Diastasis Recti: What it is and How to Fix it
Diastasis Recti is a separation of the rectus abdominis (6 pack) muscle, which is extremely common during pregnancy and post-partum due to the increased stress placed on tissue as it is stretched during pregnancy. Most people won’t notice it until after delivery - at which point you may notice a bulge in your midsection which doesn’t go away, even after exercising or losing weight. Oftentimes, diastasis recti resolves on its own, however, an estimated 40% of women experience diastasis recti beyond 6 months post-partum.
While diastasis recti does not cause pain itself, it is typically correlated with weaker abdominals which may then contribute to back, hip, or pelvic pain, as well as urinary incontinence. If you are experiencing any of these symptoms, I highly recommend seeking out a women’s (or pelvic) health specialized physical therapist, who can evaluate your symptoms more in-depth and prescribe treatment specific to you.
For others, you may not have any additional symptoms, but it can feel more challenging to perform certain tasks such as lifting your child, getting on/off the floor with them, or returning to your pre-pregnancy fitness routine because of decreased core strength. Additionally, it can contribute to feelings of decreased self-confidence and poor body image as your physique has not returned to the way it looked pre-pregnancy. Below are some exercises to try to improve your core strength and reduce the bulging of your stomach.
Exercises to Try with Diastasis Recti
The key to reduce diastasis recti and improve core strength is learning how to appropriately engage your deep abdominal muscles and control intra-abdominal pressure. While the below exercises may seem “easy,” the key is to learn how to engage your transverse abdominis muscle, which runs across your lower abdomen and acts as a girdle or brace for your spine.
Abdominal Bracing
Lie on your back on a firm surface.
Bend your knees and place your feet flat on the ground.
Place your hands on your hips with your fingertips resting at the sides of your lower abdominal muscles.
Slowly tighten your abdominal muscles as if pulling your belly button toward your spine. You should feel the muscles under your fingertips tighten. Do not hold your breath.
Hold this position for 10 seconds, then relax. Repeat 10 times.
*Optional progression: Place a small ball or pillow between your knees. Squeeze your knees together as you perform the abdominal brace.
Bent Knee Fallouts
Perform the abdominal bracing exercise (above).
Keeping your abdominal muscles tight, slowly drop one knee to the side, then bring it back to the center.
Repeat on the opposite side.
Perform 10 times on each side.
Supine Marches
Perform the abdominal bracing exercise (above).
Keeping your abdominal muscles tight, lift one foot off the ground and lower it back down.
Repeat on the opposite side.
Continue "marching," alternating legs, 10 times on each side.
*Optional progression: Lift one knee up and keep it up while you lift the other knee. Lower one leg slowly down, then the other. *You should maintain the abdominal brace throughout and your lower back should stay flat to the floor.
Bridging
Lie on your back on a firm surface.
Bend your knees, and place your feet on the ground.
Squeeze your buttocks together, and lift your hips off the ground.
Keep your shoulder blades in contact with the ground. Hold for two to three seconds, then lower back down.
Repeat 10 times and work up to three sets in a row.
*Optional progression: While hips are lifted, extend one foot out, keeping knees parallel to each other. Lower that foot, then extend the other foot. Lower hips. *Your hips should stay level, not drop when you kick the leg out.
Exercises to Avoid with Diastasis Recti
You may have heard that individuals with diastasis recti should not perform certain exercises, such as crunches, sit ups, and planks. This is not necessarily true - it depends on whether you can perform the exercise correctly. How do you know? You should not perform an exercise if it causes your diastasis to bulge out more.
Once you learn how to appropriately perform an abdominal brace, you may be able to add in more challenging exercises such as crunches. The key is to maintain the abdominal brace as you perform the crunch, which should prevent the diastasis recti from bulging out.
Prone exercises such as planks are more difficult because gravity pulls your stomach down. It can be safe to begin these exercises before your diastasis is completely healed, just start with a modified version on your knees, and make sure you are performing the abdominal brace maneuver to appropriately engage your deep core muscles while performing these exercises. You never want your lower back to arch down - then the exercise will be doing more harm than good.
If you have additional questions about safe exercises to perform with diastasis recti or are wondering if you should see a pelvic health physical therapist, feel free to reach out to me! You can send a message on my website, or email me directly at christy@kobe-coaching.com.
