Women's pelvic health
What is diastasis recti, and does it need surgery?
Diastasis recti is a widening of the gap between the two halves of the rectus abdominis, which happens in most pregnancies and often persists afterward. Physical therapy is the recommended first-line treatment; surgery is considered only when a hernia is present or conservative care has not helped.
The details
What to know
Answered by the practice of Dr. Elana Shalem, DPT, pelvic floor and orthopedic physical therapist.
The width of the gap matters less than how well the connective tissue tensions under load. A midline that domes or bulges when sitting up is not managing pressure; a midline that stays flat under load is doing its job even if a gap can still be felt.
The program retrains breathing and pressure management first, then deep abdominal activation, then loaded movement, 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.
Diastasis responds to training at any point; women years postpartum improve just as well as those months out.
Where you live
Tell us where you are
Insurance, referral rules, and booking depend on where you live. Choose your area and we take you to the right page.
Not listed? Dr. Shalem can only treat patients located in a state where she holds a license. Send a message and we will tell you what is possible.
How it works
How a virtual visit works
Most of pelvic floor physical therapy is education, breathing and pressure management, movement retraining, and a home program. All of it works on camera. During the evaluation, Dr. Shalem guides a self-assessment so she can see how the pelvic floor is coordinating with breath and movement. An internal examination is not possible by video; if a hands-on assessment would change the plan, she says so and helps the patient find local care.
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
Your physical therapist
Dr. Elana Shalem, DPT
Doctor of Physical Therapy, University of St. Augustine for Health Sciences, Miami. Licensed physical therapist.
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.