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It is well known that the abdominal wall and pelvic floor play key roles in function of the trunk and that pregnancy and delivery can have a significant, and long lasting, impact. Non-optimal strategies for the transference of loads through the trunk can create pain in a multitude of areas as well as affect the urinary continence mechanism and support of the pelvic organs. The Integrated Systems Model will be highlighted in part one of this lecture to demonstrate its use for determining when to treat the thorax, when to treat the pelvis and when to train the various muscles of the deep system (i.e. transversus abdominis and/or pelvic floor) for the restoration of form and function after pregnancy (how to Find the Primary Driver).

Widening of the linea alba and separation of the recti, known as diastasis rectus abominis (DRA), may prevent restoration of both the appearance and the function of the trunk and women with this condition often ask whether surgery will help them. Currently, there are no guidelines for clinicians to know which patients with DRA are appropriate for conservative treatment and which ones will also require surgery. Part two of this lecture will highlight Diane’s research that led to clinical tests that reveal who can be treated conservatively and who will require a surgical intervention. If you do consult a surgeon for your DRA and surgery is suggested please ensure that they repair both the anterior and posterior rectus sheaths and use non-absorbable sutures.  A good repair is not just cosmetic, it is functional and requires proper restoration of anatomy.

Learning Objectives

Upon completion of this module you should be able to:

  • Understand how dysfunction in any area of the trunk can be a primary underlying cause, or significant contributing factor, of common postpartum conditions such as pelvic girdle pain, pelvic organ prolapse, urinary incontinence, diastasis rectus abdominis
  • Explain how the Integrated Systems Model facilitates the identification of the primary cause (Find the Primary Driver)
  • Summarize the behaviour and morphology of the linea alba in healthy vs individuals with diastasis rectus abdominis and the current clinical research of Diane Lee on this topic

Course Reviews

  1. Would highly recommend


    As always, Diane does an amazing job teaching this information. Her videos, US images and photos are incredibly helpful throughout the course. I feel more confident in my ability to treat patient’s with DRA and other MSK and pelvic issues.

  2. 5

    Very good review about the training for women with DRA. Also helpful to go through about clinical expertise when surgery is recommended for DRA.

  3. Great lecture


    Excellent presentation with a lot of information. As I was listening and watching the videos, I could see how I can approach my patients from a different perspective. Thank you!

  4. Diane Lee Profile picture of Erin KProfile Lecture: New ISM Perspectives for Treating Women with PGP, UI, POP, and DRA


    Very informative and valuable information. Thank you for offering it!

  5. 5

    Excellent information! Loved the videos of actual patients and different strategies! Now I want to learn more!

  6. 5

    Great online resource – thank you!

  7. Extremely Educational


    Diane does such a wonderful job integrating research and clinical application. This presentation is extremely insightful and educational. We are so lucky to have her in the world of Physical Therapy!

  8. Fantastic info


    This is just fantastic information that you share freely with us. Thank you

  9. Thank you


    Thank you for sharing this knowledge from a balanced clinical and research and patient perspectives. It’s a fantastic introduction and makes me want to further my skills in this area. I would like to hear more of the successful non operative DR cases if it’s within this lectures scope. Also what type of surgical repair to request-are some more effective than others?

  10. Lecture:New ISM Perspective for Treating Women with PGP; UI, POP and DRA


    Very interesting lecture and informative.

  11. Thank you!


    Thank you for providing this material! I am so thankful for the insight. I hope to join you in person some day to soak up even more of your wisdom!

  12. Lecture: New ISM Perspectives for Treating Women with PGP, UI, POP, and DRA


    Thank you Diane for sharing all your knowledge and help advance the field forward.

  13. 5

    A really fresh perspective on treating pelvic health issues! Thanks so much for making this information so accessible to us clinicians, Diane!

  14. Clear and inspiring


    Thank you for such a clear delivery of new information; and helping to answer alot of questions I had on both assessment and treatment of Women’s health. I’m definitely keen to do some more of Diane’s course work.

  15. Highly Recommend


    Very clear, thorough and well presented explanation of the subjects

  16. 5

    Very very informative for a postnatal yoga instructor 🙂

  17. New perspectives for treating women with PGP,UI,POP, and DRA


    I found this lecture fascinating. I do not feel the standard assessment techniques I have been taught have prepared me to take this in to a clinical setting so I am keen to improve my assessment and clinical reasoning skills. Seeing the ISM model applied has reinforce my opinion that current models for assessment and treatment are not holistic enough. Thank you.

  18. Thank You!


    Fantastic! Learned so much in such a short time.

  19. Forget what you thought you knew about DRA


    If you’re wondering what you are missing with IU, POP and pelvic pain, then take a look at the this. It is well worth the time.

  20. 5

    Thankyou Diane Lee for this enlightening course. Love Your teaching style, making everything comprehensive and “simple”. Really looking forward to the hands on course in White Rock this spring!

  21. New ISM Perspectives for treatimg women with PGP, UI, POP, and DRA


    Thank you, this is very enlightening. It is changing the way I practice.

  22. Clear


    Thank you, good teaching style

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