Diastasis Recti Do’s & Don’ts during Pregnancy and after Pregnancy

You might be asking yourself how to exercise with diastasis recti?  I have two specific exercises for this abdominal separation.  But first let’s chat about why diastasis recti occurs and a list of do’s and don’ts.

How does diastasis recti occur?

diastasis recti during pregnancyDiastasis Recti occurs in 33-60% of pregnant women.[1][2] You are more prone to this abdominal gap if you have a weaker abdominal wall, if you are carrying a large baby, if you are carrying more than one baby, if you have a narrow pelvis, if you have more than one child and had them close together, or if you’re over 35 when you get pregnant. After that long list of predisposing factors, you can see why 33-60% of mamas have diastasis recti during the second half of pregnancy.  That said our bodies are made to bear children and are also resilient in getting back to their prior self.

This abdominal separation occurs when the tissue between the right and left recti is distanced more than 2 finger widths. You can’t change the pressure on your abdominal wall – you’re pregnant! But there are a few things you can change: posture, functional moving in daily activity, strength in the transverse abdominis and pelvic floor and stopping exercises that can make it worse.

Generally, women don’t have this ab separation during the first trimester, but if you experience any discomfort in this area, you may want to modify your core exercises. If you have had diastasis recti with previous pregnancies you may or may not have it with this pregnancy.

How do I exercise with diastasis?

Tip #1 Correct your posture

It sounds simple, but years of habit can take a bit to correct.  In fact some studies show it takes thousands of repetitions to correct bad habits.

From a standing position, stack your rib cage over your pelvis and keep your pelvis stacked neutrally over your feet.  Or as I like to call it “close your ribs”. Don’t stand with a swayback and open rib cage. This exacerbates the issue. The smallest of changes – closing the ribs and stacking the pelvis over the feet – takes pressure off the linea alba (where the recti separation occurs).

Tip #2 Activate the Transverse Abdominis & Pelvic Floor

You will want to start training the pelvic floor and transverse abdominis – these muscles act as a sling to support the baby and are extremely important both during pregnancy and after pregnancy. It will also help in getting a flat stomach after the baby is born.

ab-exercises-during-pregnancy

The first exercise is the Transverse Abdominis (TA) breath – using the diaphragm. But wait its hard to breathe during pregnancy! As the uterus continues to expand there is a flaring or widening of the lower ribs, and an upward displacement of the diaphragm by approximately 4cm. the diaphragm widens when the uterus overtakes its domain. This adjustment, combined with the chest’s adjustment, allows more air to flow into and out of the lungs. Rib cage remodeling occurs so that the thoracic cavity is not reduced in pregnancy. Because of these adaptations, the total volume of air moving in and out of the lungs is not compromised in normal pregnancy. Whoa…mind blown…it was for me too!

Abdominal muscles help move the diaphragm and give you more power to empty your lungs. So why is this helpful in women with diastasis recti? Think of your mid-section, or your core, as everything but your limbs. It’s a powerhouse that needs to work in harmony for healthy and resilient muscles.

Here’s how to do the TA breath. It’s a simple and natural process that will soon come second nature.

Note: When you first learn the TA breathing technique, it’ll be easier to make the connection lying down. Then move to a seated position or standing position. If you have diastasis recti – and don’t necessarily have all the posture pointers mastered from above, try it from the lying position. It is best not to be in the lying (or supine in anatomical terms) position for too long as the pressure of the baby restricts blood return.

Feel free to practice this first round while sitting up and reading this article!

  • Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
  • Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should keep as still as possible.
  • Tighten your stomach muscles, letting them hug your baby as you exhale through pursed lips. Keep the hand on your upper chest as still as possible. Another cue is belly button to baby or saying the word “haaaaa” or “ssssss”.
  • Repeat for 30 seconds. Rest. Repeat 2-3 times.

It sounds simple, but it is hard to train our brain this way. So practice, practice, practice, and we will do it again after your baby is born. We get into diastasis recti after pregnancy here in a bit.

 

pelvic-floor-pregnancy

The second exercise is Pelvic Floor activation – cause it’s the bottom of your core. Your cannot function without the work of the pelvic floor. You can activate the pelvic floor by controlling the flow of urine or performing a kegel. If you are not familiar with activating the pelvic floor please read this article on pelvic floor exercises.

Now perform the TA breath again.  This time as you exhale activating the transverse abdomins, I want you to think about also activating the pelvic floor. It’s not your traditional way of ab training, but it is the most beneficial, I promise!

Tip #3 Stretching and strengthening

It kind of goes without saying, but if we take care of our body it will more than likely take care of us. Daily exercise is essential. And that doesn’t mean a solid 40 minute exercise routine everyday, it can mean moving 20 minutes a day. In your first trimester I know you are green to the gills. In your second trimester you feel like superwoman. And in your third trimester all those aches and pains can kick in.

As you move daily – in exercise and in daily activity – you will want to work “functionally” with your diastasis recti. For you, this might mean you need to see a physical therapist or physiotherapist for some 1-1 attention. Or it could mean making a few postural adjustments, activating the transverse abdominis and doing functional exercises that don’t make your diastasis recti worse. Healthy (from toning) and supple (from stretching) muscles will treat you well!

While including overall strength and stretch exercises, there are some modifications to your overall exercise routine, like not doing planks.  We cover this full list of don’ts in Tip #5.

I recommend using a comprehensive workout that does not load the abs – like our Free Prenatal Workouts. Anytime your abdominal wall is “loaded” i.e. putting extra pressure on the tissues by doing pushups or planks, you can worsen your diastasis recti. You can read more about the Don’ts during Pregnancy Exercise below.

pregnancy-dvd-image

Tip #4 Exercises you shouldn’t do

There is no universal list of don’ts in the diastasis recti world. But because it is usually the the intra-abdominal pressure that causes the recti muscles to have a bigger gap between them, our direction is to stay away from applying extra intra-abdominal pressure.

In addition to abdominal exercises for diastasis recti, you should also include overall strength and stretch exercises. That said, there are some modifications to your overall exercise routine, like not doing planks.  So we will cover a list of don’ts and recommend a program modified for diastasis recti.

You should refrain from twisting and spinal flexion (crunches). We also recommend you don’t do planks, push ups, quadruped positions, crunches and most traditional abdominal exercises.

safe-exercises-diastasis-recti-pregnancy

Diastasis recti after pregnancy

Diastasis recti has been shown to resolve on it’s own after pregnancy – once the pressure of the baby on the abdomen is gone. But most of the time postural cues & strengthening of the transverse abdominis are necessary to minimize the gap.

Overall what we do see is non-exercising women don’t usually see improvement in the recti distance, while exercising women better theirs. But what type of exercises? Because it was the intra-abdominal pressure that caused the distance between the recti muscle in the first place, we will assume we should not continue to apply intra-abdominal pressure.

The same rule rings true – no traditional ab exercises – See our full library of Diastasis-Friendly workouts.

Diastasis Recti After Pregnancy

Please note that Moms Into Fitness is not a medical facility.  Anything that your doctor recommend or does not recommend should supersede anything on this page!

[1] Boissonnault JS. Incidence of diastasis recti abdominis during the childbearing year. Phys Ther (1988).

[2] http://bjsm.bmj.com/content/early/2016/06/20/bjsports-2016-096065.full , accessed August 1, 2017.

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