA QUEST (Hawaii Medicaid). We confirm coverage before your first visit. Private pay: Available for any other plan. HSA and FSA cards accepted.
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed in Hawaii.
Dr. Shalem treats pelvic health for women and men, from pregnancy and postpartum recovery to bladder, bowel, and pelvic pain conditions and recovery after prostate or pelvic surgery, and general orthopedic conditions of the back, neck, hips, knees, shoulders, and feet. Visits are one-on-one and unhurried, and she explains what she is seeing in plain language.
More about Dr. ShalemPrefer to write? Send a message.
Questions about insurance, pricing, or whether physical therapy is the right next step? We reply within one business day.
Start with a free 15-minute call.
Tell us what is going on, hear how Dr. Shalem would approach it, and decide from there.