CME Journal of Clinical Case Reports
ISSN: 3067-7998 | DOI: 10.64030/3067-7998
Cynthia Penfold PT, DPT
Background: Diastasis Recti Abdominis (DRA) is a prevalent postpartum condition that can persist chronically, contributing to
low back pain (LBP), impaired function, and reduced quality of life. While conservative treatment is recommended, evidence for
effective interventions beyond the early postpartum period is limited.
Purpose: This case study examines the outcomes of an eight-week physical therapy intervention combining neuromuscular
electrical stimulation (NMES), core stabilization exercises, and scar tissue mobilization for a 54-year-old postmenopausal
woman with chronic DRA and acute-on-chronic LBP, 11 years after her last Cesarean delivery.
Methods: A tailored home exercise program (HEP) was designed and progressed to include NMES, abdominal bracing, scar
mobilization, and graded functional core strengthening. Weekly in-clinic physical therapy sessions were conducted to assess
progress, provide manual therapy, and adjust interventions based on tolerance and performance. Outcomes were measured
using the Visual Analog Scale (VAS) for pain, Oswestry Disability Index (ODI), palpation-based inter-recti distance (IRD), and
functional strength tests.
Results: The patient reported complete resolution of LBP (VAS 0/10), improvement in ODI from 22% to 0%, and subjective
improvements in abdominal control and appearance. While IRD at rest remained unchanged, active IRD decreased from three
to one fingerbreadth above and at the umbilicus. Functional strength markedly improved across all tested domains, and scar
tissue mobility significantly increased, potentially contributing to symptom resolution and improved muscular coordination.
Conclusion: This case highlights the potential efficacy of combining NMES, targeted core stabilization, and scar mobilization to
manage chronic DRA and LBP. While further research is needed, particularly in long-term postpartum populations, these results
suggest that functional improvements and symptom reduction are achievable with conservative treatment strategies even many
years after childbirth.